Clinical and Histologic Evaluation of Picato 0.15% Gel in the Cosmetic Improvement of Photoaged Skin

Inclusion Criteria: * Subjects must be adults aged 45-75 years of age. * Subjects must be in good general health as confirmed by the medical history. * Subjects must be able to read, sign, and understand the informed consent. * Subjects must meet the criteris for Glogau Photoaging class III or class IV. * Subjects have a diagnosis of actinic keratosis. * Subjects must be willing to apply Picato 0.015% gel * Subjects must be willing to forego any other treatments on the face, including cosmetic treatments, tanning bed use, and excessive sun exposure while enrolled in the study. * If a subject is a female of childbearing potential she must have a urine pregnancy test result prior to study treatment initiation and must agree to use an approved method of birth control while enrolled in the study. Exclusion Criteria: -. Subjects with a history of melanoma anywhere on the body. * Subjects with any unstable medical condition as determined by the clinical investigator. * Subjects with untreated non-melanoma skin cancer on the face or within the treatment area. * Subjects with dermatitis or any dermatologic disease in the treatment area that would obscure the evaluation of photoaging parameters. * Subjects who have undergone any form of 'field treatment' including 5-fluorouracil, photodynamic therapy, or ingenol mebutate in the preceeding six months. * Women who are pregnant, lactating, or planning to become pregnant during the study period. * Subjects who have experienced a major medical event (including stroke, heart attack, etc) within 90 days of starting the study. * Subjects who have active substance abuse disorders. * Subjects who have known allergies to any components of the study drug. * Subjects who are currently particpating in another clinical trial or who have completed a study involving laser, systemic, or topical treatment of the face within 30 days prior to study treatment initiation. * Subjects who have received any of the following within 90 days prior to study treatment initiation: * Interferon or interferon inducers * Cytotoxic drugs * Immunomodulators or immunosuppressive treatments (except inhaled or intranasal corticosteroids) * Oral or parenteral corticosteroids * Topical steroids to treatment area * Any dermatologic procedures or surgeries to the treatment area, including cryosurgery for AKs * Subjects who have used any topical prescription medications on the study area within 30 days prior to study treatment initiation