East Sussex - Better Together

13.5.2 Photodamage

The 2007 British Association of Dermatologists guidelines suggest that ‘no therapy’ or ‘emollient only’ are reasonable options for mild actinic keratoses. Where treatment is warranted, the table below specifies the formulary treatment options.

Actinic keratosis Grade 1 Actinic keratosis Grade 2 Actinic keratosis thick, hyperkeratotic lesions Grade 3 Small superficial basal cell carcinomas

Diclofenac 3% gel (Solaraze®)

Fluorouracil 5% cream (Efudix®)

Liquid Nitrogen/ curettage Imiquimod 5% cream (Aldara®)

Ingenol mebutate gel (Picato®)

Ingenol mebutate gel (Picato®)



Moderately thick hyperkeratotic actinic keratosis

Fluorouracil 0.5%/ salicylic acid 10% solution (Actikerall®)



For face, scalp, genital areas

Imiquimod 5% cream (Aldara®)


Excipients include benzyl alcohol

50 gram

Excipients include hydroxybenzoates (parabens)

40 gram

Excipients include benzyl alcohol

For use on face and scalp

1 gram (3 x 0.47g tubes)

For use on trunk and extremities

1 gram (2 x 0.47g tubes)

Excipients include benzyl alcohol, cetyl alcohol, stearyl alcohol, hydroxybenzoates (parabens), polysorbate 60

12 sachet
  • First Line Drugs
  • Second Line Drugs
  • Specialist Initiated Drugs
  • Specialist Only Drugs
  • Mixed Status