5-Fluorouracil (e.g. Efudex) and Calcipitriene (e.g. Dovonex) are two prescription skin products that when used in combination are excellent for sun-damaged skin.
This treatment specifically targets pre-cancerous cells and sun-damaged skin but has little effect on normal skin. Treatment will result in healthier, smoother skin with a reduced risk of skin cancers.
YOU WILL EXPERIENCE A SKIN REACTION: Depending upon how much sun damage you have, you can expect some amount of itching, burning, tenderness, redness, oozing, mild swelling, and crusting. The crusting/scabs may take up to 2 weeks to heal. A residual redness may disappear over weeks to months.
There are rare side effects of ulceration, bleeding, infection (severe swelling, drainage, fever), fatigue, nausea, vomiting, diarrhea. If you experience any of these, stop the treatment immediately and notify your doctor.
HOW TO USE; Cleanse the treatment area with a gentle soap. Completely dry area with a towel. Mix the 5-fluorouracil 5% cream in a 1:1 ratio with calcipotriene, 0.005% cream (or ointment) in your hand and apply a thin layer to affected areas twice daily for 4-6 consecutive days depending upon the location. Do NOT apply close to the eyes/eyelids/lips.
If you have multiple areas of sun damage, you may want to consider treating just one area at a time, e.g., the scalp only or one side of the face only. This treatment is not for widespread use.
The area will get inflamed, red, scabby, etc., for the time that you are using it. It is okay for the mixture to get on normal skin as normal skin will not react. However, if the skin has subtle sun damage, it may react and you may develop more inflamed areas than you thought you would. It is fine to take a break for a few days if the inflammation gets too severe. During treatment, you can apply Vaseline multiple times during the day to soothe and protect the skin.
After you stop, the skin will take a week or so to heal. During this time, you may apply Vaseline, hydrocortisone 1% ointment or cream, or other emollients to soothe the area. Sometimes there is some residual redness for a few weeks to a month after the therapy, but the roughness should be gone. If redness persists, covering the area with makeup is fine (often a green-tinted one is optimum for covering the redness).
PROTECT YOURSELF FROM THE SUN: It is critical to strictly avoid the sun during treatment and use sunscreen religiously afterward. The newly treated skin will be very sensitive to the sun. In fact, without daily sunscreen, the skin will become damaged again.
After the initial treatment has been completed, some patients like to use this treatment once or twice a year to keep their skin "in shape." Some like to spot-treat individual lesions that come up. That is fine if they are red and scaly. But any brown or black lesions should not be treated.
Finally, 5-fluorouracil will not treat skin cancers, just precancers. If you have any growths, tumors, bleeding spots that won't heal, or black/brown irregular moles bigger than a pencil eraser, let your doctor know.