Kare Plastic Surgery & Skin Health Center · Santa Monica & Los Angeles
Actinic Keratosis Treatment Santa Monica
804 7th Street, Santa Monica, CA 90403 · Near Montana Avenue · (310) 998-5533
Our Board-certified dermatologist Dr. Tiffany Sierro is an expert in skin cancer screening and the prevention of skin cancers through proper diagnosis, examination, and skin cancer surgery.
Call (310) 998-5533 Request an Appointment
On-Staff DermatologistBoard certified expert
Actinic KeratosisSpot + Field Treatment
Annual Skin Cancer ScreeningFull-Body Skin Cancer Screening
Actinic Keratosis Treatment Santa Monica
Actinic Keratoses Are Precancers. Treat Them Before They Become Cancer.
Dr. Tiffany Sierro, MD Board-Certified Dermatologist Actinic Keratosis · Skin Cancer Screening · PDT · Field Cancerization · Kare Plastic Surgery & Skin Health Center, Santa Monica
Actinic keratoses — also called solar keratoses — are precancerous lesions caused by years of cumulative ultraviolet radiation exposure. They appear as rough, scaly, erythematous patches that are often easier to feel than to see — a sandpaper-like texture on chronically sun-exposed skin of the face, scalp, ears, forearms, and dorsal hands. Without treatment, approximately 5–10% of actinic keratoses progress to squamous cell carcinoma (SCC), the second most common skin cancer. In the Santa Monica and Los Angeles environment — where year-round UV exposure is among the highest in the United States and outdoor activity is the cultural norm — actinic keratoses are among the most common conditions seen in dermatology practice.
At Kare Plastic Surgery & Skin Health Center at 804 7th Street in Santa Monica near Montana Avenue, board-certified dermatologist Dr. Tiffany Sierro, MD provides comprehensive actinic keratosis evaluation and treatment — from individual lesion cryotherapy to whole-field cancerization treatment with PDT and topical agents — as part of an integrated annual skin cancer screening and surveillance protocol that protects the most sun-damaged patients in the Los Angeles area.
Actinic keratoses are not cosmetic. They are the most common precancerous skin lesion in adults and a direct precursor to squamous cell carcinoma. Treatment is recommended for all AKs — not only those that look most concerning. The ones that look innocent are the ones that progress when untreated. Call (310) 998-5533 to schedule your AK evaluation at Kare Skin Health Center in Santa Monica.
5–10%Of untreated AKs progress to squamous cell carcinoma
#1Most common reason adults visit a dermatologist in LA
AnnualSkin cancer screening recommended for all AK patients
Actinic Keratosis Services at Kare Skin Health Center Santa Monica
- Cryotherapy with liquid nitrogen — spot AK treatment
- PDT (Photodynamic Therapy) with Levulan — field treatment
- Efudex (5-fluorouracil) topical — home field treatment protocol
- Aldara (imiquimod) topical — immune-mediated field clearance
- Curettage and electrodesiccation — thick, hyperkeratotic AKs
- Dermoscopy evaluation — AK vs. SCC in situ differentiation
- Biopsy — when AK vs. early SCC distinction requires histology
- Annual full-body skin cancer screening — AK surveillance protocol
Kare Skin Health Center · Santa Monica · Near Montana Avenue
Do You Have Skin Cancer?
Clinical Case — Dr. Tiffany Sierro · Kare Skin Health Center, Santa Monica
Severe Field Cancerization — Forearm Actinic Keratosis
Actual patient of Dr. Tiffany Sierro · Severe UV-damaged skin field · Diffuse AK field with hyperkeratotic lesions
Forearm Field Cancerization — Multiple AKs Severe diffuse photodamage field related to UV exposure. Our dermatologist performs a rigid skin cancer screening of these spots.
Clinical Finding
Diffuse rough, erythematous, scaling pre-cancerous skin on the arm with discrete hyperkeratotic lesions and a prominent thick area of actinic keratosis needs skin cancer screening.
Field Treatment Plan
PDT with Levulan (aminolevulinic acid) applied to entire forearm field, activated with red light after 1-hour incubation — targeting all visible and sub-clinical AK lesions simultaneously. Individual thick hyperkeratotic lesions pre-treated with cryotherapy or curettage before PDT application.
Surveillance Protocol
After management of the pre-cancerous sunspots, these patients require annual screening and actinic keratosis management.
This forearm presentation demonstrates why individual spot cryotherapy is insufficient for severe field cancerization: the entire photodamaged skin field contains genetically damaged keratinocytes that are pre-malignant even when not yet visibly abnormal. Treating only the three most obvious lesions leaves the surrounding field to generate new AKs over the following months. Field treatment addresses the problem at the correct level. Dr. Tiffany Sierro · Kare Plastic Surgery, Santa Monica
Treatment Modalities
Understanding How to Treat Pre-Cancerous Actinic Keratosis
The most important clinical decision in actinic keratosis management is not which treatment to use — it is spot treatment vs. field treatment. A patient with two isolated AKs on sun-protected skin is an ideal candidate for spot cryotherapy. A patient with the severe field cancerization shown in the clinical image above — multiple AKs on heavily photodamaged skin — requires field treatment that addresses the entire UV-damaged skin background, not just the lesions visible today. Dr. Sierro makes this clinical assessment at every AK appointment using dermoscopy to evaluate the full extent of field damage and sub-clinical AK density before selecting the most appropriate treatment modality.
01
Cryotherapy
Liquid nitrogen applied directly to individual AK lesions — the most common AK treatment. Fast, in-office, no preparation required. Best for patients with few isolated lesions on a background of minimal photodamage. Not appropriate as the sole treatment for extensive field cancerization.
02
PDT with Levulan
Aminolevulinic acid (Levulan) applied to the treatment field and incubated for approximately 1 hour — then activated with a red light source. The photosensitizer is preferentially absorbed by AK cells; light activation destroys them selectively. Treats visible and sub-clinical AKs simultaneously. Ideal for face and scalp field cancerization.
03
Efudex (5-FU)
Topical 5-fluorouracil cream applied to the treatment field at home once or twice daily for 2–4 weeks. Causes an inflammatory reaction in AK lesions as the medication selectively targets rapidly dividing pre-malignant cells. Effective for large field areas — face, scalp, forearms — where office PDT is impractical to cover.
04
Aldara (Imiquimod)
Topical imiquimod applied to the AK field activates the local immune response to target and destroy AK cells through T-cell-mediated destruction. Slower and milder than Efudex — preferred for patients with sensitive skin or those who cannot tolerate the inflammatory reaction of 5-FU. Applied 2–3 times weekly for 12–16 weeks.
05
Curettage + ED
Thick, hyperkeratotic, or resistant AK lesions are scraped (curetted) and the base treated with electrodesiccation — destroying the AK base and sampling tissue for histologic evaluation to exclude progression to early SCC. Used for individual recalcitrant AKs that fail cryotherapy or are too thick for topical penetration.
06
Biopsy
When dermoscopy evaluation raises concern for progression beyond AK to SCC in situ (Bowen’s disease) or early invasive SCC, shave or punch biopsy for histologic examination is performed before or concurrent with treatment. A suspicious AK that does not respond to standard treatment is biopsied at the next visit.
“Annual Skin cancer screenings by a board-certified dermatologist works to prevent the development of avoidable skin cancers. ”
Board-Certified Dermatologist · Kare Skin Health Center, Santa Monica
Annual skin cancer screening for all AK patients: Patients diagnosed with actinic keratoses are at significantly elevated lifetime risk for developing BCC, SCC, and melanoma compared to the general population. The Skin Cancer Foundation recommends annual professional full-body skin exam for all patients with a history of AKs. Dr. Sierro provides annual skin cancer screening at Kare Skin Health Center near Montana Avenue in Santa Monica — AK evaluation and treatment can be combined with annual screening in a single appointment. Call (310) 998-5533.
Authority Page · Kare Plastic Surgery & Skin Health Center Skin Cancer Screening Santa Monica — Annual Full-Body Exam with Dr. Sierro →
Annual full-body skin cancer screening, BCC / SCC / melanoma detection, ABCDE criteria evaluation, and actinic keratosis surveillance in a single appointment with board-certified dermatologist Dr. Tiffany Sierro at Kare Skin Health Center in Santa Monica.
Frequently Asked Questions
Where can I get actinic keratosis treatment in Santa Monica?
Kare Plastic Surgery at 804 7th Street in Santa Monica near Montana Avenue offers expert treatment for precancerous sunspots by board-certified dermatologist Dr. Tiffany Sierro Call (310) 998-5533. We serve patients from Santa Monica, Beverly Hills, Brentwood, Pacific Palisades, Malibu, and all of Los Angeles.
Can actinic keratoses become skin cancer?
Approximately 5–10% of untreated actinic keratoses progress to squamous cell carcinoma (SCC). The challenge is that there is no clinically reliable way to identify which individual AK will progress and which will remain stable or regress — which is why treatment of all AKs is recommended rather than watchful waiting. Patients with extensive field cancerization (multiple AKs on heavily photodamaged skin) have a substantially higher cumulative risk of SCC development than patients with isolated AKs. Annual skin cancer screening is recommended for all patients with a history of AKs at Kare Skin Health Center in Santa Monica.
Does insurance cover actinic keratosis treatment in Santa Monica?
Actinic keratosis treatment is a medically necessary procedure covered by most PPO insurance plans, including Medicare, because AKs are pre-malignant lesions requiring treatment to prevent squamous cell carcinoma. Cryotherapy, PDT with Levulan, topical Efudex, and biopsy for AK management are all reimbursable under standard dermatology medical codes. Kare Skin Health Center verifies insurance coverage before your appointment. Call (310) 998-5533.
Related Resources at Kare Plastic Surgery
Kare Plastic Surgery & Skin Health Center · Santa Monica · Near Montana Avenue
Schedule an AK Evaluation
Schedule an actinic keratosis evaluation or annual skin cancer screening with Dr. Tiffany Sierro, board-certified dermatologist at Kare Skin Health Center in Santa Monica