Interview transcription:

We interviewed Dr Penelope Pratsou to find out the best treatment for Bowen’s disease and actinic keratoses.

What is the best treatment for actinic keratoses and Bowen’s disease?

Penelope Pratsou: There are so many treatments that we can offer now for these types of sun damage. First of all, it’s important to avoid getting any more. The first thing that I advise is good sun protection measures. We do have some evidence to suggest that even sunblock on a daily basis can allow some of these actinic keratoses to go down if they’re really mild, but beyond that, it all depends on how many you’ve got and what type you have. If you just have the one distinct area of actinic keratoses on your face, then it might be that I can perform a one-off treatment called cryotherapy with a gentle, freezing spray on the day that you come into the clinic. That may be all you need. If you do have a number of these actinic keratoses or Bowen’s disease, then you may be better off having a topical cream treatment. We have a number of these that we can try.

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Penelope Pratsou: It’s important to tell patients that they will get a level of inflammation while they’re using those treatments, and the treatments are dependent on the person who’s using them. You are responsible for putting the treatment on. They can really have an excellent cosmetic result as well as an excellent result altogether.

For thicker areas, we’ve got a minor op that can be performed (curettage and cautery), where you can have the actinic keratoses skimmed off the surface of the skin and cauterised. Then there is something else known as photodynamic therapy, which is another excellent treatment for really small and diffuse areas where you have it all over the face, for example. That can be a very effective and very well-tolerated treatment indeed.

If you have any of the symptoms or conditions that we’ve just discussed, we invite you to book a consultation with Dr Penelope Pratsou where she’ll be able to assess your condition and give you a suitable treatment plan.

About the author

Dr Penelope Pratsou | Consultant Dermatologist

MBChB, MRCP (UK) (Dermatology)

I’m Dr Penelope Pratsou, a skilled independent Consultant Dermatologist based in Berkshire. I have specialist expertise in the diagnosis and management of all skin cancers, and in performing mole checks. I’m a trained skin surgeon and remove skin cancers, moles, skin tags, cysts and warts.

I also have invaluable experience in dealing with all skin conditions, from the common skin complaints of acne, rosacea, eczema and psoriasis, to the rarer and more complex skin problems, having seen it all through years of NHS work.

After I obtained my Membership to the Royal College of Physicians, I undertook rigorous specialist training in dermatology, before being appointed as a Consultant Dermatologist at the Royal Berkshire Hospital, Reading. There, I helped set up and lead a busy clinic for the diagnosis and treatment of suspected skin cancer. I was also actively involved in supervising and training both dermatology and GP trainees.

Alongside my increasingly busy private practice, I have maintained an NHS practice in Oxford in order to continue to engage with challenging cases and to develop my specialist interest in skin allergy.