The first step in the management of the patient with multiple actinic keratoses (AK) and field cancerization (FC) is rigorous sun protection.

Sunscreens should contain liposomal DNA-photolyase and high UVA and UVB protection filters to reduce subclinical FC.

Treatment of AK and FC can be lesion-directed or field-directed, and it can require the treatment of large surfaces.

The choice of therapy should be based on multiple factors such as efficacy, tolerability, patient risk profile, costs, and cosmetic results.

Nutricosmetics with Polypodium leucotomus can be an excellent option in patients who do outdoor activities, as an adjuvant to topical photoprotection in susceptible populations.