Forty patients with actinic cheilitis were treated with one of four modalities: topical fluorouracil, chemical peel with trichloroacetic acid, lip shave, or carbon dioxide laser ablation of the vermilion. Patients treated with lip shave or carbon dioxide laser ablation had no recurrence of the problem during a 4-year period. While the lip shave procedure offers the advantage of histologic examination of the specimen, the patients treated with the laser ablation had fewer postoperative complications.