Creams for suitable lesions

Prescription creams such as fluorouracil, imiquimod and Tirbanibulin are used to treat selected superficial skin lesions. They are particularly useful for areas of sun damaged skin with multiple lesions such as actinic keratoses and early squamous cell carcinoma in situ (Bowen’s disease).

During treatment	After 1 month	After 3 months

 

During treatment	After treatment

 

How topical treatments work

These creams either directly damage abnormal cells or stimulate the local immune system to attack them.

• Fluorouracil interferes with DNA synthesis in rapidly dividing cells
• Imiquimod enhances immune recognition and clearance of abnormal cells
• Tirbanibulin provides targeted treatment for actinic keratoses using a short daily application course

Treatment courses typically last several weeks, with the exact schedule tailored to the type and extent of lesions.

When creams are appropriate

Topical therapy may be recommended when:

• There are multiple superficial lesions in a field of sun damage
• Lesions are too numerous for individual cryotherapy
• Early superficial skin cancers are present in suitable locations

Deeper or nodular lesions and suspicious pigmented lesions are not treated with creams alone and usually require surgical removal.

Expected reaction and follow up

During treatment the skin typically becomes red, inflamed and sometimes crusted as abnormal cells are destroyed. This response is expected and usually settles in the weeks following completion of therapy.

• Discomfort can be managed with simple measures and moisturisers
• Follow up review checks that lesions have cleared
• Further courses or alternative treatments may be discussed if needed

If you have been told you have actinic keratoses or Bowen’s disease and would like to discuss cream based treatments, please contact us via the contact page.