Treatment of Actinic Keratoses Lesion-directed therapy or field-directed therapy Treatment options depend on the number of lesions, their location, extent of photodamage, and patient preference, but typically they are divided into two categories: Lesion-directed therapy Field-directed therapy In lesion-directed therapy, individual lesions are physically removed. This option may be better if the patient has only a few actinic keratoses, or if the patient is unable or unwilling to undergo other therapy options.