What is PDT?

Photodynamic Therapy (PDT)
PDT may be used to treat lesions on the face and scalp. Topical 5-aminolevulinic acid (5-ALA) is applied to the lesions by the physician. Within the next 24 hours, the medicated areas are exposed to strong light, which activates the 5-ALA. The treatment selectively destroys actinic keratoses, causing little damage to surrounding normal skin, although some swelling and redness often occur.

Laser surgery for skin cancer information

A carbon dioxide or erbium YAG laser is focused onto the lesion, removing epidermis and different amounts of deeper skin. This finely controlled treatment is an option for lesions in small or narrow areas; it can be effective for keratoses on the face and scalp, as well as actinic cheilitis on the lips. Laser surgery is useful for people with bleeding disorders and is also used as a secondary therapy when other techniques are unsuccessful. However, local anesthesia is usually necessary, and some scarring and pigment loss can occur.

What is chemical peeling?

This method makes use of trichloroacetic acid (TCA) or a similar agent applied directly to the skin. The top skin layers slough off, usually replaced within seven days by new epidermis (the skin’s outermost layer). This technique requires local anesthesia and can cause temporary discoloration and irritation.

Topical medications for precancers

Medicated creams and solutions are especially useful in removing both visible and invisible AKs when the lesions are numerous. The patient applies the medication according to a schedule worked out by the physician. The doctor will also regularly check progress. After treatment, some discomfort may result from skin breakdown, but the risk of scarring is minimal.
5-fluorouracil (5-FU) cream or solution, in concentrations from 0.5 to 5 percent, is the most widely used topical treatment for AK. It works well on the face, ears, and neck. Some redness, swelling, and crusting may occur.
Another preparation, imiquimod cream, is used for multiple keratoses. It causes cells to produce interferon, a chemical that destroys cancerous and precancerous cells.
An alternative treatment, a gel combining, hyaluronic acid and the anti-inflammatory drug diclofenac, also may prove effective.

Curettage and Desiccation

This is a valuable procedure for lesions suspected to be early cancers. To test for malignancy, the physician takes a biopsy specimen, either by shaving off the top of the lesion with a scalpel or scraping it off with a curette. Then the curette is used to remove the base of the lesion. Bleeding is stopped with an electrocautery needle, and local anesthesia is required.

Cyrosurgery

The most common treatment for AKs, it is especially effective when a limited number of lesions exist. Liquid nitrogen is applied to the growths with a spray device or cotton-tipped applicator to freeze them. They subsequently shrink or become crusted and fall off, without requiring any cutting or anesthesia. Some temporary redness and swelling may occur after treatment, and in dark-skinned patients, some pigment may be lost.

Treatment of precancers

There is no one best method to treat all skin cancers and precancers. The choice is determined by many factors, including the location, type, size, whether it is a primary tumor or a recurrent one, and also health and preference of the patient. For example, a treatment that has a high cure rate and is painless but leaves a large scar might not be preferred for a tumor on the face.
Almost all treatments can be performed in the physician’s office or in a special surgical facilities. Most skin cancer removal can be done using a local anesthetic. Rarely, extensive tumors may require general anesthesia and hospital admission. There are many effective methods for eliminating AKs. All cause a certain amount of reddening, and some may cause scarring, while other approaches are less likely to do so. You and your doctor should decide together the best course of treatment, based on the nature of the lesion and your age and health.

Types of precancer

Actinic cheilitisActinic cheilitis is a type of actinic keratosis occurring on the lips. It causes them to become dry, cracked, scaly and pale or white. It mainly affects the lower lip, which typically receives more sun exposure than the upper lip.
Arsenical keratosisFar less common, arsenical keratosis is an accumulation of keratinized tissue that at first resembles numerous small, yellowish corns. These arise most often on the palms, soles, and inner surfaces of the finger and toes, and then enlarge and thicken, sometimes increasing in number. Although rarely seen today, arsenical keratoses usually occur on patients who were at some time in their live exposed to arsenic, either contained in medication or from an industrial or environmental source.
Leukoplakia Leukoplakia is a disease of the mucous membrane. White patches or plaques develop on the tongue or inside of the mouth, and have the ability to develop into SCC. It is caused by sources of continuous irritation, including smoking or other tobacco use, rough teeth or rough edges on dentures and fillings. Leukoplakia on the lips are mainly caused by sun damage.
Bowen's DiseaseThis is generally considered to be a superficial SCC that has not yet spread. It appears as a persistent red–brown, scaly patch which may resemble psoriasis or eczema. If untreated, it may invade deeper structures.Regardless of appearance, any change in a preexisting skin growth, or the development of a new growth or open sore that fails to heal, should prompt an immediate visit to a physician. If it is a precursor condition, early treatment will prevent it from developing into SCC. Often, all that is needed is a simple surgical procedure or application of a topical chemotherapeutic agent.

One type of precancer

Actinic Keratosis
Actinic keratosis (AK), also known as solar keratosis, is the result of prolonged exposure to sunlight. It is a small crusty, scaly or crumbly bump or horn that arises on the skin surface. The base may be light or dark, tan, pink, red, or a combination of these... or the same color as your skin. The scale or crust is horny, dry, and rough, and is often recognized by touch rather than sight. Occasionally it itches or produces a pricking or tender sensation. It can also become inflamed and surrounded by redness. In rare instances, actinic keratoses can bleed.
The skin abnormality or lesion develops slowly and usually reaches a size from an eighth to a quarter of an inch (2mm to 4mm) but can sometimes be as large as one inch. Early on, it may disappear only to reappear later. It is not unusual to see several AKs at a time. AKs most likely appear on the face, lips, ears, scalp, neck, backs of the hands and forearms, shoulders and back — the parts of the body most often exposed to sunshine. The growths may be flat and pink or raised and rough.

Precancer

What is Precancer?
A number of abnormal but relatively harmless skin growths constitute the early warning signs of skin cancer. These may be precancerous lesions, benign tumors that mask or mimic more serious ones, or malignant tumors that are at the moment just on the topmost layer of the skin. They are important to recognize, because they are a warning sign of potential skin cancer.
Precancerous Growths
Skin in a precancerous state is abnormal but not malignant. The term "precancerous" is used because these abnormal areas of skin are more likely to turn malignant than healthy skin. Precancerous growths are visible to the naked eye, and they look different from normal cells when they are examined under a microscope.
What is Early Cancer?
When malignant changes occur to the skin, but haven't spread beyond the top layer of the skin, they are called early cancers, or cancers in situ. A barrier called the basement membrane helps delay invasion by malignant cells deeper into the skin.
source-The Skin Cancer Foundation

No excuse!

While it's fun to be in the sun, letting it shine on unprotected skin is not wise.If you are going to spend much time in the sun -- be it fishing, boating, water skiing, biking, hiking or whatever -- you should take care to protect your skin.Skin cancer is one of the most common -- and dangerous -- types of cancer.The American Cancer Society reports melanoma rates in the United States have doubled in the past 20 years, with about 44,200 new cases of the skin cancer and 7,300 deaths being reported each year. Many scientists believe there might be a connection between sunburns and melanoma later in life.There's no excuse for not wearing sunscreen when spending time outdoors. It could help save your life.Some outdoors enthusiasts don't like the greasy feeling some sunscreens leave on their skin. There are non-greasy formulas available, including alcohol-based sunscreens.The Alabama Cooperative Extension System recommends using a sunscreen with a sun protection factor (SPF) of at least 15. It should be applied every two hours.Wearing a hat and tightly woven clothing also helps protect skin.Sunglasses should be worn to protect your eyes. Research has shown that ultraviolet radiation from the sun can increase the likelihood of some cataracts. Have fun in the sun, but take time to protect your skin and eyes.

To Brian and Annie

Thanks Brian for your comment. DermAlert sounds very interesting. Anyone who checked it out please comment on what you thought.

Annie, also, thanks for your comment and the pics are quite shocking, I checked them out.

Malignant melanoma

Every year, approximately 3,000 Canadians are afflicted with malignant melanoma, and 500 of these die as a result of it. This cancer can spread rapidly to other organs in the body through the blood and lymph (the almost clear fluid that bathes body tissues), and this can lead to death. The incidence of malignant melanomas in men is rising faster than any other cancer. The death rate is also increasing for this particular cancer, with more men dying than women.
You should see your doctor if you have a mole, birthmark, beauty mark, spot, or sore that:
has irregularly shaped outline
changes colour or is dark black in colour
increases in size or thickness or shape
changes in texture
is larger than 6 mm
bleeds
itches or hurts
crusts or scabs
ulcerates or bleeds
fails to heal within three weeks leading to ulceration, scabbing or bleeding