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Joanna Emilio,1 Michelle Schwartz,2–4 Eleanor Feldman,2–4 Amy Kalowitz Bieber,2–4 Amanda Bienenfeld,2–4 Min-Kyung Jung,1 Daniel M Siegel,2,3 Orit Markowitz2–4 1Department of Dermatology, NYIT College of Osteopathic Medicine, Old Westbury, 2Department of Dermatology, SUNY Downstate Medical Center, 3Department of Dermatology, NY Harbor Healthcare System, Brooklyn, 4Department of Dermatology, Mount Sinai Medical Center, New York, NY, USA Abstract: Actinic keratoses (AKs), especially on areas of the face, have a negative impact on a patient's quality of life (QoL). These lesions manifest on sun-damaged skin and have the potential to progress to squamous cell carcinoma. Field-directed therapy alone and in combination with lesion-directed treatment is effective in clearing both visible and nonvisible AK lesions. Topical treatments of AKs thus have the potential to improve a patient's well-being. However, evidence demonstrating improvements in patient QoL is limited, and is mostly based on observational or retrospective studies. Some prospective studies have reported unchanged or even worsening QoL despite excellent treatment outcomes. Our prospective, pilot study demonstrated a significant increase in QoL in 28 subjects with AKs of the face treated with ingenol mebutate gel 0.015%. QoL was assessed at days 0 and 60 using the Skindex-16 survey. Mean overall scores improved from 24.5% at baseline to 15.5% at day 60 (P=0.031). Improvements in QoL were consistent with an 80% reduction in AK lesion number at day 60. These improved QoL findings are in line with those from a recent retrospective study using ingenol mebutate 0.015% gel. This study therefore further demonstrates the potential for field therapy to improve both treatment outcomes and patient satisfaction. Keywords: actinic keratosis, squamous cell carcinoma, ingenol mebutate gel, local skin reaction, quality of life, Skindex-16