Patient Experiences and Real-World Evidence on Actinic Keratosis, With Mark S. Nestor, MD, PhD

Mark S. Nestor, MD, PhD, spoke in a recent interview on-site at the 2025 Fall Clinical Dermatology Conference with HCPLive regarding 1 of his presentations at the meeting titled ‘The Reality of Actinic Keratosis: Centering Patient Experiences and Real-World Evidence.’1

Nestor, known for his work as the director of the Center for Cosmetic Enhancement and of the Center for Clinical and Cosmetic Research in Aventura, Florida, spoke in this interview about his session’s biggest highlights related to treating and managing actinic keratosis.

“It's Todd Schlesinger and myself, and we talked about the use of topicals and photodynamic therapy,” Nestor said. “Not just with the treatment of activity keratosis, but also with the treatment of superficial skin cancers. And these were studies that we performed in our research center, using both types of photodynamic therapy, both the gel and the liquid, so Levulan and Ameluz, with blue and red light. Both of them showed, literally, 100% clearance with 2 treatments of squamous cell carcinoma in situ.”

Nestor highlighted another study in which the incidence of skin cancers was noted, with the rise in skin cancer and squamous cell carcinomas being singled out.

“About 72% were squamous [in our study], including squamous cell carcinoma in situ, and more aggressive squamous cell carcinomas,” Nestor said. “We delved into why this is happening. And the thought process is that, certainly, early on, sun blocks were primarily UVB-based…UVA is much more associated with squamous cell carcinoma and melanoma, whereas UVB is much more associated with burns and with basal cell carcinomas. Now, because patients are putting on UVB sunblocks, they stay out much longer, and the sunblocks, even modern sunblocks, are not doing a great job with UVA.”

As a result, Nestor noted, patients are consequently being exposed to much more UVA.

“We need to start really thinking about making sure that we're blocking UVA, because we're seeing the issue of a tremendous uptick in squamous cell carcinoma,” Nestor said. “The thought process is that we need to aggressively treat actinic keratosis so that they don't turn into squamous cell carcinomas as well.”

For any further information on Nestor’s sessions at Fall Clinical, view his full interview segment posted above.

In this summary of his interview, the quotes used were edited for the purposes of clarity.

Nestor has reported serving as a consultant for Revian.

References

1. Nestor M, Schlesinger T. Seminar-in-Depth: The Reality of Actinic Keratosis: Centering Patient Experiences and Real-World Evidence. Session presentation at the 2025 Fall Clinical Dermatology Conference, Las Vegas, Nevada, Oct 23-26, 2025.