Field treatment of solar damage

In Australia we are seeing more and more elderly patients with diffuse solar damage like this. Most of this is solar keratosis type rather than full thickness SCC in situ but it is difficult to be certain.

Freezing multiple lesions like this is not realistic to clear the damage, much of which may still be subclinical in the apparently normal looking skin. Consider a field treatment such as fluorouracil cream, imiquimod cream, Photodynamic therapy (PDT) or radiotherapy.

The latter is especially effective on males with bald scalps because it causes permanent hair loss. Fluorouracil is cheap but gives poorer long term clearing than imiquimod. PDT is expensive and painful compared to the others but gives good longer term clearing. Regular sunscreen use is imperative.

For further discussion, log into www.skinconsult.com.au