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Skin Care and Diseases

How do I now that the Efudex has worked?

02/23/2006

Question:

I am on a 2 x a day for 14 days treatment with Efudex 5%. How do I know that I should really stop treatment on the 14th day. How do I know it has done all it is going to do? I am out of the country and can not visit my doctor.

Answer:

Efudex produces a significant inflammatory response in solar damaged skin, and particularly in actinic keratosis and/or early in situ cancers, particularly squamous cell cancers.  It is  usually applied to the skin of individuals who have had long exposure to ultraviolet light and have numerous crusted scaly lesions over their exposed skin.  The regimen that you have been given should produce redness, crusting, and often stinging and burning within a seven to ten day period.  You know that the medication has performed well when the crusted areas now have scales that are usually peeled away or very superficial ulcers form.  All individuals that use the drug in the regimen you have suggested, in my experience, get red crusted tender areas at the site of abnormality.  The entire skin surface may be severely injured by light and may become quite red, angry and superficially crusted with some oozing.

When you have had an appropriate and significant response of your keratoses, you should discontinue the use of Efudex and use gentle cleansing twice a day with mild lubrication with a good moisturizer.  I am sure your physician has a number that can be reached from international sources.  Please feel free to contact that individual for his specific aims in your case.

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati