Topical treatments for solar keratoses

Your treatment options

Topical treatments are applied to the affected skin area – typically in the form of a cream, gel or ointment. The treatments differ in how they work and in treatment duration from a few days to several months. However, they also share common characteristics: 
  • Field treatments: They all treat a field, including the single lesions and the potentially hidden lesions in the treatment.  
  • Local skin responses: They all treat sun damaged skin cells and will usually involve some redness, swelling, or local irritation or pain. 
  • Less scarring or white spots: Compared to lesion-directed treatments, there is less risk of long-term cosmetic side effects such as scarring and pigmentation loss (white spots). 

Finding the time to apply your treatment properly and knowing what side effects to look out for can make all the difference.


Here is a list of active ingredients that are often used in topical treatments: 

5-Fluorouracil cream - three to four week treatment period (As per PI)

5-Fluorouracil is a chemo therapy that in its topical form is used for solar keratoses. The cream is applied once or twice daily during a one to four week treatment period. 

Imiquimod 

Imiquimod is a topical cream for the treatment for solar keratoses on the face and scalp. Treatment duration depends on the treatment regimen. It can be applied once daily, 3 times per week, for four to sixteen weeks. 

Ingenol mebutate

Ingenol mebutate is a topical treatment for solar keratoses. It is applied once daily for two days on the body or three days on the face or scalp 

Diclofenac gel

Diclofenac gel is a topical treatment for solar keratoses on the face and scalp or the body. Topical diclofenac is applied to the affected area twice a day for 60-90 days

Photodynamic therapy 

Photodynamic therapy is a combination of a topical treatment and an in-clinic procedure. It uses a chemical substance and a strong source of light to destroy the sun damaged skin cells. The treated area will heal over a couple of weeks.

Whichever treatment you use, it’s essential that you use your treatment as your doctor advises. Make sure you apply the right amount of treatment directly to the affected skin, and use it for the full length of time your doctor has prescribed.

For best results, always follow the instructions that come with the prescribed product and your doctor’s advice. 

Questions to consider

If you are unsure about how to use your treatment it may be helpful to make a list of questions to ensure that all your concerns are covered. To get started, you might consider:
  • How should I apply my treatment?
  • How often do I need to use my treatment?
  • For how long will I need to use my treatment?
  • How does it work?
  • How soon might I see results?
  • What are the possible side effects of my treatment? 
  • What is the risk of long-term cosmetic effects?
  • Can I combine this treatment with another medication?
  • Can I go out in the sun after applying this treatment?