HPV Vaccine Significantly Reduces Actinic Keratosis Lesions - EMJ

HPV Vaccine Significantly Reduces Actinic Keratosis Lesions

A new clinical trial has found that the human papillomavirus (HPV) vaccine may significantly reduce the burden of actinic keratosis (AK) in immunocompetent adults. AK is a common precancerous skin condition, often requiring ongoing treatment and contributing to substantial healthcare costs and patient morbidity.

The VAXAK trial, conducted at Bispebjerg University Hospital in Copenhagen, Denmark, enrolled 70 adults aged 69 to 79 years with at least 15 AK lesions in a defined test area. Participants were randomly assigned to receive either a standard 9-valent HPV vaccine or a sham saline injection at 0, 2, and 6 months. Thick AK lesions were treated with cryotherapy at months 6 and 9, but no other treatments were given to the test areas during the study.

Results from the 12-month double-blind, placebo-controlled trial revealed that the vaccinated group consistently experienced greater reductions in AK lesions than the control group. By month 2, the median reduction in AK count in the HPV group was 35% compared to 25% in the sham group. By month 6, this difference had grown to 47% vs 29%, respectively, both results reaching statistical significance. Improvements continued through months 9 and 12, though not all comparisons remained statistically significant.

In addition to total lesion reduction, the vaccinated group also showed fewer thick Aks, those more likely to progress to skin cancer, than the control group. However, no meaningful differences were found between groups in terms of new AK development or rates of keratinocyte carcinoma (KC), a type of skin cancer.

These findings suggest that HPV vaccination may offer a novel therapeutic approach for managing AK, particularly in older adults with a high lesion burden. Given AK’s chronic and recurrent nature, and its potential to progress to squamous cell carcinoma, the use of HPV-targeted vaccines may represent a valuable addition to dermatological care strategies. Further research is needed to explore long-term benefits and the vaccine’s preventive potential in broader populations.

Reference

Wenande E et al. Human papillomavirus vaccination and actinic keratosis burden: the VAXAK randomized clinical trial. JAMA Dermatol. 2025;161(6):605-14.

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