Current issues in the management of actinic keratosis

Actinic keratoses are common sun-induced skin lesions that should be treated to prevent the development of nonmelanoma skin cancer. Although cryotherapy is commonly used to treat individual lesions, it fails to address the actinically damaged field of neighboring sun-damaged skin, which is more effectively treated by field therapies to clear both visible and subclinical lesions. Most topical treatments require prolonged use and cause an inflammatory response that limits tolerability and adherence. Education is essential to teach patients about the chronic nature of actinic keratosis, the risk of nonmelanoma skin cancer, and the importance of correct use of topical medications. The addition of nonphysician clinicians to dermatologic practices provides a valuable source of education, treatment, and follow-up care to the management of actinic keratosis.