What are actinic keratoses (AKs)?
Actinic keratoses are rough, scaly sun-damaged patches that can progress to skin cancer if untreated. They occur on sun-exposed areas such as the face, scalp, ears, hands, and forearms.
About this treatment
- 5-Fluorouracil (5-FU) targets abnormal sun-damaged skin cells
- Calcipotriol (vitamin D analogue) enhances the immune response
- Used together, treatment is shorter and more effective than 5-FU alone
- The creams are purchased separately and mixed before use
How to apply
Preparation
- Wash with water or a gentle soap-free cleanser
- Pat dry and wait until skin is completely dry
Application
- Mix 50% 5-FU (Efudix) + 50% calcipotriol
- Apply a thin layer with a clean finger or cotton bud
- Do not cover with a dressing
- Wash hands after use
Treatment schedule
- Face, chest, scalp: twice daily for 4 days
- Lip: twice daily for 2 days
- Hands, forearms, legs: twice daily for 6 days
Apply in the morning and 1–2 hours before bed.
Expected skin reaction
Redness, burning, itching, peeling, and crusting are expected and indicate the treatment is working.
Contact your dermatologist if pain is severe, ulceration develops, or symptoms are concerning.
Managing irritation
- Cool compresses
- Paracetamol up to 1 g, four times daily
- Gentle skincare only (soap-free wash)
- Plain emollients: Dermeeze, Aquaphor, Vaseline
- Saline soaks: ½ tsp salt in 1 cup cooled boiled water, apply for 5–10 minutes daily
Important precautions
- Strict sun protection during and after treatment (hats, clothing, SPF)
- Avoid eyes, lips (unless directed), and mucous membranes
- Avoid use during pregnancy or breastfeeding — inform your doctor
Follow-up
Your dermatologist will review your response.
Seek review early if the skin becomes very painful, inflamed, ulcerated, or crusted.
Ongoing sun protection is essential to reduce recurrence and skin cancer risk.
Dr Anes Yang 