Efudix or 5 FU cream is a commonly prescribed treatment for sunspots, solar keratosis and Bowen’s disease. This treatment has been readily available in Australia for the past 20 years and is the cream of choice for both Skin Cancer Doctors and Specialists. It destroys sun damaged skin and abnormal cells. Efudix can be used on most areas of sun damage, with treatment regimes lasting between 2- 8 weeks.
Important Facts on Efudix for Sunspots
Solar keratosis or sunspots are very common pre cancerous lesions, seen in over 25% of Brisbane’s population over the age of 40. The high UV radiation in Queensland predisposes their residents to sun-damage and solar keratosis.
Solar keratosis, also known as sunspots, present as red, scaly, rough, dry and sometimes stingy persistent patches on the face, neck and hands. Sun spots should be treated due to their pre cancerous potential. Treatment depends on your age, location of sunspots, and your lifestyle.
Read more about treating solar keratosis – sunspots
Efudix is also known as 5FU or FLUROURACIL topical. This is chemotherapy for sun spots, solar keratosis, and some forms of skin cancer including intraepidermal cancers (Bowen’s disease or SCC insitu). It does not work well for the treatment of BCC or Basal Cell Cancers.
Efudix is a chemotherapy and works by destroying abnormal skin cells, cancerous cells and pre cancer. The more sun-damage you have, the bigger the reaction.
Patients need to apply the cream twice a day for a specified time frame (on average 3 weeks to allocated areas.
Day 1-4: Mild reaction, not much may happen during the first few days of treatment, persist as per application guide.
Day 4-8: Efudix starts kicking in, and the skin will be red, slightly at first, increasing as the days go by.
Day 8-14: This is when things really start to cook. The skin may have a mild, moderate or severe stinging or burning sensation, and you may start to itch. Dry crusty areas will form. Your skin is now looking angry and irritated. These are all normal reactions following Efudix application. As the treatment continues, sores and crust may appear.
Day 14-21: You will need to see your Specialist or skin cancer doctor during this period. During this appointment, we will check your progress, and determine how much longer you should be on the cream. We may prescribe an anti-inflammatory cream to help you recover from Efudix once the treatment stops.
Day 21-28: Your skin will start to heal. Slowly at first, then more rapidly after 3 days of stopping Efudix. Redness may take a few weeks or months to settle.
Your skin cancer doctor- specialist will give you an extensive and comprehensive treatment guide before you commence on Efudix treatment.
Most treatment regimes are tailored according to your skin condition and lifestyle factors.
Efudix has a great safety record spanning over two decades, however this treatment should not be used if-
Time limits will vary between 2-8 weeks, depending on your treatment regime for sun spot clearance.
No. The treated areas should NOT be covered with makeup or sunscreen. You may start using cosmetics and skin care 3-5 days after stopping Efudix Cream.
Redness will ensure for the course of treatment, and will take upto 3-4 weeks to settle down. In patients who are red to begin with (rosacea type skin), Efudix is not the first choice treatment. Treatment with either 1927 Fraxel Laser or with PDT is considered a better choice in this patient subgroup.
In most patients, redness following Efudix treatment will start to settle within 3-5 days of stopping the treatment.
Specialists and leading skin cancer doctors can give you treatment options for removing sunspots, apart from Efudix. Treatments such as Fraxel Laser or PDT can be an excellent method of sunspot removal, without the 4 week downtime of Efudix. A suitable treatment will depend on downtime, convenience, and costing for each patient.
|Fraxel 1927||5-7 days||From $990||Cost; may need two procedures if severe sun damage||One off treatment, very quick recovery time – less than 7 d.||Helps with skin rejuvenation|
|Efudix||21-28 days||$160+ including follow up||Downtime, follow up visit mid treatment||Cost effective, works very well||*Best option if downtime is not an issue and tolerable skin type|
|PDT –photodynamic therapy||7-8 days||$2500- $3500Face and scalp||Cost||Short downtime, very effective, one off application||Good treatment for smaller areas of sun-damage. Eg upper lip|
|Picato||5-7 days||$150 for 5 cm by 5 cm||Cost; variable levels of inflammation.||Shorter downtime||Variable inflammation; needs physician monitoring.|
|Aldara||4-8 weeks||$300-$700 including follow ups||Long treatment regime||–||Limited use|
Regardless of bad press, Efudix is still considered a very effective and cost effective treatment for sun spots, solar keratosis and sun damage. The downside of this treatment is the prolonged regime of Efudix. Downtime can be up to 8 weeks or longer.
Shorter treatments for sunspots include –
Read more about Fraxel laser for sunspots
Read more about PDT