What is the best chemical peel for actinic keratosis?

Question

I usually just get them frozen but looking into a peel that may take care of those and some cosmetic benefit too.

David Hansen, MD · Answer

Peels do great for actinic keratoses and can need 1 or 2 peels of 35%TCA.  Freezing does well but can leave white spots in it's place.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Kenneth D. Steinsapir, MD · Answer

Actinic keratosis is rough scaly skin caused by sun damage. The lesions are considered premalignant and commonly degenerate into squamous cell carcinoma. For this reason, dermatologist are looking for these and use various treatments to control them including liquid nitrogen to freeze the lesions. Chemical peels are not FDA approved for controlling actinic keratosis. They can reduce the number of active lesions in my experience and there is a body of literature on this.  Having said that, I generally recommend working with a board certified dermatologist. There are other treatments that have been far better studied than chemical peels such as 5-FU creams for the treatment of these lesions. Best.

What is the best chemical peel for actinic keratosis?

Answers (3)

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