Topical chemotherapy using prescription creams such as 5-fluorouracil (Efudex or Efucal) provides an effective non-surgical option for treating precancerous skin lesions (actinic keratoses) and select superficial skin cancers, including some cases of superficial basal cell carcinoma. This convenient, at-home treatment is ideal for patients seeking field therapy for sun-damaged skin.
What Topical Chemotherapy Can Treat
Topical chemotherapy may be prescribed for:
- Actinic keratoses (precancerous sun spots)
- Superficial basal cell carcinoma (in select cases)
- Field cancerization (areas with extensive sun damage or multiple lesions)
Treatment & Application
Topical chemotherapy works by targeting abnormal, rapidly dividing skin cells. It is applied directly to the affected area over a course of several days to weeks, depending on the condition and severity.
During treatment, visible inflammation is expected, as the medication destroys atypical cells. This reaction is a sign that the treatment is working.
Treatment plans are personalized, but typical regimens may include:
- Efucal applied twice daily for 4–6 days per treatment area
- Periodic follow-up visits to monitor progress and guide care
Common Treated Areas
- Scalp and forehead
- Face (cheeks, nose, temples)
- Chest and décolletage
- Arms and hands
- Lower legs
What to Know Before Your Treatment
- Avoid sun exposure during treatment, as the skin will be more sensitive
- Inform your provider of any history of allergies, immune conditions, or recent treatments
- Understand that redness, crusting, and discomfort are normal and expected parts of the healing process
What to Expect
Before Treatment
- Full skin assessment with dermooscopy and review of medical history
- Prescription and instructions provided for at-home use
During Treatment
- Skin will become red, inflamed, crusted, and may weep in areas of abnormal cells
- Reactions may intensify during the second and third weeks
After Treatment
- Healing typically begins once the cream is stopped
- Redness and peeling will gradually subside over 2–4 weeks
- Follow-up visit may be needed to assess resolution and skin recovery
Results & Recovery
- Lesions typically resolve completely, and healthy new skin is revealed as healing progresses
- Excellent cosmetic outcomes are possible when aftercare is followed
- A follow-up visit may be needed to confirm clearance or plan further treatment if required
How Long Will Results Last?
Treated lesions do not typically return, but new lesions may develop over time. Ongoing sun protection and skin surveillance are important to reduce recurrence risk.
Is Topical Chemotherapy Right for You?
This treatment is ideal for clients with:
- Widespread actinic damage or field cancerization
- Multiple thin, precancerous lesions
- Select cases of superficial skin cancer not suitable for surgery
Not Suitable If You
- Are pregnant or breastfeeding
- Have open wounds or active skin infection in the treatment area
- Are allergic to 5-fluorouracil or any components of the cream
- Have poor immune function or significant skin barrier disorders
BookingÂ
A referral from your primary care provider is required for topical chemotherapy. Once a referral is received, a consultation and skin assessment will determine if this is the appropriate option for your condition.
