The Preventive Role of Fractionated Laser Resurfacing Against Actinic Neoplasia in an At-Risk Geriatric Population

Inclusion Criteria: * Adult Males and Females aged 60 and older * Have at least 5 AKs on each forearm/wrist, but no more than 10 to allow for easy monitoring * Skin type fair (Fitzpatrick I-II) * Females must be post-menopausal and not be on systemic hormone replacement therapy * Able to comprehend procedures and risks Exclusion Criteria: * More than 10 AKs on an extremity * AKs that are large (2-3+, hyperkeratotic grade 3 lesions) * AKs that are very thick (\>3 mm) * Medical history of diabetes * History of poor wound healing or scarring * Large tattoos that can interfere with study * Other serious health issues and other skin diseases that could interfere with the study * Recent (within 1 year) field therapies such as efudex cream or PDT to forearms/wrists. * Planning to leave region in next 5 years * Subjects with allergies to xylocaine will be excluded if they need this topical anesthetic.