Introduction: The aim of the study was to evaluate the results on effectiveness and safety of topical treatment for actinic keratosis (AK) with ingenol mebutate gel (IMG) in real-life conditions and to perform an analysis of the factors that may influence the treatment outcomes.Materials and methods: Retrospective study of patients with non-hyperkeratotic AK lesions prescribed with IMG in Spain according to clinical practice. Dermatologists reported the characteristics of patients and AK at baseline, and the findings observed up to 60d after treatment.Results and conclusions: A total of 260 treatments in 246 patients with a mean (SD) age 70.6 (10.4) years were reviewed. The number of clinically visible AK in the treated area decreased from 6.16 (3.02) to 1.22 (2.02) (p<.001) lesions with an average reduction of 84%. Univariate analysis showed higher reduction rates when IMG was applied in the face/scalp (p=.026), in women (p=.041), and in patients under 70years of age (p=.033). According to multivariate analysis, advanced age was associated with worse clearance rates (p=.038). However, besides statistical significance, we can conclude that gender (female) and age (under 70years-old) show a tendency to have better efficacy outcomes but without clinical relevance. Topical IMG was generally well tolerated and had positive cosmetic results after 60d. Age influences on IMG effectiveness for AK and LSRs were correlated with higher effectiveness ratios.