Update on the treatment of actinic keratosis

Several new therapy options have recently become available for the management of actinic keratosis (AK). Most of these treatments are intended to treat small, or large, areas of sundamaged skin – recognising the importance of field cancerisation, where skin adjacent to AK may contain dysplastic cells, while other therapies are best suited for individual lesions. It is impossible to predict which AK might develop into invasive squamous cell carcinoma (SCC), so guidelines recommend widespread treatment of AK. As approximately 20% of the UK population over 60 years of age will have at least one AK, with prevalence increasing with age, this represents a considerable therapeutic challenge in an era of restricted healthcare budgets. In this article, we briefly review the therapies now available and propose a practical approach to treatment choice.