Advancements in Actinic Keratosis Management: Expert Insights from the 2025 Winter Clinical Dermatology Conference

Neal Bhatia, MD

Photo courtesy of dermsquared

At the 2025 Winter Clinical Dermatology Conference, Neal Bhatia, MD, Director of Clinical Dermatology at Therapeutics Clinical Research in San Diego, highlighted significant updates in the management of actinic keratosis (AK), emphasizing strategies to reduce skin cancer risk and improve patient outcomes.

Integrating Effective AK Treatments in Clinical Practice

Dr Bhatia underscored the importance of a structured approach to AK treatment, incorporating:

• Cryotherapy: A well-established first-line treatment for isolated lesions.
• Topical Therapies: Including 5-fluorouracil (5-FU), imiquimod, and newer combination therapies.
• Photodynamic Therapy (PDT): Shown to significantly reduce AK recurrence and prevent non-melanoma skin cancers, particularly in high-risk patients.

Combination Therapy for Enhanced Efficacy

A recent study demonstrated that combining calcipotriol with 5-FU resulted in an 87% reduction in AK lesions compared to 26% with 5-FU alone. This combination stimulates an immune response against precancerous lesions, offering long-term benefits in AK management.

New Advances: Tirbanibulin and Expanded PDT Applications

• Tirbanibulin: A newer topical treatment with an apoptotic mechanism, providing an alternative to traditional therapies with lower inflammation and shorter application duration.
• PDT Optimization: Consensus guidelines now recommend shorter incubation times and temperature modulation to enhance efficacy and minimize discomfort, making PDT a more practical option for primary care settings.