Actinic Keratosis · Newport News
Actinic keratosis treatment.
The rough patch that keeps coming back is your skin’s check-engine light. Don’t just buff it off.
An actinic keratosis — AK for short — is a small, rough, scaly patch that shows up on skin that’s collected decades of sun: face, ears, scalp, forearms, backs of the hands. You usually feel it before you see it, like a patch of fine sandpaper that flakes off and returns in the same spot. That “returns in the same spot” detail matters. Dry skin moves around. AKs are territorial.
Here’s the plain-English version of what an AK actually is: sun-damaged skin cells that have started growing wrong, but haven’t crossed the line into skin cancer. Precancerous is the honest word. Most individual AKs never cross that line — but a meaningful share of squamous cell carcinomas start life as one, and there’s no reliable way to look at a given AK and know which kind it’ll be. So the rule is simple: they get evaluated, and they get treated, not ignored.
Think of it as a check-engine light. Usually it’s nothing urgent. You still don’t put tape over it.
Evaluation first — and when the answer is “dermatology, not us”
Every lesion here gets examined by the nurse practitioner — including under the dermatoscope, the polarized magnifier that shows the structures inside a lesion that the naked eye can’t see — before anything gets treated. Some of those looks end in a referral. Anything thickened, tender, growing, bleeding, or just off goes to dermatology for a biopsy — that’s non-negotiable, and we’ll help you get the appointment. Same if your sun damage is extensive: when the whole forearm or scalp is involved, the problem isn’t a few weeds, it’s the soil, and field treatment (prescription creams that treat the whole area over weeks) managed by a dermatologist usually beats picking off lesions one at a time. We can start or coordinate prescription field therapy where it’s appropriate — and we’ll tell you plainly when it isn’t our lane.
One more thing a salesperson wouldn’t tell you: AK treatment is medical, and if you have insurance and an established dermatologist, getting them frozen at that office is often the cheaper route. People choose us anyway for a few specific reasons — they can get in quickly, they want the precision of laser treatment on cosmetically sensitive spots like the face, or they’re already here combining it with resurfacing work. If none of those apply to you, we’ll say so.
How we treat them
We treat discrete AKs with the Er:YAG laser — a precisely controlled ablation of the abnormal cells, one thin layer at a time, with margins we can see. Compared to freezing, laser treatment lets us control exactly how deep we go and is gentler on skin pigment, which matters on the face and on deeper skin tones where cryotherapy can leave permanent light spots. (Cryotherapy is a good, standard treatment — this is a difference in precision and cosmetic outcome, not a knock on your dermatologist’s method.)
Treatment is quick — numbing, then minutes per lesion cluster — at $200 per lesion cluster. The treated spot heals over one to two weeks like a well-behaved scrape. Then comes the part we actually care about: the recheck, because skin that made one AK has proven it knows how, and daily sunscreen from here on is the closest thing to a warranty.
Questions
Is actinic keratosis skin cancer?
No — it’s precancerous. An AK is sun-damaged skin growing abnormally, and a minority of them can progress to squamous cell carcinoma over time. That’s why AKs get evaluated and treated rather than watched, and why anything suspicious gets a dermatology biopsy first.
What’s the difference between actinic keratosis and seborrheic keratosis?
Confusingly similar names, completely different situations. Seborrheic keratoses are the waxy, stuck-on-looking growths that come with age — benign, never becoming cancer, removable ($150 for one to three) purely because they annoy you. Actinic keratoses are flat, rough, sandpapery sun-damage patches that are precancerous. Telling them apart is exactly what the evaluation is for.
Do you freeze them like a dermatologist does?
No — we use the Er:YAG laser instead of cryotherapy. Both work; laser gives us visible, layer-by-layer control of depth and carries less risk of leaving a permanent light spot, which we care about on faces and deeper skin tones.
How much does actinic keratosis treatment cost?
$200 per lesion cluster here, cash-pay. Honest counterpoint: if you’re insured and established with a dermatologist, treatment there is often cheaper. We’ll tell you the same thing at your evaluation.
Should I see a dermatologist for actinic keratosis?
If a lesion is thick, tender, growing, or bleeding, or you have widespread sun damage — yes, and we’ll refer you. For evaluated, discrete AKs, treatment here is appropriate; for anything ambiguous, dermatology first, always.
Newport News · Virginia
Start with a consultation. It’s free.
Every plan here starts with a conversation, not a treatment. Bring your questions and your skepticism — and if the honest answer is that you don’t need us, that’s the answer you’ll get.
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