5-fluorouracil cream for actinic keratoses

Patient Information: Using 5-fluorouracil cream for Actinic Keratoses

What are Actinic Keratoses (AKs)? Actinic keratoses are rough, scaly patches of skin that develop from years of sun exposure. They are often found on sun-exposed areas such as the face, scalp, ears, neck, arms, and hands. While usually harmless, AKs can sometimes progress to skin cancer if left untreated. 5-fluorouracil is a topical treatment commonly used to manage actinic keratoses and reduce the risk of progression to skin cancer.

How Does it Work? 5-fluorouracil is a topical chemotherapy cream. When applied to the skin, it works by selectively targeting and destroying abnormal cells, including those present in actinic keratoses, while sparing healthy tissue. This helps to clear visible AKs and reduce the risk of underlying precancerous cells.

Instructions:

1. Preparation: Cleanse the affected area with a gentle soap and water, then pat dry with a soft towel. Avoid using any other creams, lotions, or cosmetics on the treated area unless instructed otherwise.
2. Application: Apply a thin layer of cream to the affected area using clean fingertips or a cotton swab. Be sure to cover all visible actinic keratoses and surrounding areas of sun-damaged skin.
3. Frequency: Your dermatologist will advise you on the frequency of application, typically once or twice daily. Follow their instructions closely to ensure optimal results.
   
4. Duration of Treatment: The duration of treatment can vary depending on the extent and severity. Most treatment courses last between 2 to 4 weeks.
   
5. Side Effects: Expect to experience redness, inflammation and mild crusting during treatment. These side effects typically peak around the second or third week of treatment and gradually subside after discontinuation. If you experience severe or persistent side effects, contact your dermatologist for guidance.
6. Sun Protection: During treatment and during the healing process, protect the treated areas from sun exposure by wearing protective clothing, wide-brimmed hats, and using broad-spectrum sunscreen with SPF 30 or higher.
7. Follow-up Appointments: Attend all scheduled follow-up appointments to monitor your progress, assess treatment response, and address any concerns or side effects.

While (5-fluorouracil) is an effective treatment for various skin conditions, it does carry certain risks and potential side effects. It’s essential to be aware of these risks before starting treatment. Common risks include:

1. Skin Irritation: Often causes redness, inflammation, itching, burning, and stinging at the site of application. These symptoms are common and usually peak around the second or third week of treatment before gradually improving.
2. Crusting and Peeling: The treated area may develop crusts, scabs, or patches of dry, flaky skin. This is a normal part of the healing process and typically resolves after discontinuing treatment.
3. Pain and Discomfort: Some individuals may experience discomfort or pain, particularly in areas where the skin is thin or sensitive. This can occur during the application of cream or as a result of skin irritation.
4. Photosensitivity: The cream can increase the skin’s sensitivity to sunlight, making it more prone to sunburn and damage. It is essential to protect the treated areas from sun exposure by wearing protective clothing and applying sunscreen with a high SPF rating.
5. Allergic Reactions: While rare, some people may experience allergic reactions characterised by rash, itching, swelling, or difficulty breathing. If you develop signs of an allergic reaction, discontinue use and seek medical attention immediately.
6. Secondary Infections: In some cases, treatment can lead to the development of secondary bacterial or fungal infections in the treated area. Watch for signs of infection, such as increased redness, warmth, swelling, or discharge, and notify your healthcare provider if you suspect an infection.
7. Eye Irritation: Avoid getting cream in your eyes, as it can cause irritation and discomfort. If accidental contact occurs, rinse thoroughly with water and seek medical advice if symptoms persist.
8. Systemic Absorption: Although rare, there is a risk of systemic absorption of Efudix, particularly if applied to large areas of the skin or used for an extended period. This can lead to systemic side effects, such as nausea, vomiting, diarrhoea, or bone marrow suppression.

For personal use only. Intended for the patients of Dr Anes Yang. Please refer to the disclaimer.