Facial Resurfacing Treatments for Photoaging May Also Help Prevent Skin Cancer (Part 2)

Treatments Compared

Liquid nitrogen, or LN2 cryotherapy, a destructive method which freezes lesions and causes them to fall off, is the most common AK treatment. But, in the VA study, Susan M. Swetter, MD, and colleagues treated 24 patients with either a 30 percent TCA chemical peel, a 5% fluorouracil (5-FU) cream applied twice a day for three weeks, or a CO2 laser peel to assess both reductions in development of AKs and prevention of nonmelanoma skin cancers. All participants had histories of facial or scalp AKs and/or basal or squamous cell carcinoma (BCC or SCC).

Following treatment, all subjects were examined every three months for two years, and all procedures proved to reduce incidence of AKs effectively at the first three month evaluation post-treatment. With 5-FU, the number decreased from almost 62 before treatment to less than 9 three months after treatment (83% reduction); with TCA, the number was reduced from over 83 to less than 8 (89%); with the laser, from 78 to 5.5 (92%). And all three methods reduced BCCs and SCCs significantly (TCA by 40%) in up to 4.5 years of long-term follow-up, compared to the number found in a sampling of patients who were not treated.

While the three treatments performed comparably, one method was most popular with patients. "From a subjective standpoint," notes Dr. Sweeter, "the TCA arm was tolerated more favorably, with rapid time to healing and less discomfort than the 5-FU and CO2 laser arms."

The study was small, so "larger samples are definitely needed to confirm our findings," Dr. Sweeter explains. But the outcome was nonetheless extremely promising, not only for expanding the arsenal of AK treatments, but in offering another tool for skin cancer prevention.