5-Fluorouracil (e.g. Efudex) and Calcipotriene (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. (Note: this treatment is NOT effective against skin cancer. If any bumps or growths fail to respond to this treatment, let your doctor know right away.)
Depending upon how much sun damage you have, you can expect some amount of redness, itching, burning and scale. The skin reaction will peak for most by day 10-11 and be mostly gone by day 14. Some mild redness may persist and disappear over weeks to months.
Cleanse the treatment area with a gentle soap. Completely dry area with a towel. Apply a thin layer of the medication to affected areas twice daily for 4-6 consecutive days depending upon the location. Do NOT apply close to the eyes/eyelids.
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. During treatment and after, you can apply Vaseline multiple times during the day to soothe and protect the skin.
Very rarely, a patient will be allergic to one of the medications. In that case, the skin can become very inflamed (as if you had rubbed poison oak on it). If you think your reaction is too severe, stop and call your doctor.
After you stop, the skin will take a week or two 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).
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.
Finally, this treatment will not treat skin cancers, just pre cancers. If you have any growths, tumors, or bleeding spots that won't heal, let your doctor know.
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