Therapeutic Decision Making in the Therapy of Actinic Keratoses
May 2005 | Volume 4 | Issue 3 | Original Article | 296 | Copyright © May 2005
James M. Spencer MD MS, Carole Hazan MD, Sherry Hsiung MD, Perry Robins MD
Actinic keratoses (AKs) represent the second most common reason to visit a dermatologist in the United States and
their therapy has become a major portion of most dermatologists’ practice. An ever-increasing array of therapeutic
options exist for the therapy of actinic keratoses, offering physicians and patients a greater number of choices than ever
before. Patient expectations and needs seem to be changing at the same time, thus effecting therapeutic decisionmaking.
While destructive therapies with resultant wounds, time for wound healing, and possible hypopigmentation or
scarring were acceptable in the past, many patients from the baby-boom generation are now developing AKs and have
little tolerance for any time for wound healing or any cosmetic changes. This paper will raise some fundamental questions
regarding AKs and their management.