Efudix Cream
Efudix Cream Treatment for Sun-Damaged Skin
Efudix (5-fluorouracil) is a commonly used treatment for sun-damaged skin and precancerous lesions (actinic keratoses). It works by targeting abnormal cells and allowing healthier skin to regenerate.
At QLD Skin Cancer Clinic, we assess whether Efudix is appropriate for your condition and guide you through treatment safely.
Who is Efudix suitable for?
Efudix may be recommended if you have:
- Multiple sunspots (actinic keratoses)
- Widespread sun-damaged skin
- Superficial early skin cancers (in selected cases)
It is particularly useful when treating larger areas where individual lesion treatment is less effective.
How to use Efudix
- Wash the skin with lukewarm water. After your skin is completely dry, apply a thin film of the cream to the affected skin and rub it gently onto your skin. Apply a small amount of medication to the affected skin, using just enough to cover the area with a thin film.
- After using the cream, wait at least 20 minutes before applying sunscreen, moisturiser or make-up to the treated area. Avoid make-up creams if you notice erosion or ulceration in the skin.
- Efudix cream can be applied with a clean fingertip. Wash your hands thoroughly after applying the cream.
- Do not allow the cream to come in contact with eyes, eyelids, nostrils and lips. Do not apply to broken skin or open cuts. Use it with care in skin folds (such as those around the nose and lips). Efudix could be quite irritating in these areas.
- If you are using the cream in the evening, do not use it on your face immediately before going to bed; contact with the pillow may cause undesirable spreading of cream to your mouth and eyes. It is best to apply the cream few hours before bedtime.
- Limit your exposure to sunlight during treatment with Efudix. You can use sunscreen but wipe off the sunscreen , using a gentle cleanser, before your next Efudix application.
- Do not start the treatment on your face before important social engagements such as weddings or overseas travelling. Efudix cream must not be used during pregnancy and breastfeeding.
It usually takes 2 – 4 weeks for your skin to return to normal after you finish applying the cream. Your skin may remain pink for up to 2 months after you finish the treatment. Other rare side effects are depigmentation at the site of the original lesions, sun sensitivity and developing small blood vessels. Occasionally patients report symptoms such as mild nausea, loss of appetite and tiredness during treatment.
If you develop significant pain and/or ulceration during the treatment, temporarily stop using cream and contact our clinic. If a sunspot does not clear with therapy it will require biopsy and possibly a surgical excision.
Exfoliating creams such as retinol, salicylic acid, urea cream or glycolic acid improve the absorption and efficacy of Efudix cream by peeling off the top layer of skin. Exfoliating creams may be used for two weeks prior to Efudix treatment to enhance the effect of Efudix.
Your doctor may recommend applying salicylic acid 5% cream, twice daily, start 14 days before efudix treatment.
Important: proper assessment is essential
Efudix is not suitable for all lesions.
Some skin cancers require:
- Biopsy
- Surgical removal
- Alternative treatment
A clinical examination is important to ensure the correct diagnosis before starting treatment.
What to expect during treatment
Efudix works by targeting damaged skin cells, which leads to a visible skin reaction.
This reaction is expected and indicates the treatment is working.
Typical progression:
- Week 1: Mild redness and irritation
- Week 2–3: Increasing inflammation, redness, and crusting
- Healing phase: Skin gradually settles and renews
The severity of the reaction varies depending on:
- The area being treated
- The extent of sun damage
- Individual skin response
If the reaction becomes excessive or concerning, review may be required.
| Treatment | indication | consideration |
|---|---|---|
| Efudix | Field treatment | Non-surgical, requires time and tolerance |
| Cryotherapy | Individual lesions | Quick but treats isolated spots |
| Surgery | Confirmed cancers | Definitive treatment, may leave scar |
Efudix
Indication: Field treatment
Consideration: Non-surgical, requires time and tolerance
Cryotheapy
Indication: Individual Lesions
Consideration: Quick but treats isolated spots
Surgery
Indication:confirmed cancers
Consideration: definitive treatment , may leave scar
Dealing with intense reaction
If you have a severe reaction (like ulceration) it may be appropriate to reduce the frequency with which you are applying the cream. Doctor will usually see you after 2 weeks of treatment. If you develop significant pain and/or ulceration during the treatment then temporarily stop using the cream and request an urgent review with your doctor. If you stop applying the cream your skin will gradually return to normal.
It usually takes 2-4 weeks for your skin to return to normal after you finish applying the cream. This varies according to the duration of your therapy and the severity of your skin reaction. Your skin may remain pink for up to 2 months after you finish the treatment.
Other rare side effects are depigmentation at the site of the original lesions, sun sensitivity and developing small blood vessels. Occasionally patients report systemic symptoms such as mild nausea, loss of appetite and tiredness during treatment.
If needed, your doctor may recommend pre-treatment cream to exfoliate your skin. This makes the treatment more effective.
Complications
Itching, pain, erosion, crusting, dermatitis and other inflammatory reactions are expected during treatment. The following complications may follow the treatment: – Persistent white marks or scarring
– Undiagnosed skin cancers; these may appear to heal with 5-FU cream but recur later.
Inflammation of the skin is expected, but if the skin becomes very sore, stop using 5-FU cream. Bathe the area with water, dab the skin dry and apply one of the following topical treatments to the affected skin:
- Vaseline, every few hours
- Cera Ve Advanced Repair Balm, few times a day
- Lipikar Balm, few times a day
- Flamigel, twice a day.
These should be newly opened and free from potential contamination from fingertips. When the skin settles, you may be able to continue 5-FU cream to complete the treatment course.
After completing your efudix treatment
After completing the treatment, apply one of these healing creams few times a day.
- Vaseline
- Cera Ve Advanced Repair Balm,
- Lipikar Balm,
- Flamigel, (twice a day).
Once skin irritation and inflammation settles, you can add the following creams to your aftercare regimen:
- Cicaplast Baume B5 Balm
- Solar Care Vit B3 cream 5%
Protect your skin by applying fragrance-free, non-comedogenic, and hypoallergenic mineral sunscreens such as Zinc. Here is a list of recommended zinc based sunscreens in Australia:
- Cetaphil Defence,
- Invisible Zinc
- Ethical Zinc
- Medik8 Physical Sunscreen SPF 50+
- Dermalogica Invisible Physical Defense SPF30
Sunscreen should be used every morning and be topped up during the day. .
Avoid:
- Fragranced products
- Alcohol-containing serums or toners
- Actives like retinoids, AHAs/BHAs for at least 4 weeks after the treatment
Sunscreens with chemical filters immediately post-treatment
When to seek medical advice
You should consider a skin check if you have:
- Persistent scaly or crusted lesions
- Areas of sun damage
- Spots that do not heal
- Concerns about skin cancer
New Treatments
Efudix is a very powerful treatment however, the duration of treatment and severe inflammatory reaction are the drawbacks of this treatment. Recently, a new compound has been proven to be promising, with least side effects and similar efficacy.
Find out more about this new compound here.
