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 ¹.

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 ¹.

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.