Laser Treatment for Precancerous Cells on the Face

Skin cancer is the most common type of cancer in the United States, with an estimated one in five Americans receiving a skin cancer diagnosis in their lifetime. Risk factors for developing both melanoma skin cancer and nonmelanoma skin cancer include having sun-damaged skin, having light-colored hair or eyes, working outside, being older than 40 years old, and having a tendency to develop freckles when exposed to the sun’s UV rays without sunscreen. The risk of developing skin cancer, such as melanoma, squamous cell carcinoma (SCC), or basal cell carcinoma (BCC), can be decreased if precancerous lesions, such as actinic keratosis, are treated and removed. The best first step in eliminating precancerous cells on the face is to schedule an appointment with an expert board-certified dermatologist, such as Dr. Michele Green.

Many treatment options are available at Dr. Michele Green’s Upper East Side New York City dermatology office, including topical treatments, chemical peels, dermatologic surgery like excision and Mohs surgery, photodynamic therapy such as Blu Light treatment and laser treatments. Several forms of laser therapy are effective in reducing the non-ablative Fraxel Dual fractional laser and ablative lasers like the CO2 laser. The Fraxel Dual laser targets precancerous cells with a precise 1927 nm wavelength of light, destroying the cancer cells while leaving the surrounding tissue intact. As a non-ablative laser, the Fraxel Dual requires no downtime but multiple treatment sessions to achieve the best results. The ablative CO2 laser, on the other hand, eliminates precancerous lesions by vaporizing the top layer of skin to promote new skin cell growth. The results of ablative laser treatment are dramatic, but the procedure requires more downtime. To find out which laser treatment option is best for you, schedule your initial consultation with expert dermatologist Dr. Michele Green.

Experienced board-certified dermatologist Dr. Michele Green has been expertly treating patients at her Upper East Side New York City dermatology office for more than 25 years. Dr. Green is an expert in many medical and cosmetic treatments, including chemical peels, Microneedling, microdermabrasion, laser therapies, dermatologic surgery, and injectable treatments, such as Botox and dermal fillers. Well-known for high patient satisfaction, Dr. Green has been frequently voted one of New York City’s best dermatologists by publications such as Castle Connolly, New York Magazine, and Super Doctors.

What are the early signs of skin cancer?

The signs of skin cancer often include the development of lesions on the skin’s surface. If you notice any irregular dark spots on your skin, it is best to schedule an appointment with an expert dermatologist like Dr. Green to determine if the lesion is cancerous. Actinic Keratoses are precancerous lesions that may develop into squamous cell carcinoma or melanoma skin cancer when left untreated. The most common risk factor for developing actinic keratosis is unprotected sun exposure, which can lead to sun-damaged skin. Actinic Keratoses can look like pink, brown, or red crusty bumps on the skin’s surface. They are generally small—less than an inch in diameter—and are slightly raised or flat.

How serious are precancerous cells?

While very common, skin cancer can be relatively easily treated when it is caught in its early stages. Precancerous lesions can be removed before developing into cancer, which will reduce the risk of the cancer spreading to other areas of the body. If patients notice a new lesion on the skin that has an asymmetrical border, has recently changed in size or color, has an unusual border, or has recently started itching or bleeding, it is essential to schedule an appointment with a board certified dermatologist like Dr. Green to determine whether or not the lesion is dangerous.

Can lasers remove precancerous cells?

Laser treatments are an effective option for removing precancerous cells and lesions like actinic keratoses. At Dr. Green’s dermatology office, several laser treatment options are available, including nonablative laser treatments like the Fraxel Dual laser and ablative laser treatments like the CO2 laser. By removing precancerous lesions, laser treatment can help to prevent the development of skin cancers like squamous cell carcinoma, basal cell carcinoma, and melanoma.

What is laser surgery for skin cancer treatment?

Another option for treating precancerous lesions or skin cancer is dermatologic surgery. To remove a lesion, Dr. Green may turn to cryosurgery, which involves freezing off the lesion; excision, which involves cutting and extracting the lesion; and Mohs surgery, which involves removing the cancer one layer at a time until there are no more cancer cells. Lasers can be used as part of surgical procedures to help seal nerve endings to reduce pain, seal blood vessels to reduce bleeding, and seal lymph vessels to reduce swelling. Lasers can also be used instead of scalpels to cut through tissue precisely during surgery.

Does laser treatment work for precancerous cells?

Laser treatments are effective treatment options for precancerous cells. When treating precancerous lesions like actinic keratoses, Dr. Green will most often turn to the Fraxel Dual Laser or the C02 ablative laser:

Fraxel Dual Laser

Fraxel laser therapy is a non-ablative skin resurfacing treatment option that is FDA-approved to treat a range of skin concerns, including acne scars, surgical scars, uneven skin texture, stretch marks, fine lines, and precancerous lesions. Fraxel is a non-ablative laser resurfacing option, meaning that the treatment penetrates the dermis and boosts new collagen growth without vaporizing the outer layer of the skin. As a result, Fraxel laser therapy can provide improved skin tone and texture without the need for any downtime. The laser emits controlled, targeted beams of fractionated energy that penetrate the deeper layers of the skin while leaving the surrounding tissue unaffected. The microscopic columns treat a fraction of the skin at a time, creating controlled micro-damage to the tissue. This triggers the body’s natural healing process and boosts collagen production to eliminate precancerous lesions and provide patients with smoother, brighter skin.

CO2 Laser

CO2 laser resurfacing is an ablative laser treatment that vaporizes the outer layer of skin, known as the epidermis, which boosts collagen production and increases the skin cell turnover rate for full facial rejuvenation. The CO2 laser emits a mid-infrared beam of laser energy in a continuous wave at 10,600 nanometers, making it one of the highest output power lasers available for use. The CO2 laser can either be used as an ablative laser, which provides dramatic vaporization of the epidermis, or as a fractional laser, which is a gentler form of facial rejuvenation. Ablative or fractional lasers, such as the CO2 laser, are safest when used in people with Fitzpatrick skin type I or II, as patients with darker skin are more susceptible to serious side effects, such as post-inflammatory hyperpigmentation or hypopigmentation.

What is photodynamic therapy (PDT)/BLU light?

Photodynamic Therapy is a procedure designed to target harmful agents in the body, such as cancer cells and precancerous lesions. Specifically, the treatment is most effective for cancers affecting the head and neck, skin, and lungs, including advanced cutaneous T-cell lymphoma, Barrett’s esophagus, basal cell carcinoma (BCC), stage 0 of squamous cell carcinoma (also known as Bowen’s disease or SCC), throat cancer (also known as esophageal cancer), and non-small cell lung cancer. PDT can also be used for the precancerous stage of skin cancer, called actinic keratosis and nonmelanoma skin cancer.

Photodynamic therapy is performed in two parts: (1) administration of the photosensitizing agent and (2) light activation. The treatment begins with the topical application of the photosensitizing agent—a drug sensitive to certain wavelengths of light. Over a specified period, the drug travels through the patient’s body, leaving normal cells while remaining in the precancerous skin cells or harmful agents. During this incubation period, the photosensitizing drug is non-toxic and does not affect the cells or tissue in the body. However, when a specific wavelength of light shines onto the treatment area, the drug activates and produces a particular form of oxygen, known as an oxygen radical, that targets and kills the cells that have absorbed the drug.

Blu-U is a specific blue light photodynamic therapy primarily used to treat actinic keratoses, or precancerous cells. During treatment, the photosensitizing medication known as Levulan (aminolevulinic acid) is applied to the treatment area and left to incubate for one hour, allowing absorption by the precancerous skin cells. Once the hour is complete, patients are placed under the blue light to activate the Levulan and destroy the actinic keratoses. After treatment, patients will notice that certain areas in the treatment zone will ‘light up’ and turn red—this reaction indicates that the actinic keratoses are being eliminated. Patients must avoid sun exposure and direct light after treatment, as any exposure can further activate the medication. The redness will typically dissipate within several days to a week after treatment, depending on the area treated and the number of precancerous cells present. While it is most common to treat the face with Blu-U, treatment can also be performed on the scalp, arms, legs, back, and chest. Multiple treatments spaced one month apart may be required based on the severity and quantity of precancerous cells.

Do topical treatments work for precancerous cells?

Patients often wonder, “What cream is good for precancerous cells on the face?” Topical treatment options, such as creams and gels, to eliminate precancerous lesions are also available at Dr. Green’s office. When treating skin cancer lesions, which typically affect one area of the skin, topical forms of chemotherapy are effective and safer than systemic chemotherapy. The best creams that are effective in eliminating precancerous lesions are 5-fluorouracil (brand name Efudex, Carac, and Fluroplex), Imiquimod, and Diclofenac. All three types of creams can be prescribed for actinic keratoses and applied at home for a set period. While these creams are effective at eliminating precancerous lesions, they are associated with side effects that include skin irritation, redness, blisters, and sores.

What is the best treatment for precancerous skin on the face?

At Dr. Green’s Upper East Side New York City dermatology office, many treatment options are available for treating precancerous skin on the face. No one treatment option is inherently “better” than the others; rather, Dr. Green will choose the treatment or series of treatments that will best address your needs. The choice for which treatment will depend on the number of precancerous lesions, their location, and the type of lesion. Dr. Green may choose to treat patients with laser therapies, including the Fraxel Dual non-ablative laser, CO2 laser, chemical peels, topical treatments, or photodynamic therapy (PDT). Schedule your initial consultation with expert dermatologist Dr. Michele Green to determine which treatment option will be best for you.

Skin Cancer Treatment FAQs

Are there negative effects of laser therapy?

Non-ablative laser therapy, such as the Fraxel Dual laser, is not associated with any downtime and typically does not cause significant side effects. Ablative laser treatments, on the other hand, may result in more significant side effects and require more downtime. Due to the ablative nature of the laser treatment, the CO2 laser can be dangerous for patients with Fitzpatrick skin type III-VI, as patients with darker skin tones are at a higher risk for developing post-inflammatory hyperpigmentation or laser burns. Dr. Green has many options available for patients with darker skin that are effective at eliminating precancerous lesions while being gentle and safe for Skin of Color.

What are the side effects of laser treatment for skin cancer?

Patients often ask, “Does face laser treatment have side effects?” In any patient being treated with the CO2 laser, the common side effects of treatment include:

• Redness or discoloration at the treatment site
• Irritation and itchiness
• A burning sensation like that of a mild sunburn
• Scabbing, peeling, or dryness
• Increase photosensitivity

More serious adverse events can occur, including the development of milia, which are small white bumps on the skin, acne breakouts, scarring, infection, hyperpigmentation, and laser burns. However, the risk of developing any serious side effects greatly decreases when seeking treatment from an expert dermatologist, such as Dr. Green.

The Fraxel Dual laser, on the other hand, is a non-ablative laser treatment, meaning that Fraxel is associated with much fewer side effects than an ablative laser. Where ablative laser treatments destroy the outer layer of the skin, Fraxel leaves the skin’s surface intact and targets the tissue in the deeper layer of the skin. In the first week after receiving Fraxel laser treatment, patients may experience some common, mild side effects, including swelling, redness, dry skin, tenderness in the treatment area, and flaking. These side effects will resolve within one week of receiving the treatment as the treatment results continue to improve over time. Patients with a history of active acne breakouts and cold sores should inform Dr. Green before treatment, as Fraxel laser treatment can worsen these conditions.

How painful is laser resurfacing on the face?

Laser resurfacing on the face is associated with some pain during the treatment, though Dr. Green’s office will have methods to help reduce discomfort during the procedure. Afterward, patients may experience some swelling, pain, redness, and itchiness. Dr. Green will bandage the treatment area and advise patients to clean the area 24 hours after the procedure and then keep it clean in the days following. Dr. Green recommends that patients apply a petroleum jelly to the treated area to keep it moist. Any side effects should resolve on their own without the need for a follow-up appointment if patients follow the aftercare instructions.

Is photodynamic therapy painful?

The possible side effects of photodynamic therapy include:

• Redness
• Swelling
• Peeling
• Crusting
• Burning
• Sunburn
• Temporary hyperpigmentation
• Stinging
• Blisters

Approximately 50% of patients experience stinging or burning during the treatments. To improve patient comfort during the procedure, Dr. Green will apply a fan to cool the area.

What does your face look like after laser treatment?

In the first day or two after receiving laser treatment for precancerous lesions, patients will likely experience swelling and itching. Five to seven days following the procedure, the skin will start to peel and slough off before being replaced by new skin cells. The full healing process can take between ten and 21 days for ablative laser resurfacing, after which patients will see the full results of the treatment. Following any laser treatment, the skin will be particularly sensitive to sunlight. Dr. Green highly recommends that patients apply sunscreen every morning before going outside.

What is the best laser treatment for actinic keratosis?

The best laser treatment for actinic keratosis depends on the size and scope of the lesions, the patient’s skin type, and the number of lesions present. When you arrive for your consultation appointment, Dr. Green will begin by examining the treatment area to determine if the lesions are, in fact, precancerous. Then, she will make a recommendation about which treatment option will be best for you. Typically, Dr. Green will turn to Fraxel laser treatment, as the procedure is safe and effective for addressing actinic keratosis without the need for significant downtime. To achieve the best results, patients will need several treatment sessions.

Do chemical peels get rid of precancerous cells?

A chemical peel is a treatment that uses a chemical solution — also known as a chemical exfoliant — to remove the outermost layer of skin. When dead skin cells, oil, dirt, and other debris are removed from the skin’s surface, the exfoliation helps to promote new skin cell growth and skin cell turnover for clearer, smoother, brighter skin. One of the most commonly performed cosmetic procedures, chemical peels can be used to address many skin concerns, including hyperpigmentation, active acne breakouts, acne scars, wrinkles, sun damage, age spots, uneven skin tone, and precancerous cells.

When it comes to treating precancerous skin lesions, Dr. Green will most often turn to a deep chemical peel, which penetrates deep into the inner layers of skin to address deep lines and wrinkles, severe scarring, extensive sun damage, and precancerous growths. Deep chemical peels are a significant procedure that necessitates the use of a numbing solution to reduce discomfort during the process. While deep chemical peels provide patients with dramatic results, there is significant downtime associated with deep chemical peels and a higher risk of side effects. Patients with darker skin tones should avoid deep chemical peels as they can result in scarring and post-inflammatory hyperpigmentation.

Do Fraxel lasers get rid of precancerous cells?

Fraxel laser treatment is a fractional laser that uses different wavelengths of laser light energy to address a wide variety of skin concerns, including uneven skin tone and texture, hyperpigmentation, brown spots, acne scars, fine lines, wrinkles, large pores, stretch marks, and Actinic Keratosis. By emitting targeted beams of light, the Fraxel laser creates controlled micro-wounds that trigger the body’s natural healing process, which increases new skin cells and new collagen production for smooth, clear, and healthy skin. Unlike ablative laser resurfacing, which can cause significant discomfort in the treatment area and require significant recovery time, the Fraxel laser provides patients with dramatic results with only minimal downtime. Additionally, the Fraxel fractional laser allows for precise bursts of laser energy, creating controlled damaged tissue only in the treated area, leaving the surrounding skin unharmed.

According to a study performed by Massachusetts General Hospital, non-ablative laser treatment options like the Fraxel laser can help reduce the risk of developing squamous cell skin cancer and basal cell skin cancer in patients with a history of facial keratinocyte carcinoma. Only 20.9% of patients treated with non-ablative laser therapy developed skin cancer compared with 40.4% of study participants who did not receive the treatment. Additionally, the patients who were treated with non-ablative laser therapy that did develop skin cancer took longer to develop the cancer than those who did not receive treatment.

Do other lasers get rid of precancerous cells?

One alternative to the Fraxel laser for getting rid of precancerous cells is the CO2 ablative laser. The CO2 laser is one of the most commonly used ablative lasers and has been used to treat patients for facial resurfacing since 1964. Long deemed safe and effective for use on patients with Fitzpatrick skin types I and II, the CO2 laser can address various skin conditions, including fine lines, acne scars, hyperpigmentation, warts, high skin laxity, and cancerous lesions. The CO2 ablative laser is more powerful than non-ablative lasers, providing patients with dramatic and clearly visible results with some downtime required. When used in the fractional laser setting, the CO2 laser can also target precise treatment areas without damaging the surrounding tissue.

Does freezing precancerous cells work?

One common type of surgery for removing precancerous cells is cryosurgery, which involves the application of liquid nitrogen to freeze off the lesion. When the liquid nitrogen is applied to the actinic keratoses, it causes the lesion to blister, crust over, and then fall off. While cryosurgery is a well-known procedure, Dr. Green does not often use any form of cryotherapy. The procedure is associated with discomfort, skin discoloration, and scarring.

How to get started with laser treatment for precancerous cells today

Skin cancer is an extremely common skin condition, affecting as many as 20% of all Americans in their lifetime. Unprotected sun exposure can lead to sun damage and increase the risk of developing precancerous lesions known as actinic keratosis. Luckily, if caught and addressed early enough, actinic keratosis is fairly simple to eliminate, reducing the risk of developing skin cancer. Several treatment options are available for eliminating precancerous lesions, including photodynamic therapy, chemical peels, and laser treatments like the ablative CO2 laser or the Fraxel fractional laser. To find out which treatment option will be the most effective for you, schedule your initial consultation with expert board-certified dermatologist Dr. Michele Green.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing her patients with the best non-invasive treatment options. Dr. Green takes a holistic approach and embraces a less-is-more philosophy, creating customized skincare routines and treatment plans that cater to the unique concerns and aesthetic goals of her patients. She is consistently identified as one of New York’s best dermatologists by Castle Connolly, New York Magazine, and Super Doctors for her dedication to her patients and expertise. Please call us at 212-535-3088 or email our New York City-based office today to schedule a consultation with Dr. Michele Green to determine if laser therapy for precancerous cells on the face is the best option for you.