Fluorouracil
Fluorouracil is a cream that clears sun-damaged skin patches such as actinic keratosis and superficial basal cell carcinoma; it is sold as Efudex tubes in 1% and 5%.
A cream that clears sun-damaged patches
Fluorouracil belongs to a group of medicines called antimetabolites: it interferes with the way cells copy their DNA. On the skin it is used to treat actinic keratosis — the dry, rough, scaly patches that years of sun leave behind on the face, ears, scalp, hands and forearms. They are usually small, roughly 1cm to 2cm across, and may be pink, red, brown or the same colour as the skin around them. A patch like this is not skin cancer, but a small number of them can turn into one, which is why they are treated. The same cream also clears superficial basal cell carcinoma, a slow-growing skin cancer that sits in the top layer of skin.
Cells that divide quickly take the medicine in, stop dividing and die, and the skin around them becomes inflamed and then repairs itself. Because it is applied to the patch, the effect stays local. It is not used during pregnancy.
What the skin does during a course
A thin film goes on the patch, usually twice a day, spread slightly past its edges. Wash your hands afterwards, keep it clear of the eyes, eyelids, nostrils and lips, and leave the area uncovered.
The reaction is the treatment working, not a problem with it. The patch reddens and begins to sting or burn, then crusts, peels and sometimes weeps; it looks worse before it looks better. Itching, soreness and a darker colour in the treated skin are all expected. A course usually runs for a few weeks and stops once the skin has reacted and is healing; the area then settles and fresh skin covers it over the following weeks. Keep the tube out of direct sun, and do not use it past the date on the tube.
Efudex tubes, 1% and 5%
Efudex is the fluorouracil cream sold here, in tubes of 1% and 5% — the percentage is simply how much fluorouracil the cream holds. It is also sold as Fluorouracil tubes in the same two strengths. Both are applied in the same way and produce the same kind of skin reaction.
Sun, side effects and when to stop
The patches are sun damage, and treated skin is more sensitive to light while it heals. Wear a hat and cover up outdoors, and use an SPF 30 sunscreen on the skin you are not treating; strong sun on the patch can make the reaction harsher.
Redness, burning, crusting and peeling in the treated area are the common effects. Skin that breaks down into a raw, weeping sore, or a reaction spreading well beyond the patch, is not the usual course. A sudden swelling of the face or throat with difficulty breathing needs urgent treatment.
Sources
- Fluorouracil Topical: MedlinePlus Drug Information — National Library of Medicine
- Actinic keratoses (solar keratoses) - NHS — NHS
Is Fluorouracil available to order in Hong Kong?
Fluorouracil can be ordered online with delivery to Hong Kong. The page lists generic Efudex, 1% and 5% tubes also sold as Fluorouracil tubes. Payment is by Visa, Mastercard or American Express on a secure, encrypted page, or by Bitcoin or Ethereum.
How much do Fluorouracil products cost in Hong Kong?
The fluorouracil product has its own price per pack, shown on its page in HKD or your selected currency; larger packs usually cost less per unit.
Is there a generic Efudex?
Yes, generic Efudex is listed as 1% and 5% tubes and contains fluorouracil. It is also sold as Fluorouracil tubes, in the same 1% and 5% strengths, as tubes containing fluorouracil.
What are the brand names for fluorouracil?
Efudex is a brand name of fluorouracil, which is also sold as Adrucil, Carac and Tolak. Here, fluorouracil can be bought online as generic Efudex. These are generics, not the original brand.
Where on the body can I use fluorouracil cream?
It is most often used on the face, ears, scalp, hands and forearms — the areas that catch the most sun — and sometimes on the chest or lower legs. Keep it away from the eyelids, the corners of the eyes, the nostrils, the lips and any skin that is broken or already sore.
What is the difference between the 1% and 5% fluorouracil tubes?
The percentage is the amount of fluorouracil the cream holds, so a 5% tube is the stronger of the two. Both are tubes of the same medicine and both are spread thinly over the patch; the strength chosen depends on the patch being treated.
How long does a course of Efudex last?
Two to six weeks is the usual range for actinic keratosis, and the cream is stopped once the skin has reacted and started to heal. Superficial basal cell carcinoma is sometimes treated for longer. The reaction itself fades over the weeks after the last application.
Can I go out in the sun while using fluorouracil cream?
Yes, but the treated skin burns more easily, so cover the area with clothing or a hat and stay out of the strongest midday sun. Use sunscreen of at least SPF 30 on the skin around it, and skip sunbeds and sunbathing altogether.
Does fluorouracil cream treat skin cancer?
It treats superficial basal cell carcinoma, a slow-growing skin cancer that stays in the top layer of skin, as well as actinic keratosis, the sun-damaged patches that can sometimes turn into cancer. Other, deeper skin cancers are not treated with this cream.