Topical Treatments for Basal Cell Carcinoma and Actinic Keratosis in the United States

SIMPLE SUMMARY: Basal cell carcinoma and actinic keratosis are two of the most common cutaneous lesions identified in the dermatology clinic. There is established evidence suggesting that topical treatments play a significant role in treating early forms of superficial BCC while also lowering the economic burden of healthcare by alleviating the need for unnecessary biopsies. Considering the expected continued rise in prevalence of BCC and AK in the coming years, topical therapies can decrease the cost of treatment, limit in-office procedures, and lessen the risks associated with surgery, including infection and scarring. ABSTRACT: Skin cancer is an overarching label used to classify a variety of cutaneous malignancies. Surgical excision procedures are the commonly used treatments for these lesions; however, the choice to perform operative intervention may be influenced by other factors. Established research and literature suggest that topical treatments limit the need for surgical intervention and its commonly associated adverse effects, including infection and scarring. In addition, the growing indications for the usage of topical therapies in BCC treatment, as well as their increased availability and therapeutic options, allow for their greater applicability in the dermatology clinic. Certain topical therapies have been highlighted in research, especially those targeting basal cell carcinoma (BCC) and actinic keratosis (AK). There is also a clear correlation between cost and treatment outcomes, considering BCC’s ever-growing prevalence and the proportion of excised lesions being reported as malignant. This review will discuss BCC and AK lesion criteria that result in the most successful outcomes using topical treatments, then highlight the various topical treatment options, and finally address their clinical significance moving forward.