What is Efudix?

Efudix is “chemotherapy in a cream” which is effective for pre-cancerous sun damage and some types of early skin cancer.

It contains the active ingredient 5-fluorouracil which preferentially targets and kills sun-damaged cells on the top layer of skin.

It is usually used for actinic keratosis or solar keratosis, which are sun-damaged cells that are not yet cancerous.

It can also be used for intraepidermal carcinomas, which are skin cancers which have not invaded through the top layer of skin.

How do I use it

  • Apply a thin layer to the affected area with an extra 5mm border around

  • Use disposable gloves and wash the hands after

  • Avoid the eye area

For actinic keratosis:

  • Use daily at night time, wash off in the morning, for 2-4 weeks

For intraepidermal carcinomas (IECs):

  • Use twice a day- once in the morning and once at night, leaving on for 8 hours at each time wash off 8 hours, for 6 weeks

What to expect?

After about 2 weeks, sunspots should become red, irritated and inflamed.

After 4-6 weeks, the skin lesions will be crusted and peeling. This is a good indicator that the cream is working.

Expected side effects:

  • Mild pain

  • Irritation

  • Itch

  • Redness/inflammation

  • Increased sensitivity to the sun

  • Crusting

  • Scabbing

Unexpected side effects- if you experience any of these stop and seek medical attention.

  • Deep ulceration

  • Nausea/vomiting

  • Fevers and chills

  • Rash all over the body

Efudix reaction to actinic keratosis after 4 weeks

Four weeks of using efudix daily to actinic keratosis, the arm is red, irritated, and skin lesions have become crusted and eroded. Treatment was stopped at this stage.

Efudix reaction to actinic keratosis after 2 weeks

Two weeks of using efudix daily to actinic keratosis, the arm is red and irritated. Treatment was continued for two weeks.

What to do if:

My skin hasn’t reacted

Everyone responds a bit differently to efudix. The arms and lower legs can be slower to react than the face.

If you haven’t had a good reaction, talk to your doctor, and consider using the cream more frequently for longer

My skin has reacted too quickly

If you have responded very quickly to efudix, you may need to stop early or decrease the frequency of use. Consult your doctor for additional guidance.

Do’s and Don’ts

Do’s

Use a broad-spectrum sunscreen, hat or protective clothing while using efudix and for 4 weeks after

Hamilton Sun SPF 50+ Sensitive Lotion

CeraVe Facial Moisturising Lotion SPF 50

Invisible Zinc Face & Body Sunscreen SPF 50

Don’ts

Do not use efudix cream if you are pregnant or breast feeding

Do not apply close to the eyes

Do not continue if you develop significant pain and/or ulceration during the treatment