...You raise a really great question. I haven't used the cream on my hands, but I do know other users who have. While I can't say for sure how many times a day they used the cream, I do know that many doctors prescribe it for use just once daily. There are many variations in prescribed times and dosage from one patient to the next.
I would guess that if you are going to try to use the cream once daily, your doctor would suggest extending the length of time you will use it. For instance, if you generally treat twice a day for two weeks, your doctor might ask you to use the cream nightly for four weeks. All of that would depend on the severity of your actinic keratosis.
I suggest, as with any dosage questions, that you contact your prescribing physician and tell him/her about your concerns. Your doctor can give you the best guidance on how to modify your application time.
Please keep us posted on what you find out and best of luck as you begin treatment! We are here for you! April, SkinCancer.net, Moderator