Basal Cell Carcinoma on Leg

Hi @jnb, welcome. Topical fluorouracil (5-FU) is commonly used to treat skin lesions after surgery for basal cell cancer. The changes you are experiencing, like itching, burning, angry red areas, raised bumps, are also common.

You can read more in this article:
- Fluorouracil cream (DermNet) https://dermnetnz.org/topics/5-fluorouracil-cream

@mermaid7272 @gingerw @shamrock5jeg may also be able to share their experiences with 5-FU cream.

As to your question about whether to apply the cream only to raised scabs or also to flat, brown skin discolorations. I'm not sure. This is a question for your doctor. Are you able to contact them through a patient portal or by phone? Does your insurance help cover the cost of the cream?

@jnb Ah, flourouracil! I have used it, also! I am subject to skin cancers, and have have basal cell, squamous, amelanotic [uncolored] melanoma, and nodular basal cell.

The first time I used flourouracil, my face broke out like you are describing. remember, it takes a very little of this cream to use. Fortunately I was able to get in to see the PA at my dermatologist's office. The reaction you are seeing is the medication working on an area that needs to be addressed. More than likely you will experience these symptoms for the first few weeks, then they will simmer down and go away.

As far as where to apply it, that is your doctor's decision. What did they say on the label? When my face broke out, it was explained that even if I applied it only to areas of question that I could see, there would be a response from any place on my face that needed the medication.

I hope this relieves some of the anxiety you might be feeling?
Ginger

Thanks for sharing your experience with this drug.
The label says “Do not apply to good skin.”
It’s helpful to know that you saw a response beyond the area you originally treated. The label and the inserted drug facts that came with the tube do not mention that.
This drug is not for the weak. It takes fortitude to apply a substance that is going to make you worse before you get better!

@beatrixflower I'm glad you sought out a diagnosis on this. I have had everything from pre-cancer to melanoma, and you're smart to be checking for changes in sores or lesions. You know your skin the best! What was done for the basal cell carcinoma on your leg? I would ask your dermatologist their recommendation, then follow that. While basal cell rarely metasticize they do often grow slowly in place. And I am sure your medical team has advised you to watch your skin carefully, perhaps with a full-body check twice a year.
Here is a link from Mayo Clinic about types of skin cancer https://www.mayoclinic.org/diseases-conditions/skin-cancer/symptoms-causes/syc-20377605
Ginger

@gingerw I was recently diagnosed with squamous cell, basal cell, and two precancers. You noted that you have had multiple skin cancer and precancer diagnoses. How have you changed your lifestyle as a result? I have always been a sunscreen fanatic, very frequently applying chemical sunscreen. I have now moved to mineral sunscreen since reading more about skin cancer after my excisions. This recent experience has me a bit fearful of the sun now, which I used to enjoy as an active person, not as a sun worshipper (I never lay out because I don’t get tan anyway). I bought lots of UPF 50+ shirts and am going to Disney with the grandkids in a few weeks and I am wondering if short sleeves with sunscreen would be an okay alternative. My skin cancers are on my hand neck and my precancers are in my nose and hand. I have two other suspicious areas on my forearms. Any advice is welcomed.

@cmcp First, welcome to Mayo Clinic Connect! I'm glad to see you have been reading the discussions here and found useful information. Back in younger years, you and I were probably part of the same generation who worshipped the sun. Like you, I didn't lay out, but I did a lot of outdoor activities, with no thought to sunscreen.

After dealing with the various skin cancer issues, I now apply a sunscreen everyday, regardless of the weather. Careful to wash my face and hands thoroughly every night before bed. I use a hat to provide as much shade as possible, too. Long sleeves. Staying out of the sun's strongest hours, remembering that even if it is foggy/overcast there is still a UV risk. Don't forget your hands for sunscreen, too. I often wear lightweight white cotton gloves. You will need to make that decision about long sleeves or short sleeves with sunscreen!

My melanoma was on right forearm. Squamous on forehead and left eyebrow. Nodular basal cell near right collarbone. Precancers various places on face/ears/arms.

Hope this helps? Enjoy your trip to Disney - Florida or California?
Ginger

Thank you for replying, Ginger. We are going to Florida! It is a dream of mine to go with the kids and grandkids - I’m so excited. These diagnoses kicked me in the gut a bit, finding out pretty much right before we go but I know I’ll still have fun. Just trying to balance comfort with safety in the heat and humidity there. You say careful to wash your hands and face at night - can you expound upon that, please? Is it due to chemical sunscreen concerns or something else?

@cmcp What a nice dream to have, and to get to see it happen, you sound pretty "over the moon" about it. Being smart and sensible as we live each day with regards to sun exposure, well, it takes a bit of thinking and work, and after a while it seems we get used to it. For myself, a bit of discomfort is worth the rewards of getting to do something I have been looking forward to!

My skin is pretty sensitive, being a redhead, and there are many lotions/creams that clash with me. For decades I have only used liquid castile soap as a facial cleanser, plus a quality moisturizer containing a sunscreen. At night I might use a lightweight moisturizer, it depends. What has worked for me might not be a solution for others. It's important to give my skin a rest from chemicals. I also do crafts, so I don't want any transference of oil/greasy stuff to them!

You'll have fun! Take pictures, make memories! Enjoy!
Ginger

@beatrixflower, sometimes a marking on the skin is nothing for a period of time and then may start to change indicating cancer. I'm glad that it was sent for biopsy. According to the American Cancer Society https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/about/what-is-basal-and-squamous-cell.html "They tend to grow slowly. It’s very rare for a basal cell cancer to spread to other parts of the body. But if it's left untreated, basal cell cancer can grow into nearby areas and invade the bone or other tissues beneath the skin."

I'd like to also bring @gingerw @lk3xs @mermaid7272 and @kathyhg into this discussion to share their experiences with basal cell carcinoma.

Beatrix, did you notice a change in the shape of the lesion before you noticed pain? Spots can sometimes be itchy or even be a sore that doesn't heal well. What type of pain are you experiencing?