Debates on actinic keratoses (AKs) are increasing. The notion that AKs are harmless precursor lesions is no longer accepted. AKs are now considered a smooth transition toward squamous cell carcinoma, a process that is confirmed by molecular and genomic analysis. Increasing age and life-spans, together with high doses of cumulative ultraviolet exposure, are important risk factors in patients with AKs. Humans with skin type I to III are more commonly affected. Guidelines and recommendations from Europe (Germany, Great Britain, France, Italy, and Spain), USA, and first of all Australia underline the international interest. Besides the increasing interest in primary and secondary prevention, the focus is on the effectiveness, sustainability, and tolerability of the treatment procedures, and the outcome of combined approaches. This overview on the broad spectrum of standard therapies offers an update on treatment results and side effects. It also highlights the preliminary studies of sequential therapies, meant to be useful in daily practice.