There are a number of different treatment options available for management of IEC. The type of treatment selected will depend on where the IEC is located, its size, thickness and how many there are.
Cryotherapy
Liquid nitrogen is sprayed on to the affected area to freeze it. This treatment is suitable for small, flat patches of IEC. After treatment, you will have a scab, which usually falls off within a few weeks. This removes the affected skin.
Creams (topical therapy)
A chemotherapy (anti-cancer treatment) cream called 5-fluorouracil (Efudix), may be used. Clinical studies have shown 5FU to be efficacious in clearing IEC with cure rates of 66-93% reported. Treatment appears to be most successful when Efudix is applied once or twice a day for 6-16 weeks. It can make the skin red and inflamed following treatment. Usually there are no other side effects.
Another cream commonly used is Imiquimod (Aldara), which works by stimulating the immune system to kill the abnormal cells. Treatment takes several weeks and usually causes redness and inflammation to the treated skin
Curettage and Electrocautery
When small patches of IECs are present they may be scraped away (curettage) followed by the use of an electrically heated needle (electrocautery)to stop any bleeding and destroy any remaining abnormal cells. A local anaesthetic is given prior to the procedure to prevent pain and discomfort.
Surgery
Surgery may be used for isolated or small areas of IEC that can removed under local anaesthetic.
are carrying out research trials to find out how effective this treatment is in the long term.
Photodynamic therapy (PDT)
PDT or Photodynamic therapy can be an excellent method of treating skin cancers such as IECs or thin- superficial BCCs. This is a non-surgical treatment for skin cancer that has a very high cure rate, if performed in the correct setting.
PDT uses a special cream called METVIX, which is applied to the skin cancer. The cancerous cells of IECs and BCCs take up this chemical over a period of 3 hours. A special low level laser light then activates the chemical, and destroys the skin cancer cells. Patients will require two treatments spaced a week or two apart.
The advantages of PDT over surgery include-
- Less scarring
- Much less downtime, with minimal restrictions on daily activities of living
PDT is ideal for IECs on cosmetically sensitive areas such as the face, or for IECs that occur on the legs.
Read more about PDT for skin cancers
For those who have larger areas of skin affected by IECs, PDT can be very useful. Clinical trials have shown cure rates from PDT to be to other conventional treatments such as cryotherapy or surgery. The benefit of PDT is that it selectively targets abnormal/cancer cells without affecting the normalhealthy cells therefore cosmetic outcomes are improved.