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Common Questions about Topical Chemotherapy Creams

1 of the frequent questions we go here on SkinCancerConnection is about the apply of topical medications used to care for pre-malignant growths such as actinic keratoses which can be a precursor to developing squamous prison cell peel cancer. Three of the most commonly used medications to treat such lesions include Efudex, Aldara and Carac.
Nosotros have asked Doc Lawrence Green, a practicing dermatologist and Assistant Clinical Professor of Dermatology at George Washington University School of Medicine in Washington DC to respond some questions near these topical chemo creams and how they work.

Welcome Doctor Green. Nosotros are glad you could join us hither SkinCancerConnection.

Iii of the well-nigh commonly asked nearly topical chemo creams include: Efudex, Carac, and Aldara. Are in that location any other topical medications commonly prescribed for treating precancerous skin lesions?

Zyclara is a new topical foam that is FDA canonical to treat precancerous skin growths. It is a less potent version of Aldara, and is meant to utilize as "field therapy", pregnant all over 1 area (like the face or arms) instead of just spot treating like Aldara is used. What conditions can be treated with such topical creams? Topical creams are FDA canonical for treating precancerous skin growths called actinic keratoses. Aldara is also FDA approved for treatment of superficial basal cell carcinomas- a less common form of basal cell carcinoma-on the trunk. Some people feel Efudex can also treat superficial basal cell carcinomas on the trunk and in that location are some small case studies that evidence this. In my experience, these medications are best used for treating just precancerous actinic keratoses, and non basal cell carcinomas.

Some members question whether freezing is more effective in treating precancerous lesions such every bit actinic keratoses. What factors go into choosing one handling over some other?

In my opinion, freezing is preferred if the person has just a few precancerous lesions to treat. If they have many, freezing is too cumbersome and a cream is a amend pick. On the other hand, to care for merely ane or 2 spots with a foam daily for a few weeks is a lot of trouble when you can just freeze those few spots in the part chop-chop. I also think freezing gives improve results if yous are treating just a few lesions, because the dermatologist can focus on only those and be thorough. If there are many spots to care for, it is more than difficult to get them all accurately.

What are the possible dangers or side furnishings of using such topical medications on the skin?** Are in that location any patients who should not be using these medications?**

No real dangers, just skin that is precancerous can go very scabbed, ruddy and irritated. Just that is what y'all want and is a desired result. That said, I would not recommend using Carac or Efudex on children or significant/nursing women. For Aldara and Zyclara (which are also used in an off label style to care for warts in children) there are occasional instances of flu like symptoms following their utilize, peculiarly if the person doesn't wash the area where they applied the foam on the forenoon following their bedtime application (approximately eight hours later).

If the medication gets on "normal" skin, what happens?

All of these medications cause the skin to become very scabbed on precancerous pare. They do not touch on skin that is normal even if you put information technology on normal skin. So, that is a good thing. The i exception is intertriginous pare like the penis, groin, vaginal area, axillas, etc. These creams tin can crusade a very irritating rash if information technology gets in that location. So, the best idea is to wash your hands well afterwards you utilise any of these creams and then you don't accidentally bear upon a sensitive expanse later on y'all have applied them.

Is there any part of the trunk where these creams should not exist used?
Some people ask nigh the skin around the eyes.

See higher up, but I would besides be careful on skin in the corners of the eyes and around the eyelids.

What is the full general fourth dimension line for healing from such medications? What can the patient reasonably expect?

Healing should occur nearly two-3 weeks one time you stop using these medications. You should wait all the precancerous areas of your skin (which is usually much more than yous realize) where you use the foam to become red, inflamed and scabbed until a few weeks after y'all terminate using information technology. But people almost ever heal very well and actually their skin looks quite refreshed afterwards it has healed.

Should a patient get concerned when they see redness, scaling, or scabs? Whatever dangers in picking off the scab?

Redness, scaling, and scabs are expected, but please don't option at them. Picking can crusade these areas to become infected. If the scabbed areas bother yous, utilise a topical antibiotic ointment like Bacitracin or Aquaphor. Sometimes, your dermatologist volition prescribe topical cortisone creams to help the redness.

Many members ask nigh what they can safely employ after they are done using the topical chemo creams such as make upwardly, soaps, and general pare care products. They too want to know what products might speed up the healing procedure.

I think gentle cleansers, soaps, and lotions are all OK to utilise. Aquaphor is a groovy idea to help speed upwardly the healing or just help things heal well.

Cheers Doctor Green, for sharing your expertise with us today. For even more information almost topical medications to treat early forms of peel cancer please read Md Kevin Berman's article entitled, Efudex, Aldara, and Other Skin Cancer Topical Creams.

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Anne Windermere

These manufactures were written by a longtime HealthCentral community member who shared valuable insights from her experience living with multiple chronic health conditions. She used the pen name "Simply Me."