Treatment for actinic and seborrheic keratosis? BBL, Photofractional?

Question

I'm a male in my mid 60s with a lot of actinic and seborrheic keratosis on my face. Some are pigmented but most aren't. Is there a treatment for them? Would BBL or Photofractional help? What about Photodynamic Therapy with Levulan Kerastik? I know that the AKs can turn into cancers so I get screened regularly.

Rebecca Gelber, MD · Answer

The first place I would start is asking the dermatologist who diagnosed you what they would recommend as they are the one who is looking at both your lesions and your skin - both are unique to you.

BBL is a great treatment for brown spots from sun damage, reds and antiaging, but the last time I reviewed the literature there wasn't much or any data approving it for precancerous or cancerous lesions and it will not work for SK's - one of the most frequent causes of patient disappointment with BBL is that lesions they thought were sun damage/freckles were actually flat SK's

SK's generally respond best to full field resurfacing, so MicroLaserPeel or TRL to the appropriate depths for the downtime you can handle and the lesion itself.

AK's respond very well to fractional lasers, particularly hybrid lasers like Halo over Profractional. The advantage of Halo in most patients is that you get a great cosmetic improvement in skin issues beyond just the AK's. However, for some patients PDT may be covered by their insurance which can be a big plus.

Treatment for actinic and seborrheic keratosis? BBL, Photofractional?

Answers (1)

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