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Fluorouracil (5-FU) for Nonmelanoma Skin Cancer

Examples

Generic Name Brand Name
fluorouracil (5-FU) Carac, Efudex, Fluoroplex

How It Works

Fluorouracil (5-FU) is an anticancer medicine that works by slowing or stopping cell growth. The medicine interferes with the ability of abnormal cells to grow on the skin's top layer.

5-FU is usually applied once or twice daily for several weeks. It works by causing a painful irritation in actinic keratosis or a skin cancer. Successful treatment results in the specific areas of diseased skin becoming inflamed and crusting as the abnormal cells die.

Why It Is Used

5-FU cream or solution is used to treat actinic keratosis and basal cell carcinomas that are superficial (only in the top layer of skin). It can also be used to treat some squamous cell carcinomas in the eye.1

How Well It Works

This medicine works well for treating superficial actinic keratosis.2 If you have superficial basal cell carcinoma or squamous cell carcinoma in situ and surgery is not possible, your doctor may suggest treatment with 5-FU cream.

Studies show a clearance rate of 90% when 5-FU cream is used to treat superficial basal cell carcinoma and 27% to 85% when this cream is used to treat squamous cell carcinoma in situ.3 Treatment with 5-FU does not usually cause scarring.

Side Effects

Side effects from fluorouracil (5-FU) treatment are common and include:

  • Redness and swelling.
  • Signs of infection.
  • Burning and oozing.
  • Pain and itching.
  • Skin color changes.

It is expected that people receiving 5-FU treatment will experience pain and burning while the medicine works to destroy the skin disease. It may be hard to tell the difference between the expected action of 5-FU on your skin and an allergic reaction.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

People treated with 5-FU will need to have regular follow-up visits with their doctors to make sure the skin cancer is gone.

Your skin may be sensitive to sunlight during your treatment with 5-FU. So you will need to protect your skin from the sun.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Grossman D, Leffell DJ (2008). Squamous cell carcinoma. In K Wolff et al., eds., Fitzpatrick's Dermatology in General Medicine, 7th ed., vol. 1, pp. 1028–1036. New York: McGraw-Hill Medical.
  2. Habif TP (2010). Premalignant and malignant nonmelanoma skin tumors. In Clinical Dermatology: A Color Guide to Diagnosis and Therapy, 5th ed., pp. 801–846. Edinburgh: Mosby Elsevier.
  3. Love WE, et al. (2009). Topical imiquimod or fluorouracil therapy for basal and squamous cell carcinoma: A systematic review. Archives of Dermatology, 145(12): 1431–1438.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Randall D. Burr, MD - Dermatology
Last Revised October 1, 2010

Last Revised: October 1, 2010

Author: Healthwise Staff

Medical Review: Kathleen Romito, MD - Family Medicine & Randall D. Burr, MD - Dermatology

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