Introduction: Actinic keratosis (AK) is a pre-malignant
condition that has a very high prevalence in Australia. Field
treatments such as Photodynamic Therapy, Imiquimod,
5FU, ingenol mebutate and fully ablative laser resurfacing
are associated with long recovery times, unpredictable
adverse reactions and signiﬁcant costs to patients.
Method: 1927 thulium laser has a long safety record for the
treatment of actinic pigmentation, skin rejuvenation, and
melasma. Several papers have demonstrated variable AK
clearance rates, however densities and ﬂuences were not
controlled. We treated 46 patients with moderate to severe
AK with speciﬁc parameters and controlled energy settings.
Results: With high density 1927 thulium laser (>92% coverage),
20 mj, clearance rates of up to 95% were consistently
achieved during follow ups at 6 and 12 months. This treatment
has been adopted as the ﬁeld treatment of choice in
patients with moderate to severe AK in our group practice.