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A New Topical Medication For Actinic Keratosis, a Skin Condition Caused by Excessive Exposure to the Sun

Updated on February 5, 2015
Parts of the skin regularly exposed to the sun over a number of years are subject to a condition called actinic keratosis.
Parts of the skin regularly exposed to the sun over a number of years are subject to a condition called actinic keratosis. | Source

Actinic Keratosis

Certain areas of the skin which are regularly exposed to the sun over a long period of time may develop symptoms of a condition called actinic keratosis. Areas of the skin commonly affected include the scalp, neck, forearms, back of the hands, ears, lips and face. Actinic keratosis occurs most frequently in older adults, and shows up as small, rough, scaly patches that may be accompanied by itching or burning. The patches may be pink, red, brown or flesh-colored. Some doctors believe that actinic keratosis is a precancerous condition because it has the potential to become skin cancer.

You can protect yourself from getting actinic keratosis by wearing protective clothing such as hats and long-sleeved shirts when going out into the sun and by using a high-quality sunscreen with a sun protection factor (SPF) of 15 or more on areas of your skin that are exposed to the sun. Sunscreen should protect against both the UVA and UVB rays of the sun.

Previous Topical Medications for Actinic Keratosis

Intravenously administered fluorouracil is a mainstay of cancer chemotherapy for cancers of the colon, breast, stomach, pancreas, ovaries, cervix, bladder and elsewhere. Fluorouracil belongs to a group of medications called antimetabolites, and it interferes with the growth and development of cancer cells. Fluoroplex, known generically as fluorouracil topical, is a formulation of fluorouracil that can be applied directly to areas of actinic keratosis on the skin. It causes the death of the abnormal skin cells of actinic keratosis. These cells multiply much more rapidly than normal skin cells. Fluoroplex is available by prescription as a cream or a lotion, and comes in a variety of strengths. Patients typically use it for two to four weeks, but complete healing of the lesions does not occur until about one or two months after usage is discontinued.

Imiquimod, brand name Aldara, is a prescription, topical cream classified as an immune response modifier, according to It is used to treat actinic keratosis on the face and scalp. Common side effects may include itching, burning, mild pain or tenderness at the application site, redness, dryness, flaking, scabbing or swelling at the application site, diarrhea, dizziness, headache and fatigue. Treatment regimens for patients usually involve two to five applications a week for up to 16 weeks.

The Australian plant, Euphorbia peplus, contains the active ingredient in Picato, the newest topical medication for actinic keratosis.
The Australian plant, Euphorbia peplus, contains the active ingredient in Picato, the newest topical medication for actinic keratosis. | Source

Picato, The Newest Topical Treatment

On January 23, 2012, the U.S. Food and Drug Administration approved Picato, known generically as ingenol mebutate, as a prescription topical gel treatment for actinic keratosis of the face, scalp, trunk and extremities. The active ingredient in Picato is a natural product, occurring in the sap of the Australian plant Euphorbia peplus . Developed by a company called Leo Pharma, Picato works by inducing apoptosis (cell death) in the abnormal skin cells of actinic keratosis.

The efficacy of Picato was demonstrated in controlled clinical trials conducted before Picato was placed on the market. In one trial, 547 adults with actinic keratosis of the face or scalp were treated with Picato for three consecutive days. After treatment, patients were monitored for eight weeks. Results of the trial indicated that 97% of the treated patients had complete or partial removal of the actinic keratosis whereas only 9% of the patients in the placebo group achieved complete or partial removal.

The principal advantage of Picato over previous topical medications is that the duration of treatment is very short. For actinic keratosis of the face and scalp, patients apply Picato once a day for three consecutive days, and for cases of the trunk and extremities Picato is applied once a day for only two consecutive days.

Common side effects of Picato may include skin reactions at the site of treatment. These reactions involve redness, flaking or scaling, crusting or swelling. Other common side effects may include pain or itching in the treatment area, infection at the treatment site, nose and throat irritation and headache.

Picato (Ingenol mebutate) Heals Actinic Keratosis


This hub has been written for the sole purpose of providing information to the reader. It is not intended to be a source of any kind of medical advice or instruction, and it should not be used in the diagnosis of any illness, disease or condition. You should consult your doctor if you have questions about a specific medical problem.


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    • healthwriterbob profile image

      healthwriterbob 2 years ago from United States

      To RTalloni. This is a good point that you make. The safety and efficacy of any drug are established only by careful study and observation as the drug is used over the course of many years.

    • RTalloni profile image

      RTalloni 2 years ago from the short journey

      Thanks for the introduction to this topical product so we can do more research on it as time goes by.