What follow-up schedule is appropriate for patients treated for actinic keratosis?

There is no specific UK national guideline that prescribes a fixed follow-up schedule for patients treated for actinic keratosis (AK). However, clinical practice generally involves personalised follow-up based on individual risk factors, lesion characteristics, and treatment response. Patients treated for AK should be advised on regular self-examination and sun protection measures to reduce recurrence and progression risk. Follow-up appointments are typically arranged to monitor for new or recurrent lesions, especially in patients at high risk of progression to squamous cell carcinoma or with extensive sun-damaged skin. The frequency of follow-up may range from every 3 to 6 months initially, then annually if stable, but should be tailored to the patient's risk profile and clinical findings NICE NG14.

Expert consensus from recent literature supports this personalised approach, emphasising that patients with multiple or high-risk AK lesions require closer surveillance, potentially with more frequent clinical reviews to detect malignant transformation early Richard et al. 2018. Additionally, ongoing education about skin self-monitoring and prompt reporting of suspicious changes is critical Thamm et al. 2024. This approach aligns with the broader principles of skin cancer follow-up in UK guidelines, which recommend follow-up by healthcare professionals skilled in skin examination and dermoscopy, with access to medical photography when needed NICE NG14.

In summary, the appropriate follow-up schedule for patients treated for actinic keratosis is personalised, typically involving initial follow-up every 3 to 6 months, then annually if stable, combined with patient education on self-examination and sun protection. High-risk patients may require more frequent and intensive monitoring.