5-Flurouracil (Efudix)

Efudix is an anti cancer drug (5 florouracil) in an ointment form. It is used to treat sun damaged skin and
surface skin cancers, but will not work on 'thick' skin cancers. Any skin cancers that feel 'thick' need to
be removed surgically.
Efudix attacks rapidly developing cells but tends to leave normal skin cells alone. Thus it can be used
over a larger area up to 500cm2 (23x23cm) to treat a field of sun damaged skin. It will even treat sun damaged skin that is not visibile yet. It is not to be used by pregnant women.

Treatment Length
Your doctor will advise you on your treatment length and monitoring, below are general guidelines:
For Actinic keratoses: apply twice daily for three to four weeks
Bowen's disease/SCC in situ: apply twice daily for eight weeks
The efudix is used until the skin is red and irritated. At the end of your Efudix course  a steroid cream (Locoid) may be used twice a day for up to two weeks to calm the inflammation down.

How to apply
Wash skin with water and dry. Apply Efudix thinly with the tip of a finger or cotton bud. Wash hands thoroughly afterwards. The maximum area of skin that should be treated is 22cmx22cm. Take care when using Efudix close to the eyes, lips or opening of the nose. Please keep it at least 1cm away from the edge of your eyes. If it gets in the nose or eyes wash it out. Only use efudix in months were sun light levels are low as it reacts with sunlight which can cause a more severe reaction. Do not use sunscreen while using efudix however you may apply a moisturiser 20 mins after applying the efudix.

What to expect
Areas treated with efudix will become inflamed. These effects include itching, burning, redness, scabbing,
flaking and pain. These reactions indicate that the cream is likely to be effective. Generally, the more intense the inflammation the better the end result! If you develop a severe reaction with black scabs and ulceration, stop applying the cream and arrange to see your doctor as soon as possible.
The time for results to show will vary amongst individuals. The following is a guide as to when to expect results:
• Weeks 1 - 3 - Inflammation with crusting and redness of the skin
• Weeks 4 - 6 - Skin inflammation settling down
• Weeks 7 - 16 - Clearance of the sun damaged skin

Monitoring
Your doctor will want to monitor your progress. Please email a photo after 1 week treatment or sooner if you have any concerns to bruce@skincancerdoctors.co.nz or christian@skincancerdoctors.co.nz. Alternatively you may book a consultation.
If you are concerned about your reaction to the cream or are unable to complete the prescribed treatment
please discuss with your doctor. Following treatment, check in with your doctor a month or two after the skin has settled to discuss ongoing skin management and skin protection.