From the Guidelines
Efudex (5-fluorouracil) should be applied once or twice daily to affected skin areas for 2-4 weeks for actinic keratoses, with the standard concentration being 5% cream or solution, as recommended by the most recent guidelines 1. The treatment duration and frequency may vary depending on the condition being treated and its location on the body.
- The 5% concentration is widely used and has been shown to be effective in treating actinic keratoses, with benefits assessed as moderate or large 1.
- Lower concentrations, such as 0.5% and 1%, may be used for sensitive areas like the face.
- Application should be done once or twice daily, with a thin film covering the lesion and extending slightly beyond its visible margins.
- It is essential to wash hands thoroughly after application and avoid sun exposure during treatment to minimize irritation.
- The medication works by interfering with DNA synthesis in rapidly dividing cells, preferentially affecting abnormal skin cells while allowing normal skin to regenerate.
- Patients should be counselled about potential side-effects, including soreness, redness, and possible crusting, and advised on how to manage them, such as reducing the frequency of application or taking short breaks in treatment 1.
- The use of 5-FU has been conditionally recommended in combination with other treatments, such as cryosurgery, for improved outcomes 1.
From the Research
Efudex Dosing
- Efudex, also known as 5-fluorouracil (5-FU), is a common treatment for actinic keratosis (AK) 2, 3, 4, 5, 6
- The dosing of Efudex can vary depending on the treatment duration and regimen 6
- A study published in 2002 found that a microsphere-based formulation of 0.5% fluorouracil cream was effective in treating AK when applied once daily for 1,2, or 4 weeks 6
- The study found that significant improvements were seen from baseline to posttreatment follow-up in all efficacy variables for all fluorouracil regimens compared with vehicle 6
- Patients treated for one week experienced significant improvements compared with vehicle, although efficacy increased with increasing treatment duration 6
- Most patients experienced mild to moderate facial irritation of predictable onset and duration 6
- Other treatment options for AK include cryotherapy, diclofenac, photodynamic therapy (PDT), imiquimod (IQ), retinoids, and ingenol mebutate (IM) 2, 3, 4, 5