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.

MHRA safety update: Ingenol mebutate gel (Picato▼): suspension of the licence due to risk of skin malignancy

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®)


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, cetyl alcohol, stearyl alcohol, hydroxybenzoates (parabens), polysorbate 60

12 sachet

For use in licensed indications only - Click on EMC link to see Summary of Product Characteristics

2 gram
  • First Line Drugs
  • Second Line Drugs
  • Specialist Initiated Drugs with Shared Care Guidelines
  • Specialist Only Drugs
  • Mixed Status