To evaluate the impact of actinic keratosis (AK) and the effect of four AK treatments on the health-related quality of life (HRQoL), the Skindex-29 and AKQoL questionnaires were completed by 624 patients with AK participating in a randomized controlled trial (RCT) comparing 5% fluorouracil-cream, 5% imiquimod-cream, methyl-aminolevulinate photodynamic therapy (MAL-PDT), and 0.015% ingenol mebutate gel. Patients completed the questionnaires at baseline and 12 months post-treatment.