It has been estimated that approximately 4 million Germans are suffering from actinic keratoses, which are considered as a carcinoma in situ today. Typically, actinic keratoses appear in sun-exposed skin areas, conventionally they have been treated by curettage and cryotherapy. In the last years, new therapeutic modalities with a high efficacy and patient contentment are available. Among these, the photodynamic therapy (PDT), the anti-tumor treatment with 3 % Diclofenac in 2.5 % hyaluronic acid as well as the introduction of Imiquimod as an immune response modifier are the most important. The rate of complete clearance from actinic keratoses varies between 50 and 90 % in clinical trials. In contrast to the conventional treatment modalities, these new options promise advantages in the treatment of field and offer excellent cosmetic outcomes, too. This overview will report on the actual treatment opportunities and a careful consideration in the year 2006.