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Actinic keratosis

Actinic keratosis (AK), rough scaly patches that arise on chronically ultraviolet-exposed skin, is one of the most common conditions diagnosed and treated by dermatologists in the United States. This guideline addresses the management of actinic keratosis, providing evidence-based recommendations for treatment.

Actinic keratosis guideline

Access the full actinic keratosis guideline from JAAD (free access).

Go to the guideline

Focused update on tirbanibulin

Access a focused update to the AK guidelines from JAAD (free access).

Go to the focused update

Guideline highlights

  • Although they often persist as chronic skin lesions, AKs can spontaneously involute, or most importantly, evolve into keratinocyte carcinoma if left untreated.

  • Treatment options for AK include field-directed therapies, such as topical medications and photodynamic therapy, and lesion-directed therapies, like cryosurgery and laser ablation.

  • Analysis of the evidence from a systematic review based on five research questions resulted in eighteen evidence-based recommendations and suggests there are several effective treatments available for AK.

  • Strong recommendations were made for the use of UV protection, cryosurgery, topical imiquimod, and 5-FU. Conditional recommendations were made for the use of PDT and diclofenac for the treatment of AK, both individually and as part of combination therapy regimens.

  • In a focused update published in June 2022, a strong recommendation for the use of tirbanibulin as field therapy was added to the guidelines.

AK Resource Center for patients

Are you looking for resources on AK to share with patients? The Academy offers a wealth of treatment help for the public in the AK Resource Center.

View the Academy guidelines disclaimer.                 

Additional Academy resources

Clinical Pathway for Management of Actinic Keratosis

Download PDF for the Clinical Pathway for Management of Actinic Keratosis.

Looking for patient pamplets?

The Academy offers patient pamphlets on AK and other common conditions.

Continuing education

Access the learning module on AK and SCC to earn credits.

Attacking actinic keratoses

Read a DermWorld article describing efforts to gather better data on AK.

Widespread AK

Read a DW Insights & Inquiries article on best approaches to widespread AK.