In your experience, what has been the most effective form of field therapy for your patients with higher burdens of actinic keratoses?

In my experience, topical 5-Fluorouracil 5% cream has been the most effective form of field therapy for my patients with higher burdens of actinic keratoses. I typically have my patients apply to the face and neck twice daily up to 2-3 weeks, and to the scalp, dorsal hands, extensor arms, and lower legs twice daily up to 3-4 weeks. The patients may apply Vaseline ointment to mitigate irritation or take a short “holiday break” and then resume treatment as needed. For patients with confluent hyper...

For severe field disease in patients who have had multiple squamous cells, we typically use calcipitrione combined with 5 FU mixed one to one twice daily for 7 days on the face and 10 days on the scalp, hands, and arms. We give patients a portal to phone in photos on day 3 day 5 and day 7. When we use it on the face we limit it to one or two cosmetic units ie forehead temple and warn them that the reaction can be very severe. I give all patients who use this my cell.

In the past, we found patie...