aspireMD Actinic Keratosis (Precancerous Lesions) Program

aspireMD - aspireMD Actinic Keratosis (Precancerous Lesions) Program

aspireMD offers a comprehensive and effective Actinic Keratosis (Precancerous Lesions) Program. This program, developed by Dr. Jane Burk-Vassallo, uses a multifaceted approach for effective treatment of actinic keratosis and for the signs of photoaging. aspireMD combines the best of traditional medical prescription therapy with treatments delivered by scientifically innovative technology for the best outcomes of long-term improvement.

Actinic Keratosis (AK) are pink, red or skin-coloured rough, scaly patches found on sun exposed areas such as the face, scalp, arms, and hands.  They are related to past sun exposure and most commonly develop in fair-skinned, light-eyed and light haired people. If left untreated, they can increase in size and develop into skin cancer (squamous cell carcinoma), requiring surgical treatment.

During your first visit, you will meet with Dr. Jane Burk-Vassallo and a member of the aspireMD health care team for a complimentary consultation. After reviewing your medical history, Dr. Burk-Vassallo will assess your current concerns integrating her 20+ year professional expertise to your care. A detailed conversation and thorough skin examination with photo documentation will formulate your diagnosis. Dr. Jane will develop the best treatment approach for you.

Dr. Jane believes knowledge is empowering, and she will fully explain each recommendation to that end. When all of your questions are answered, Dr. Jane Burk-Vassallo will work with you to create your treatment plan, which encompasses your personal objectives and desired outcomes.

The traditional medical treatment of yesteryear consisted of ‘spot treatment’ with liquid nitrogen cryotherapy.

Our evolving perspective is to ‘topical field treat’ as we now understand that where one lesion has come to the surface – there are similarly damaged areas brewing beside, but still beneath, the skin’s surface.

There are DIY at-home topical field therapies (apply a cream or lotion to surrounding area) such as imiquimod (e.g. Zyclara®, Aldara®), ingenol mebutate (Picato®) or 5-fluorouracil (e.g. Efudex®).

Your aspireMD skincare team will guide you in the use of these options.

As an alternative, aspireMD’s clinic photodynamic therapy is guided by our clinicians every step of the way. A ‘damaged cell seeking’ photosensitive chemical called Aminolevulinic Acid (also known as ALA or Levulan®) is applied to the skin 45-60 minutes prior to exposure to a clinic therapeutic light source. This treatment searches and destroys both clinically apparent lesions (pink, red, rough, scaly patches) and subclinical lesions (‘normal’ looking lesions or lesions under your skin you can’t yet see or feel).

As well, this photodynamic therapy provides overall improvements in the appearance of your photo-aged (sun-damaged) skin.

Photodynamic therapy is a preventative proactive treatment as opposed to the traditional liquid nitrogen cryotherapy spot treatments which are a reactive treatment once the pre-cancerous lesion emerged onto the skin’s surface.

As every aspireMD Actinic Keratosis Treatment Program is custom designed for each patient, costs will vary. Unfortunately, such treatments are not covered by OHIP; however, part or all of the treatment may be covered on private insurance plans. A quote and predetermination will be provided during your complimentary consultation.

After your initial consultation, once all your questions have been answered and you are comfortable with the treatment plan, your informed consent will be obtained. Expect to have your photograph taken to record your baseline image and celebrate your improvement. Your photographs will be kept in your file with the same strict confidentiality as the rest of your medical records.

Your individualized treatment plan will have been established during your consultation. aspireMD specializes in Photodynamic Therapy which is a non-surgical technique using a prescription drug that is combined with the blue light treatment or the broad band light (BBL) treatment to activate the drug. It will be applied directly on particular lesions and to the surrounding subclinical areas. After an incubation period of 45-60 minutes, the area is exposed to either the blue light and/or BBL which activates the destruction of the precancerous cells, improves overall photodamage and is your best approach for preventing future AKs that are presently in the undetectable phase of development. The drug will increase sun sensitivity for 48 hours after it is applied, so it is important that patients protect treatment areas from the sun during this time period.

  • With any of the treatments of Actinic Keratosis you should expect 5-7 days of social self-consciousness downtime. The treated area is expected to be reactive in ridding your body of your precancerous lesions. The area will be red and hot for up to 24 hours; it will then begin to ooze, crust then flake off.
  • The treatment will increase sun sensitivity for 48 hours after it is administered, so it is important that patients avoid sun exposure during this time period. Sunscreen will not protect the area during the healing process.
  • Depending on the treatment individuality prescribed; you may expect to repeat the treatment once monthly for three months to diminish your rate of recurrence.

There are two aspects of self care that will markedly improve your skin’s health.

  1. SELF OR PARTNER SKIN EXAMINATION

    Skin Cancer Self Examination
     
  2. SUN SAFETY
    • Limit sun exposure between 11 am and 4 pm.
      You can do this by scheduling outdoor activities for earlier in the morning (before 11 am) and later in the afternoon (after 4 pm)
    • Put on sunscreen every day – even on cloudy days and in the winter. Apply sunscreen to all skin that clothing will not cover.
      Things your sunscreen must offer:
      • SPF (sun protection factor) of 30 or higher
      • UVA/UVB protection (label may say ‘broad-spectrum’)
      • Water resistance
      • Sun shield with inert cosmetically elegant minerals (such as titanium and zinc) as opposed to your drugstore chemical reaction ‘protection’
    • Protect your lips. Apply a lip balm that contains sunscreen. The lip balm also should offer an SPF of 30 or greater and UVA/UVB protection. Dr. Jane’s go-to to apply when on the skin hill or in a kayak.
    • Protect your skin with clothing.  Whenever possible wear: To see how well your clothes will protect you, hold each garment in front of bright light. If you see light through the , harmful light from the sun can penetrate the cloth. You should select another garment. You also could wear that garment but apply sunscreen first to the skin that the garment will cover.
      • A wide-brimmed hat
      • Long sleeves
      • Pants
    • Use extra caution near water, snow and sand as they reflect the damaging rays of the sun.
    • Do not use tanning beds or other indoor tanning devices. Tanning beds and sun lamps emit UV rays that can be stronger than the rays from the sun. This can cause new AKs.
    • Check your skin as often as your physician recommends. Seek medical advice if you notice a growth on your skin that has any of the following traits:
      • Starts to itch or bleed
      • Becomes noticeably thicker
      • Remains after treatment
      • Changes in size, shape or colour
    • Keep all appointments with your physician. Some people will continue to develop new AKs for life, even when they protect their skin from the sun. With frequent checkups with your physician, AKs can be treated.

As a further guide to your best skin health Dr. Jane provides this ABCDE guide to alert you to more sinister skin lesions.

ABCDEs of Detecting Melanoma

No worries if it's all a bit too much – just book a complimentary appointment with Dr. Jane Burk-Vassallo and her skin health team – we’ll take care of you.

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