The
“We treat people, not just problems.”
John
L. Pfenninger, M.D.
(989) 631-4545
Visit our
website at: MPCenter.net
EFUDEX USE FOR SUN CHANGES ON THE SKIN
5-Fluorouracil
(Efudex) is a cream that is commonly used to treat sun changes on the skin that
are precancerous. These precancerous
changes are called actinic keratoses.
Actinex or Fluoroplex are two other brand creams that can also be used.
There are
many ways to treat actinic changes.
Freezing (cryotherapy) is often performed with either liquid nitrogen or
nitrous oxide. If there is only a spot
or two, this works very well. Lesions
can also be cut out with a scalpel.
However, when the changes are extensive and cover many areas of the
forehead or the scalp, then it is better to use a cream.
5-Fluorouracil
as a liquid can be injected intravenously to treat internal cancers. So, using this cream on the skin is a type of
chemotherapy. When destroying the
abnormalities on the skin, the cream can make the skin very raw. It can ulcerate and also ooze. It may dry out and feel very tight. However, it will prevent actinic keratoses
from becoming a cancer.
The
treatment protocol requires applying the cream twice a day to the entire facial
area that the doctor recommends. If the
hands or the arms are involved, the cream may even have to be put on three or
four times a day there. After a few
days, redness, ulceration, and crusting will be noted. It is good to see the doctor again two weeks
after starting it to see how the treatment is progressing. Usually the cream is still applied for
another two weeks (four weeks total) and then it is stopped. Gradually the skin heals and will be red for
four to six weeks afterward. All the
scaly sores should go away. If there are
any abnormal areas that remain when the doctor re-checks you at six to eight
weeks after stopping the Efudex, they need to be biopsied because they could be
a cancer that is resistant to this therapy.
Even small cancers may go away with the cream, however.
During
treatment, your skin will become very dry, crusty, and itchy. You will be miserable. Remember, this is chemotherapy. Keep your skin moisturized with Eucerin
(ointment or cream), antibiotic ointment (Polysporin, Bacitracin), Vaseline,
baby oil, Aquaphor Cream, Alpha-Keri Oil, Cetaphil Lotion, Nivea Skin Oil,
vitamin E ointment, etc… If this does
not work, the doctor can prescribe some cortisone cream to help out.
The reason
all these precancerous “sun changes” occurred is because of sun exposure. After treatment, it is very important that
you not be exposed to the sun while the skin is red, because it will be much
more likely to sunburn. To prevent new
lesions from occurring, it is best to avoid sun exposure. Do this by using a hat, wearing long sleeve
clothes, applying sunscreens, and avoiding the sun during the middle of the
day.
Efudex is a
prescription so it will need to be picked up at the pharmacy. It only comes in one large size tube. We do have a videotape about using it
available for you to watch. There is
also a color brochure from the company to show you what to expect. Many other handouts are also available. Ask the doctor, nurse, or receptionist if you
have questions or would like more information.
Copyright, 2011.
John L. Pfenninger, M.D. Jw02/11