In the treatment of actinic keratosis, various topicalagents are used for treatment of field cancerization as well as lesionaldestructive treatments. In this case report, it was aimed to present a photographic follow-up of a patient whodeveloped severe local irritant reaction by usage of topical 5% fluorouracilbut is very satisfied with the long-term anti-aging effect and to emphasize theplace of 5-fluorouracil in photoaging treatment. Topical 5-Fluorouracil 5%cream therapy was recommended for widespread actinic keratosis lesions in a67-year-old female patient who had previously undergone non-melanoma skincancer surgery. On day 20 of treatment, a severe local irritant reactiondeveloped. Severe local reactions were controlled by skin supportive therapy.It was observed that the patient does not have actinic keratosis recurrence inthe second year following treatment, has significant improvement in photoagingand is satisfied with the treatment. Topical 5 fluorouracil treatment treatsboth actinic keratoses and field cancerization, prevents actinic keratoses fromdeveloping and simultaneously treats photoaging. Considering all this, topical5-fluorouracil treatment, which is very economical, seems to be the treatmentmethod that should be preferred in the treatment of actinic keratosis.