Efudex topical cream for skin cancer

Topical creams are the standard treatment for basal cell carcinoma, the most common type of skin cancer worldwide. If your healthcare provider has prescribed topical medication, Efudex (Fluorouracil) For your skin cancer treatment, it is important to make sure you are using it safely and effectively.

Fluorouracil is generic and also comes under the brand names Tolak, Carac and Fluoroplex.

This article explains the uses, side effects, and contraindications of Efudex.

When is Efudex indicated?

Efudex is a topical cream used to treat superficial basal cell carcinoma when conventional methods are impractical.

Situations where Efudex may apply include:

  • multiple lesions
  • Complex treatment areas on the face or scalp
  • actinic keratosis (precancerous skin condition caused by sun exposure)

Treating actinic keratosis (also called actinic keratosis) is important because if left untreated, it can lead to more severe and aggressive squamous cell carcinomas.

Fluorouracil also treats breast, stomach, bowel and esophageal cancers in its more potent injectable form.

How Efudex Works

Efudex is a chemotherapy drug. Specifically, it is a “Antimetabolites“Suppresses chemicals in metabolism.

Efudex interferes with the formation of DNA and RNA molecules that are essential for cell division and growth. This inhibition caused the death of rapidly growing cancer cells that took up more fluorouracil than healthy cells.

Since Efudex stops cell growth, it can change the appearance of skin using it. These skin changes may be noticeable during treatment and in the weeks following.

Fluorouracil works in four stages:

  • early inflammatory stage
  • inflammatory phase
  • tumor disintegration period
  • healing stage
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During the first week of application, mild inflammation occurs. Over the next few weeks, there will be redness and swelling, along with crusting and burning. Next, the lesions will subside as the skin sloughs off. Within one to two weeks, new skin will grow into the treated area.


Efudex is a topical form of chemotherapy. The drugs stop the cells from growing and cause the lesions to die. Then, within a few weeks, new skin will grow in its place.

How does Efudex work?

The success rate of fluorouracil in the treatment of basal cell carcinoma is approximately 90% to 93%. Efudex cream has a similar success rate as Aldara (Imiquimod), another topical cream used to treat skin cancer.

However, a 2016 review suggested that, unlike imiquimod, Efudex is best for treating only superficial lesions. This is because while it successfully treats superficial lesions, it allows the tumor to continue to grow under the skin.

Notably, the same review reported that the recurrence rate dropped to 6% when doctors first performed the procedure curettage (scrape growth).

One of the benefits of Efudex is that, unlike surgery, it is less likely to leave scars or permanently discolored patches of skin. That said, isolated, readily available basal cell carcinoma should be treated surgically, as the surgical success rate for this lesion is almost 100%.

Discuss with your healthcare provider which treatment is best for you.


Efudex is an effective treatment for basal cell carcinoma, especially when combined with surgical resection.

How to use Efudex

For basal cell carcinoma, dermatologists usually recommend a 5% fluorouracil cream, enough to cover the lesion, twice a day for 3 to 6 weeks. However, sometimes treatment lasts as long as 10 to 12 weeks before the lesions disappear.

Follow these application tips:

  • Use cotton swabs or wear gloves.
  • If applying with unprotected fingertips, wash hands thoroughly afterwards.
  • Avoid eyes, nose and mouth.

What are the most common skin cancer symptoms?

side effect

Specific side effects that usually do not require medical attention include:

  • red or dark skin
  • Erosion (loss of the upper layers of the skin)
  • eye irritation, including burning, itching, sensitivity, stinging, or watering
  • photosensitivity (sensitivity of the skin to UV rays)
  • pain and burning sensation in the affected area
  • dryness, scaling, or swelling in the affected area
  • rash or itching in the affected area
  • tenderness

Of course, if side effects persist or are bothersome, report them to a healthcare professional. Be sure to notify your healthcare provider as soon as possible if you experience more serious side effects. These include:

  • stomach ache
  • Bloody stools
  • Vomit
  • fever
  • chills

safety warning

Avoid sun exposure as much as possible while using Efudex as it may increase your side effects. Wear a hat and use sunscreen if exposed to the sun.


There are certain situations in which you should not use Efudex cream, including:

  • When pregnant or considering pregnancy
  • while breastfeeding
  • if you have a dihydropyridine dehydrogenase (DPD) enzyme deficiency (an inherited disorder that occurs in 3-5% of the population and requires genetic testing for diagnosis)
  • if you are receiving radiation therapy
  • If you have had a previous unusual or allergic reaction to fluorouracil, chemotherapy, other medicines, foods, dyes, or preservatives

What is your skin cancer treatment plan?


Efudex is a local chemotherapy drug for the treatment of basal cell carcinoma. It works by stopping cell development and is effective, especially when combined with surgical removal of the lesion. Common side effects include rash and irritation. Less frequently, more serious side effects may occur. People who are pregnant, breastfeeding, have certain medical conditions, or are allergic to medications should not use Efudex.

Frequently Asked Questions

  • Can I use a moisturizer after applying Efudex?

    If your doctor agrees, you can relieve the side effects of Efudex by using a petroleum-based moisturizer (such as Aquaphor or petroleum jelly) or over-the-counter hydrocortisone. However, these treatments may not be suitable for everyone.

    understand more:

    When to use hydrocortisone

  • Can I put fluorouracil cream on my face?

    Yes. In fact, fluorouracil treatment is most successfully used on the face and scalp. Usually, it is rubbed into the skin once or twice a day for a few weeks. In some cases, treatment may be interrupted. You will stop taking it and start again in a few weeks.

    understand more:

    20 skin lesions

  • Is Efudex a form of chemotherapy?

    Yes. Efudex is a Antimetabolites, a chemotherapy drug that stops a cell’s DNA from replicating itself so cancer cells can’t reproduce. They are used to treat leukemia, breast, ovarian and bowel cancer, among other types of cancer.

    understand more:

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