Efudix (5FU, 5 Fluorouacil) Cream & Solaraze Gel

This is a great treatment for actinic keratoses and for some Bowens disease (IEC)
because it has a very high clearance rate

However, it does to be use with care and by those with some experience. The treatment does cause a vigorous inflammatory reaction which can look alarming.
On lower legs it can produce ulceration and slow healing wounds, so it does need to be used with care

I treated BBC Radio Nottingham presenter John Holmes with Efudix for his solar keratoses. John took a photo of his treatment daily and has posted a record of his treatment on the BBC website. You may find this useful if you are planning starting a patient on Efudix or if you are a patient who has been given Efudix.

Click here for Efudix Treatment images 1

Click here for Efudix Treatment images 2

Click here for Efudix Treatment images 3

The treatment for John’s SK by 5fu has been published in a journal
Varma S. Treating actinic keratoses with Efudix® cream.
Dermatology In Practice, Volume 15, Number 2.

For more information Efudix

The drug company produced an educational resource when centred around John’s treatment.

Klisyri

For non-hyperkeratotic nonhypertrophic SK of face and scalp
O.d 5d
7/10 patients 75% clearance at 2m

Mild / moderate LSR - redness flaking scaling crusting swelling blistering ulceration, peaked 8 d after starting and resolved within 2-3 w.

5x5 cm area

Solaraze gel

An alternative to Efudix is Solaraze gel. I also use this for SK and have about 7-8 years experience with it. This drug works well for SK clearing over 75% of SK in several clinical trails (refs). It produces much les inflammation and may be more cosmetically acceptable to use.

Other topical alternatives to Efudix or Solaraze include Picato, Aldara, Zyclara, Aktikerall.