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5-fluorouracil & calcipotriol for actinic keratosis
My doctor has prescribed a combination 5-fluorouracil and calcipotriol topically for solar actinic keratoses on my face. Has anyone undergone this regimen? Is it as bad as it appears to be on Dr. Google? Does the treatment work? What have you is most useful to reduce pain? Are cold compresses or acetaminophen allowed or helpful? Tips for keeping the cream from getting in your eyes? How close to the hairline and onto neck do you apply it? Long-term is your skin more sensitive? Has anyone used low-level light therapy (LED) to promote healing after completing the regime? Any insight or tips you can share would be greatly appreciated. I’m so very apprehensive.
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I'm into the 5th day after stopping the compound cream. Less red and inflamed, but still a little burning sensation. Now the skin is starting to peel.
My doctor said no makeup.
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1 ReactionI have used fluorourcil several times. The last time was several months ago. I used it around my mouth, chin and just under the chin. I had a massive reaction that still has not completely healed. Also on my lower lip which has peeled chronically for years. I had large, angry sores with very thick scabs every place I applied it. I may have made it worse by trying many things that I hoped would speed the healing. Tea tree oil, various essential oils, calamine lotion, hydrogen peroxide, aloe Vera cream, hydrocortisone, Aquaphor, bacitrin, vitamin C serum and maybe others that I have forgotten. My doctor told me to never use it again. I had him take two biopsies in the worst areas to be sure it wasn’t skin cancer. It was hard not to pick at the scabs but it is finally healing.
Sorry you had such a rough experience. I only used a mild Vanicream moisturizer sparingly.
Hello< . I will be using flourouracil on my nose. I wear glasses, so what suggestions do you have for keeping it out of my eyes.
I am on the same regime now. My dermatologist says to apply one tiny dot to al regions of the face to get it all over the face and swirl it around to reach all parts of the face. Never heard of just applying it to the nose! It's a very mild treatment Only a tiny dot is used. I have used Aldara and thats very strong, was bleeding alot and looked like a burn victim. Worth it- beautiful clear baby skin after treatment. Carac ( same as fluro ...5percent and c .... 005percent - is a very good combo - it's what's used effectively in the research literature and articles.
The tiny dot you apply just sinks into skin it never gets in the eyes unless you use your hands to spread it and then rub your eyes. You wash your hands after applying it so you don't accidentally get it in your eyes. It's compounded as a cream and only a tiny dot is used so there is never any migration into the eyes. If you are still concerned then first apply vaseline or a barrier cream around the eye area before application. Oh -I see you are new to this treatment and some Dr's will just try on nose first to see how well you tolerate it. I just came from the blue light treatment too and there aren't many AK's left to cause irritation. If you have the blue light treatment yearly then you are in good shape.
@annmckearin Welcome to Mayo Clinic Connect. As you have read through this discussion, I'm sure you have seen many different types of responses to a topical regimen.
As @sjs1 said, you will only need a little dot, spread evenly. In my experience, I had applied the flourouracil on my face where my dermatologist said, and then other areas also responded. Boy, was I freaked out! Thought it was an allergic reaction, but it was the medication doing its job. LOL Don't touch your eyes, or mouth. Wash your hands thoroughly [or wear a glove to apply the cream].
When do you start?
Ginger
@emilygordon I reacted to any treatments - over reacted I should say. My skin looked horrible after any treatments. I gave up because I can't go out anywhere for weeks and the itching and my inability to not touch is impossible.
Wish there were some other treatment alternatives; I'd prefer a good plastic surgeon to take off the worst AKs than any more creams and junk that goes on for eons...
@slarson14
Prevention is best
💊 Nicotinamide for AK and skin-cancer prevention:
Nicotinamide = niacinamide (the non-flushing form of vitamin B₃ — not niacin).
Best evidence: NEJM 2015, ONTRAC trial — 386 high-risk patients.
• Dose: 500 mg twice daily (with food).
• Duration: Continuous use; benefit fades when stopped.
• Effect:
• ↓ Actinic keratoses by ≈ 23 %
• ↓ New non-melanoma skin cancers by ≈ 20–30 %
• Mechanism: Enhances DNA-repair enzymes + restores cellular energy after UV stress + reduces immunosuppression from sunlight.
also use a sunscreen made for AK's. Also
I use European formula I buy to repair skin after carac but you may not want to go that far. In Europe they use PNs for amazing skin repair. I use Plinstfirst with an electroporation current device for just dermis penetration not injected for cellular repair. AK's are always being "made" and prevention is the best way to stop them.
Morning
Nicotinamide 500 mg + ISDIN Eryfotona Actinica SPF 50+
Evening
Nicotinamide 500 mg + my repair phase serum (exosome such as Mayo Clinic's Plated or a PN such as Plinest , there are also PN types you can buy in the US they are just weaker. Europe has the best skin care products.