Actinic prurigo is a chronic inflammatory photodermatosis with a higher incidence among Mestizo populations of Latin America. It is more common in females and young patients, usually starting before the second decade of life. The disease typically shows a chronic clinical course, exacerbating after sun exposure. The sun-exposed areas of the skin are the most affected regions, and the conjunctiva can also be involved. In the skin and the vermilion border of the lower lip, it more often manifests as macules, papules, plaques, excoriations, serohematic crusts, areas of lichenification, scars, hypo- or residual hyperpigmentation, and very often with labial edema. Severe pruritus of the lower lip occurs in over 80% of the cases, and actinic prurigo cheilitis may be the only manifestation of the disease in approximately 27% of the patients. Microscopically, particularly in labial and conjunctival biopsies, it is characterized by acanthosis, hyperkeratosis, and spongiosis, with vacuolization in the basal layer of the epithelium. In the lamina propria, there is a dense lymphoid infiltrate with well-formed lymphoid follicles and the presence of eosinophils and macrophages. Treatment is challenging and requires protection from sun exposure, along with the use of thalidomide, with or without steroids.