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BACKGROUND Diffuse widespread actinic keratoses (AK) are difficult to treat, have a tendency towards higher recurrence rates, and therefore require ablative treatment. Laser resurfacing is one of the treatment modalities that can treat whole surface areas.

OBJECTIVE To evaluate patients who underwent laser resurfacing for widespread AK with long-term follow-up for recurrence rates, time until new lesions occur, and the most common side effects.

METHODS Retrospective case-control study of 25 patients who underwent laser resurfacing for widespread AK on the scalp, forehead, or full face at our department. Follow-up varies from 7 to 70 months. Recurrence rates, adverse effects, and improvement were analyzed through chart analysis.

RESULTS The mean average follow-up was 39 months. Forty-four percent of the patients had no recurrence during the time period. Fifty-six percent of the patients developed new lesions after treatment, but only a few. Of the recurrences, 20% occurred within 1 year and 36% occurred after 1 year. The most common short- and long-term side effects were infections (12%), hypopigmentation (48%), hyperpigmentation (8%), acne (12%), milia (12%), scar formation (8%), and atrophic and/or easily bruising skin (20%).

CONCLUSION Laser resurfacing is an effective treatment modality for diffuse widespread AK with long-term recurrence-free intervals.