Side Effects of Medication for Sun Exposure Spots

QUESTION: I noticed several dark, grayish colored spots on my hands and face
and thought they were simply age spots that so many of my friends have
developed with the passing years. My doctor, however, said they were caused
by too much sun exposure, and that they could become cancerous if not treated
now. He has suggested a cream that contains a powerful medication to destroy
the spots, but has warned me that this treatment can have some painful side
effects and cause scars. Can you offer me some advice and counsel?
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ANSWER: Your doctor has made an important diagnosis, and now you must make a
difficult decision, but there is no doubt in my mind that treatment is
necessary and advisable. "Age spots" that you refer to are usually brownish
in color and warty looking, and can occur anywhere on your body, rather than
just on uncovered sites such as hands and face. They are known as seborrheic
keratoses, and though sometimes unsightly, do not become cancerous or
malignant with time. Your problem, usually seen in individuals who have had
chronic or prolonged exposure to damaging sun rays, is called Actinic
Keratosis, and may develop into skin cancer. That is why treatment should be
started now. There are two main routes of treatment. If there are but a few
areas affected, the cells may be destroyed by cryotherapy, a technique that
uses liquid nitrogen to freeze and destroy the cells. It is rapid and
produces satisfactory results. When there are too many lesions for this
method, a cream containing 5-fluorouracil (5-FU) may be used. It is applied
as a cream or lotion twice a day to all the spots. After about 3 to 5 days a
reaction will be noted, as the damaged skin turns red and irritated. Sores
and crusts can develop as treatment continues, and can be painful. The length
of treatment depends upon your progress, but after it is halted, the sores
heal rapidly and new skin will regrow, replacing the potentially dangerous
growths.