Skin Cancer
Actinic keratoses
Single or field therapy
Keratinised lesions – use urea or salicylic acid initially
5-FU (efudix) –
* Apply twice daily for 1 week then once daily for 3 weeks
* if brisk reaction with excess crusting consider superinfection, stop treatment, use emollient and use topical antibiotic cream – consider topical steroid after infection treated
* must avoid sun exposure during treatment
Cryotherapy – 5 seconds
Imiquimod – slightly lower cure rate than 5-FU (better to use for superfical BCC)
Bowen’s Disease (SCC in situ)
5-FU
Cryotherapy
Superficial BCC
Imiquimod – if biopsy proven sBCC and surgery not appropriate (eg. age, skin closure difficult)
- once daily for 5 days/week for 6 weeks
- expect erythema reaction during treatment – occasional brisk reaction (crease, swab, moisturise, antibiotics if needed)
- can get flu like symptoms – pause treatment and resume at lower dose regime
- don’t use in pregnancy, immunocompromised, lesions near hairline/eye/nose/mouth, BCC > 2cm, other types of BCC
Skin Cancer treatment guidelines
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