Transcript: Pre-cancerous growths, called actinic keratoses, are the second most frequent reason that Americans visit dermatologists. Here, we explore the options for treating actinic keratoses. At the first sign of the rough lesions that indicate actinic keratoses, or AKs, it is important to seek treatment from a dermatologist. This is vital, because untreated AKs can become skin cancer called squamous cell carcinoma. Although he is best known as our 41st President, in 2002, George H.W. Bush became one of the millions of people who successfully seek treatment for AKs. The former President underwent cryosurgery, a freezing procedure, to remove lesions on his face. Standard treatment for AKs can be broadly split into two categories: Surgical destruction and medicinal therapy. Common surgical destruction methods include cryosurgery, curettage, dermabrasion and laser resurfacing. Medical therapies include of Diclofenac sodium gel, Imiquimod, and topical chemotherapy. One of the newest treatment methods, photodynamic therapy, combines both medicinal and surgical therapies. Photodynamic therapy is the destruction of infected cells using a combination of a medication and a light source.  When undergoing photodynamic therapy, a patient will start by applying topical medication. Several hours later, a doctor will treat the affected area with a light source. The light interacts with the medication to destroy pre-cancerous cells.  The most common treatment for AKs is the one that was used to treat George Bush Senior, cryosurgery. This process is best suited for destroying a few, clearly identified, AKs.  Cryosurgery is a freezing procedure where liquid nitrogen is applied to skin lesions with a spraying device. The nitrogen freezes the skin's surface. As the skin heals, AKs are sloughed off. Sometimes, lesions progress to such an advanced state that a procedure called curettage is preformed. When this happens, a patient first receives local anesthesia. Then, a spoon-shaped instrument called a curet is used to scrape off AKs. A similar treatment option that also requires local anesthesia is called dermabrasion.  During this procedure, a rapidly moving brush is used to abrade and erode the affected skin cells. Medical therapy for AKs requires a patient to apply a prescription cream to affected areas. The creams differ in method of action and treatment time. The most frequently used medicinal treatment is a cream called 5-Fluoroucracil, or 5-FU. 5-FU destroys AK cells by blocking chemical reactions that are essential for the lesions to survive. It is imperative that pregnant and nursing women avoid using 5-FU cream. Another topical cream, called Imiquimod, must be applied for four to sixteen weeks and modifies the skin’s immune system, encouraging it to reject the sun-damaged cells and fight the lesions. Diclofenac sodium gel is another topical medication, which is used to treat multiple AKs. The gel, which destroys AKs, is applied twice a day for two to three monthsAs you can see, there are many effective treatments for actinic keratoses. Be sure to talk to your dermatologist about the advantages and disadvantages of each.