Topical field treatment for solar keratoses

What is field treatment?

Field treatment treats an area containing multiple solar keratoses and surrounding sun-damaged skin, rather than just each visible spot.

Assessment and choosing a preparation

Your doctor examines the area and checks suspicious lesions before agreeing a plan. The number of lesions, previous skin cancers, repeated episodes, your priorities and the likely reaction influence treatment choice.

Topical options used in practice include diclofenac, fluorouracil and a compounded combination of fluorouracil with calcipotriol. They differ in application schedule, course and intensity of reaction. A gentler option may suit someone who prioritises less inflammation; a stronger field treatment may be considered where skin cancer risk is higher.

You receive instructions for the exact preparation, area, frequency and duration. Apply it to the whole prescribed field, rather than only visible lesions. The short combination course is different from fluorouracil used alone; follow your own prescription rather than another patient’s schedule.

During treatment

Redness, tenderness, peeling, crusting, sores or swelling can occur. With fluorouracil/calcipotriol, the reaction may continue to build for a couple of days after applications finish. Hands and arms may react more slowly; do not extend treatment unless your doctor directs you to.

If you are concerned enough to pause a topical course, you can pause while arranging prompt review. Do not restart, extend or change the preparation without an agreed plan. See the field treatment recovery guide for comfort measures and when to seek assessment.

Recovery and review

Protect the area from sun exposure and follow your written aftercare. Attend any arranged review. Persistent or changing spots need reassessment and sometimes biopsy. If treatment is discontinued early, return about a month later to assess whether another approach is needed.

Fees

See our assessment fees. Pharmacy costs vary with the preparation; indicative costs will be explained at assessment.

Appointments and ongoing care

Initial assessment and prescribing require an in-person appointment in Melbourne. For an area already assessed or treated, contact reception to arrange follow-up, including a phone consultation where appropriate. A photograph before that consultation may help your treating doctor. We do not diagnose new skin conditions from emailed photographs.