For general education, not medical advice. This guide can’t diagnose you or replace care from your own clinician. If you’re worried about a spot or symptom, see a board-certified dermatologist.
An actinic keratosis, or AK, is a rough spot caused by years of sun exposure. It is a precancer. Some AKs can become squamous cell carcinoma, a type of skin cancer. Many do not, and some fade. Doctors cannot reliably predict which spot will become cancer.12
Key points
- AKs are rough or scaly spots on sun-damaged skin. Some can become skin cancer.
- Treatment can target a few spots or a whole area. The choice depends on your skin and health.
- A new, growing, painful, or bleeding spot needs a check. Do not burn or cut it off at home.
What is an actinic keratosis?
Ultraviolet (UV) light damages skin cells over time. Some damaged cells grow into a rough patch. AKs often form on the face, scalp, ears, hands, or arms.1
When there are many AKs, damage can also affect the skin between them. Doctors call this field cancerization. An area treatment can reach visible spots and early changes that are harder to see.1
Signs to watch for
An AK may feel like sandpaper. It can be pink, red, tan, or skin-colored. Some itch or feel sore. A thick spot may look like a wart. Sun damage on the lip can cause lasting dryness and scaling, called actinic cheilitis.1
A spot that grows fast, bleeds, gets thick, or becomes painful needs prompt assessment. It may need a biopsy to check for skin cancer.
How it's diagnosed
Your dermatologist examines the skin by sight and touch. They may use a dermoscope, a tool that gives a close-up view. If cancer is suspected, a biopsy removes skin for testing in a lab. Not every AK needs a biopsy, but a suspicious spot should not just be assumed to be an AK.1
What treatment usually looks like
There are two main approaches:
- Spot treatment targets one AK at a time. Freezing with liquid nitrogen is one option.
- Field treatment uses a cream or light treatment across a wider sun-damaged area.
Some plans use both. The right choice depends on the number, site, and thickness of the spots. Your health, the treatment schedule, and how much skin irritation you can manage also matter.1
Read all source findings
5-fluorouracil (5-FU) cream
Jansen MHE, Kessels JPHM, Nelemans PJ, et al. N Engl J Med. 2019;380(10):935–946.
Four-arm trial (624 patients with multiple head lesions): estimated freedom from treatment failure through 12 months was 74.7% with 5-FU, 53.9% with imiquimod, 37.7% with MAL-PDT, and 28.9% with ingenol. Success meant at least 75% fewer lesions, not complete clearance.
Pomerantz H, Hogan D, Eilers D, et al. JAMA Dermatol. 2015;151(9):952–960.
Trial of 932 high-risk veterans: complete AK clearance at six months was 38% with 5-FU versus 17% with vehicle. Fewer AKs and spot treatments persisted beyond two years; thick AK counts did not differ overall.
Weinstock MA, Thwin SS, Siegel JA, et al. JAMA Dermatol. 2018;154(2):167–174.
Trial of 932 veterans with prior skin cancers: SCC needing surgery on the treated face and ears fell by 75% in year one (1% versus 4%). BCC was not significantly reduced; KC, BCC, and SCC risk did not differ over the full study.
Gupta AK, Paquet M, Villanueva E, Brintnell W. Cochrane Database Syst Rev. 2012;12:CD004415.
Review of 83 trials: 0.5% 5-FU improved complete clearance versus vehicle (RR 8.86). Comparisons were limited by varying methods and reporting bias; the review found no cancer-prevention data.
Eisen DB, Asgari MM, Bennett DD, et al. J Am Acad Dermatol. 2021;85(4):e209–e233.
AAD guideline: strong recommendation for topical 5-FU. The guideline supports some specific combinations, but recommends against others.
Imiquimod cream
Jansen MHE, Kessels JPHM, Nelemans PJ, et al. N Engl J Med. 2019;380(10):935–946.
Four-arm trial: estimated freedom from treatment failure through 12 months was 53.9% with imiquimod versus 74.7% with 5-FU. Success meant at least 75% fewer lesions, not complete clearance.
Lebwohl M, Dinehart S, Whiting D, et al. J Am Acad Dermatol. 2004;50(5):714–721.
Two trials (436 patients): all target AKs cleared in 45.1% versus 3.2% with vehicle, assessed eight weeks after a twice-weekly, 16-week course. Local reactions were common.
Korman N, Moy R, Ling M, et al. Arch Dermatol. 2005;141(4):467–473.
Two trials (492 patients): complete clearance was 48.3% versus 7.2% with vehicle; partial clearance was 64.0% versus 13.6%, after three-times-weekly treatment for 16 weeks.
Gupta AK, Paquet M, Villanueva E, Brintnell W. Cochrane Database Syst Rev. 2012;12:CD004415.
Cochrane: 5% imiquimod improved complete clearance versus vehicle (RR 7.70), but more patients stopped because of adverse effects. Comparative evidence was limited.
Eisen DB, Asgari MM, Bennett DD, et al. J Am Acad Dermatol. 2021;85(4):e209–e233.
AAD guideline: strong recommendation for topical imiquimod.
Cryotherapy (freezing)
Thai KE, Fergin P, Freeman M, et al. Int J Dermatol. 2004;43(9):687–692.
Prospective study (90 patients, 421 lesions): 67.2% of lesions cleared at three months. Longer freezes cleared more; cosmetic results were good or excellent in 94% of lesions that fully responded.
Gupta AK, Paquet M, Villanueva E, Brintnell W. Cochrane Database Syst Rev. 2012;12:CD004415.
Cochrane: ALA-PDT cleared more individual lesions and had better cosmetic outcomes than freezing. This does not establish that every PDT regimen is better than every freezing regimen.
Eisen DB, Asgari MM, Bennett DD, et al. J Am Acad Dermatol. 2021;85(4):e209–e233.
AAD guideline: strong recommendation for cryosurgery, with choice based on lesion and patient factors.
Photodynamic therapy (PDT)
Piacquadio DJ, Chen DM, Farber HF, et al. Arch Dermatol. 2004;140(1):41–46.
Two phase-3 trials (243 patients): by week 12, 89% of evaluable ALA blue-light patients versus 13% with vehicle had at least 75% of treated lesions clear. This was not complete clearance of all lesions; 30% had received a second treatment.
Dirschka T, Radny P, Dominicus R, et al. Br J Dermatol. 2012;166(1):137–146.
Phase-3 trial (600 patients): complete patient clearance after the last PDT treatment was about 78% with BF-200 ALA, 64% with MAL, and 17% with placebo.
Mei X, Wang L, Zhang R, Zhong S. Photodiagnosis Photodyn Ther. 2019;25:23–28.
Six MAL-PDT trials: daylight treatment caused less pain and fewer adverse events. Overall complete response did not differ significantly, but studies including thicker grade-III lesions found lower response with daylight; blanket equivalence is not supported.
Gupta AK, Paquet M, Villanueva E, Brintnell W. Cochrane Database Syst Rev. 2012;12:CD004415.
Cochrane: PDT improved lesion clearance versus placebo. ALA-PDT had better clearance and cosmetic results than cryotherapy in the included comparisons; this is regimen-specific evidence.
Eisen DB, Asgari MM, Bennett DD, et al. J Am Acad Dermatol. 2021;85(4):e209–e233.
AAD guideline: conditional recommendations for specific PDT regimens; outcomes depend on the drug, light source, incubation, and number of sessions.
Tirbanibulin ointment
Blauvelt A, Kempers S, Lain E, et al. N Engl J Med. 2021;384(6):512–520.
Two trials (702 adults): day-57 complete clearance was 44% versus 5%, and 54% versus 13%, against vehicle. Among initial complete responders, one-year recurrence was estimated at 47%; recurrent or new lesions at 73%. Redness and scaling were common.
Eisen DB, Dellavalle RP, Frazer-Green L, et al. J Am Acad Dermatol. 2022;87(2):373–374.e5.
AAD focused update: strong recommendation for tirbanibulin field treatment based on two trials. The authors noted limited long-term efficacy and safety data.
Venturi F, Magnaterra E, Gualandi A, et al. Photodiagnosis Photodyn Ther. 2026;58:105359.
Small trial (45 patients with scalp AK relapse after diclofenac): 12-week clearance was 66.7% with tirbanibulin, 73.3% with 4% 5-FU, and 80.0% with PDT; differences were not significant. Tirbanibulin caused less inflammation. This does not prove equal efficacy.
Diclofenac gel
Wolf JE Jr, Taylor JR, Tschen E, Kang S. Int J Dermatol. 2001;40(11):709–713.
Vehicle-controlled trial: 30 days after treatment, all target lesions were absent in 50% versus 20%; all cumulative lesions were absent in 47% versus 19%. Skin adverse effects occurred.
Gupta AK, Paquet M, Villanueva E, Brintnell W. Cochrane Database Syst Rev. 2012;12:CD004415.
Cochrane: diclofenac improved complete clearance versus vehicle (RR 2.46), but withdrawals due to adverse effects were more common. Comparative certainty was limited.
Worley B, Harikumar V, Reynolds K, et al. Arch Dermatol Res. 2023;315(5):1099–1108.
Review of 80 trials (6,748 patients): diclofenac had the lowest clearance rates among the treatments reviewed. Heterogeneity prevented a network meta-analysis.
Eisen DB, Asgari MM, Bennett DD, et al. J Am Acad Dermatol. 2021;85(4):e209–e233.
AAD conditionally recommends diclofenac, based on lower-certainty evidence. The guideline notes NSAID cardiovascular and gastrointestinal warnings and does not support adding it to cryosurgery.
Curettage (scraping)
Worley B, Harikumar V, Reynolds K, et al. Arch Dermatol Res. 2023;315(5):1099–1108.
This broad trial review does not provide a reliable curettage clearance estimate. It cannot justify a numerical cure rate or a claim that scraping proves cancer is absent.
Eisen DB, Asgari MM, Bennett DD, et al. J Am Acad Dermatol. 2021;85(4):e209–e233.
AAD describes curettage as a lesion-directed office treatment. The guideline provides no specific evidence-based curettage recommendation or randomized clearance estimate.
These studies did not all measure the same result. Clearing every spot, reducing the number of spots, and keeping them away over time are different goals. The source details explain which result each study measured. Your dermatologist can help you weigh them against the downsides.
Combining treatments
The result depends on the exact pair. AAD conditionally supports 5-FU or imiquimod with freezing. It recommends against adding diclofenac or adapalene to freezing, or imiquimod after ALA blue-light PDT. One rating cannot describe all combinations.1
Calcipotriol plus 5-FU: promising, off-label use. A trial of 131 people compared four days of this combination with four days of Vaseline plus 5-FU. Face AK counts fell by 87.8% versus 26.3% at eight weeks. Other treated sites also improved. This was not a comparison with a usual multi-week 5-FU course.3
In a small follow-up group, SCC on the treated face or scalp within three years occurred in 2 of 30 people given the combination and 11 of 40 controls. BCC did not differ. Neither did SCC at years one or two. Across all treated body sites, no significant SCC or BCC reduction was found at one, two, or three years. Face/scalp SCC-free survival over the full follow-up was also not clearly different. These limits keep the finding from proving broad cancer prevention.4
Laser-assisted PDT: limited, specific evidence. In a small Korean study, lesion response was 86.9% with laser-assisted MAL-PDT versus 61.2% with MAL-PDT alone. Recurrence was 9.7% versus 26.6%. Adverse effects were numerically more common with laser assistance, but the difference was not significant. This result does not establish that all combined treatments work better.5
A review of long-term trials supports sustained clearance with several individual treatments. It does not show that combinations as a group are better. Ask which exact regimen is being offered and what evidence supports it.6
Field treatment vs. spot treatment
Freezing treats selected spots. Field creams and light treatments treat a larger area. Neither removes all future risk, and later treatment may be needed.7
In one trial comparing four field treatments, 5-FU had the highest chance of keeping at least 75% of lesions cleared through one year. This did not mean that all spots stayed gone. The trial involved people with several AKs on the head; it does not settle every treatment choice.8
Creams can cause redness, soreness, and crusting. The reaction and its duration depend on the medicine. More irritation does not mean better results. Ask what to expect and when to pause treatment or call your clinician.1
Other options patients ask about
Black salve: can harm. This corrosive paste burns skin and can scar it. It can leave cancer behind. A study of selected tissue samples from black-salve-treated sites found persistent cancer; it cannot tell us the risk for every person who uses it. Do not use black salve to treat an AK or a suspected cancer.9101112
Apple cider vinegar and other acids: can burn. Published reports describe burns after people used vinegar to try to remove skin growths. These reports do not show that vinegar treats AKs. Do not try to burn off an uncertain spot.1314
Home removal and wart-freezing kits: get a diagnosis first. Do not cut, scrape, or freeze an unknown spot yourself. A skin cancer can resemble an AK. Destroying the surface may delay diagnosis. Wart products are not a substitute for a dermatologist's AK treatment plan.1
Drugstore retinol and exfoliating acids: not established AK care. They are not substitutes for the prescription treatments in the guideline. Ask about a lasting rough spot rather than choosing a cosmetic cream to treat it.1
Ingenol mebutate (Picato): historical treatment with a safety warning. Older studies found benefit against AKs, but it had lower sustained success than 5-FU in the four-treatment trial. Later safety findings changed its place in care. Its EU authorization was withdrawn in 2020; EMA concluded that its skin-tumor risks outweighed its benefits. Do not use leftover gel. Ask your doctor about new growths in a previously treated area.7815
Why treating actinic keratoses matters
The risk from one AK is hard to predict. Studies report different rates of growth into cancer, regression, and return. Treatment decisions should consider your whole skin history, not a single risk number.216
Clearing AKs and preventing cancer are different outcomes. In a trial of people with prior skin cancers, one course of 5-FU reduced SCCs needing surgery on the treated face and ears in the first year. It did not reduce that risk over the full study. That result does not mean every AK treatment has proven long-term cancer prevention.17
If you have had an organ transplant or take medicines that suppress your immune system, tell your dermatologist. You may need a different prevention and follow-up plan.18
Reducing your risk going forward
Protect skin from further UV exposure. Use broad-spectrum SPF 30 or higher sunscreen, shade, and protective clothes. Avoid tanning beds. Trials found fewer new AKs with daily sunscreen. Trials of longer follow-up also found fewer SCCs.1192021
Keep skin checks on the schedule your clinician recommends. New spots can appear despite successful treatment.
Nicotinamide, a form of vitamin B3, reduced AKs and new skin cancers during a one-year trial in high-risk adults with normal immune systems. The benefit did not persist after it stopped. A trial in transplant recipients did not find a benefit. Do not assume that results in one group apply to another.2223
The table below distinguishes those groups and the other prevention options. Discuss supplements or prescription prevention drugs with your doctor.
Actinic keratoses come from cumulative ultraviolet exposure, so reducing UV lowers the risk. Daily sunscreen led to fewer new actinic keratoses, and over years of follow-up, fewer squamous cell cancers.
In a trial of high-risk adults with normal immune systems, new non-melanoma skin cancers fell by 23% and AKs by 13% at one year. Benefit did not persist after stopping. Reviews differ in their estimates and report more digestive side effects.
In the largest transplant trial, nicotinamide did not significantly reduce skin cancers or AKs. Smaller studies and pooled analyses have not established a benefit; uncertainty remains.
Randomized trials show fewer squamous cell cancers in this high-risk group, but side effects limit use to selected patients.
Multiple randomized trials found no reduction in actinic keratoses or skin cancer.
Whole-body prevention, separate from the spot treatments above. “No effect” means good trials found no benefit. Every source is PubMed-verified; not medical advice.
When to see a doctor
Have a lasting rough spot checked, especially if it grows, bleeds, thickens, or hurts. After treatment, call if a spot fails to heal or returns. Ask how often you need a full skin exam based on your history.
Worried about a spot?
SpotDoc offers full-body skin cancer screening in Brownwood Square, The Villages. No referral needed for most plans.
Frequently asked questions
Is an actinic keratosis skin cancer? It is a precancer. Some can become SCC. A spot that looks like an AK may already be cancer, so concerning changes need assessment.
Will my actinic keratosis turn into cancer? Many do not. Some fade and later return. There is no reliable way to predict what one spot will do. Your dermatologist weighs the spots, your skin history, and your health when recommending care.
Which treatment should I choose? Freezing can treat a few spots. Creams and light treatments can treat a wider area. Different studies measure different outcomes. Ask about complete clearance, later return, and the downsides of each option.
Should I expect a skin reaction? Many field treatments cause redness and soreness. The timing varies. Ask your clinician what is expected, how to care for the skin, and which reactions need a call.
Can actinic keratoses come back? Yes. A treated spot can return, and new spots can form in sun-damaged skin. Sun protection and follow-up remain important.
Can I use vinegar or black salve instead? No. These can injure the skin and may delay a cancer diagnosis. Have the spot assessed before trying to remove it.
Questions to ask your dermatologist
- Is this clearly an AK, or does it need a biopsy?
- Do I need spot treatment, field treatment, or both?
- What result should I expect, and how will we check it?
- Which skin reactions should make me call?
- How often should I return for a skin check?
Reviewed by Tyler Long, DO. Last reviewed November 3, 2026.
Update log
How this guide has changed since it was first published.
- November 3, 2026Corrected study endpoints and evidence details, added safety context, and separated non-comparable combinations from the treatment grid. Reviewed and accepted for publication November 3, 2026.
- July 28, 2026Guide published.
References
Sources supporting this guide are listed below, with links to the publications or issuing organizations. Numbers match the citations in the text and the grids above.
- Eisen DB, Asgari MM, Bennett DD, et al. Guidelines of care for the management of actinic keratosis. J Am Acad Dermatol. 2021;85(4):e209–e233.View source
- Werner RN, Sammain A, Erdmann R, et al. The natural history of actinic keratosis: a systematic review. Br J Dermatol. 2013;169(3):502–518.View source
- Cunningham TJ, Tabacchi M, Eliane JP, et al. Randomized trial of calcipotriol combined with 5-fluorouracil for skin cancer precursor immunotherapy. J Clin Invest. 2017;127(1):106–116.View source
- Rosenberg AR, Tabacchi M, Ngo KH, et al. Skin cancer precursor immunotherapy for squamous cell carcinoma prevention. JCI Insight. 2019;4(6):e125476.View source
- Ko DY, Jeon SY, Kim KH, Song KH. Fractional erbium:YAG laser-assisted photodynamic therapy for facial actinic keratoses: a randomized, comparative, prospective study. J Eur Acad Dermatol Venereol. 2014;28(11):1529–1539.View source
- Steeb T, Wessely A, Petzold A, et al. Evaluation of Long-term Clearance Rates of Interventions for Actinic Keratosis: A Systematic Review and Network Meta-analysis. JAMA Dermatol. 2021;157(9):1066–1077.View source
- Gupta AK, Paquet M, Villanueva E, Brintnell W. Interventions for actinic keratoses. Cochrane Database Syst Rev. 2012;12:CD004415.View source
- Jansen MHE, Kessels JPHM, Nelemans PJ, et al. Randomized Trial of Four Treatment Approaches for Actinic Keratosis. N Engl J Med. 2019;380(10):935–946.View source
- Lim A. Black salve treatment of skin cancer: a review. J Dermatolog Treat. 2018;29(4):388–392.View source
- Croaker A, Liu L, Myers SP. Persisting cancer in black salve treated skin lesions: results of a large 5-year retrospective analysis of Australian histopathology specimens. Integr Cancer Ther. 2023;22:15347354221151145.View source
- Leecy TN, Beer TW, Harvey NT, et al. Histopathological features associated with application of black salve to cutaneous lesions: a series of 16 cases and review of the literature. Pathology. 2013;45(7):670–674.View source
- Eastman KL, McFarland LV, Raugi GJ. A review of topical corrosive black salve. J Altern Complement Med. 2014;20(4):284–289.View source
- Feldstein S, Afshar M, Krakowski AC. Chemical burn from vinegar following an internet-based protocol for self-removal of nevi. J Clin Aesthet Dermatol. 2015;8(6):50.View source
- Bunick CG, Lott JP, Warren CB, Galan A, Bolognia J, King BA. Chemical burn from topical apple cider vinegar. J Am Acad Dermatol. 2012;67(4):e143–e144.View source
- European Medicines Agency. Picato: referral. Risks of Picato for actinic keratosis outweigh benefits. European Medicines Agency. 2020. Accessed November 3, 2026.View source
- Criscione VD, Weinstock MA, Naylor MF, et al. Actinic keratoses: natural history and risk of malignant transformation in the Veterans Affairs Topical Tretinoin Chemoprevention Trial. Cancer. 2009;115(11):2523–2530.View source
- Weinstock MA, Thwin SS, Siegel JA, et al. Chemoprevention of Basal and Squamous Cell Carcinoma With a Single Course of Fluorouracil, 5%, Cream: A Randomized Clinical Trial. JAMA Dermatol. 2018;154(2):167–174.View source
- Chen K, Craig JC, Shumack S. Oral retinoids for the prevention of skin cancers in solid organ transplant recipients: a systematic review of randomized controlled trials. Br J Dermatol. 2005;152(3):518–523.View source
- Thompson SC, Jolley D, Marks R. Reduction of solar keratoses by regular sunscreen use. N Engl J Med. 1993;329(16):1147–1151.View source
- Green A, Williams G, Neale R, et al. Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet. 1999;354(9180):723–729.View source
- van der Pols JC, Williams GM, Pandeya N, Logan V, Green AC. Prolonged prevention of squamous cell carcinoma of the skin by regular sunscreen use. Cancer Epidemiol Biomarkers Prev. 2006;15(12):2546–2548.View source
- Chen AC, Martin AJ, Choy B, et al. A Phase 3 Randomized Trial of Nicotinamide for Skin-Cancer Chemoprevention. N Engl J Med. 2015;373(17):1618–1626.View source
- Allen NC, Martin AJ, Snaidr VA, et al. Nicotinamide for Skin-Cancer Chemoprevention in Transplant Recipients. N Engl J Med. 2023;388(9):804–812.View source
- Pomerantz H, Hogan D, Eilers D, et al. Long-term Efficacy of Topical Fluorouracil Cream, 5%, for Treating Actinic Keratosis: A Randomized Clinical Trial. JAMA Dermatol. 2015;151(9):952–960.View source
- Lebwohl M, Dinehart S, Whiting D, et al. Imiquimod 5% cream for the treatment of actinic keratosis: results from two phase III, randomized, double-blind, parallel group, vehicle-controlled trials. J Am Acad Dermatol. 2004;50(5):714–721.View source
- Korman N, Moy R, Ling M, et al. Dosing with 5% imiquimod cream 3 times per week for the treatment of actinic keratosis: results of two phase 3, randomized, double-blind, parallel-group, vehicle-controlled trials. Arch Dermatol. 2005;141(4):467–473.View source
- Thai KE, Fergin P, Freeman M, et al. A prospective study of the use of cryosurgery for the treatment of actinic keratoses. Int J Dermatol. 2004;43(9):687–692.View source
- Piacquadio DJ, Chen DM, Farber HF, et al. Photodynamic therapy with aminolevulinic acid topical solution and visible blue light in the treatment of multiple actinic keratoses of the face and scalp: investigator-blinded, phase 3, multicenter trials. Arch Dermatol. 2004;140(1):41–46.View source
- Dirschka T, Radny P, Dominicus R, et al. Photodynamic therapy with BF-200 ALA for the treatment of actinic keratosis: results of a multicentre, randomized, observer-blind phase III study in comparison with a registered methyl-5-aminolaevulinate cream and placebo. Br J Dermatol. 2012;166(1):137–146.View source
- Mei X, Wang L, Zhang R, Zhong S. Daylight versus conventional photodynamic therapy for the treatment of actinic keratosis: A meta-analysis of randomized controlled trials. Photodiagnosis Photodyn Ther. 2019;25:23–28.View source
- Blauvelt A, Kempers S, Lain E, et al. Phase 3 Trials of Tirbanibulin Ointment for Actinic Keratosis. N Engl J Med. 2021;384(6):512–520.View source
- Eisen DB, Dellavalle RP, Frazer-Green L, et al. Focused update: Guidelines of care for the management of actinic keratosis. J Am Acad Dermatol. 2022;87(2):373–374.e5.View source
- Venturi F, Magnaterra E, Gualandi A, et al. Randomized comparative study of 5-Fluorouracil 4%, tirbanibulin, and photodynamic therapy for relapsing actinic keratoses. Photodiagnosis Photodyn Ther. 2026;58:105359.View source
- Wolf JE Jr, Taylor JR, Tschen E, Kang S. Topical 3.0% diclofenac in 2.5% hyaluronan gel in the treatment of actinic keratoses. Int J Dermatol. 2001;40(11):709–713.View source
- Worley B, Harikumar V, Reynolds K, et al. Treatment of actinic keratosis: a systematic review. Arch Dermatol Res. 2023;315(5):1099–1108.View source
- Darlington S, Williams G, Neale R, Frost C, Green A. A randomized controlled trial to assess sunscreen application and beta carotene supplementation in the prevention of solar keratoses. Arch Dermatol. 2003;139(4):451–455.View source
- Ulrich C, Jürgensen JS, Degen A, et al. Prevention of non-melanoma skin cancer in organ transplant patients by regular use of a sunscreen: a 24 months, prospective, case-control study. Br J Dermatol. 2009;161(Suppl 3):78–84.View source
- Surjana D, Halliday GM, Martin AJ, Moloney FJ, Damian DL. Oral nicotinamide reduces actinic keratoses in phase II double-blinded randomized controlled trials. J Invest Dermatol. 2012;132(5):1497–1500.View source
- Mainville L, Smilga AS, Fortin PR. Effect of Nicotinamide in Skin Cancer and Actinic Keratoses Chemoprophylaxis, and Adverse Effects Related to Nicotinamide: A Systematic Review and Meta-Analysis. J Cutan Med Surg. 2022;26(3):297–308.View source
- Zhang H, George-Washburn EA, Hashemi KB, et al. Oral Nicotinamide for Actinic Keratosis Prevention in Kidney Transplant Recipients: A Pilot Double-Blind, Randomized, Placebo-Controlled Trial. Transplant Proc. 2023;55(9):2079–2084.View source
- Tosti G, Pepe F, Gnagnarella P, et al. The Role of Nicotinamide as Chemo-Preventive Agent in NMSCs: A Systematic Review and Meta-Analysis. Nutrients. 2023;16(1):100.View source
- Bavinck JN, Tieben LM, Van der Woude FJ, et al. Prevention of skin cancer and reduction of keratotic skin lesions during acitretin therapy in renal transplant recipients: a double-blind, placebo-controlled study. J Clin Oncol. 1995;13(8):1933–1938.View source
- George R, Weightman W, Russ GR, Bannister KM, Mathew TH. Acitretin for chemoprevention of non-melanoma skin cancers in renal transplant recipients. Australas J Dermatol. 2002;43(4):269–273.View source
- Bath-Hextall F, Leonardi-Bee J, Somchand N, et al. Interventions for preventing non-melanoma skin cancers in high-risk groups. Cochrane Database Syst Rev. 2007;(4):CD005414.View source
- Greenberg ER, Baron JA, Stukel TA, et al. A clinical trial of beta carotene to prevent basal-cell and squamous-cell cancers of the skin. N Engl J Med. 1990;323(12):789–795.View source