Actinic Keratosis – Electrodessication and Curettage

Very thick actinic keratoses, which cannot be treated with liquid nitrogen or the myriad topical creams are amenable to treatment with a procedure called electrodessication and curettage.  The actinic keratosis is anesthetized with a small amount of lideocaine and a sharp instrument called a curette is used to essentially scrape away the very thick keratotic portion of the actinic keratosis.  Usually, there are abnormal keratinocyte cells remaining at the base after the curette is used.  These abnormal cells are then treated with electrodessication using a device called a hyfrecator.  The hyfrecator delivers a controlled amount of heat to the base of the lesion essentially destroying the remaining abnormal cells.  In the process, the electrodessication stops any bleeding.  The entire process is painless.  The wound appears like a cigarette burn initially, but ultimately it heals very nice over one to two weeks with only a small circular white scar remaining.