DERMATOLOGY ASSOCIATES, LLC 50 Sewall Street, Portland, ME 04102 (207) 775-3526 57 Barra Road, Biddeford, ME 04005 (207) 282-3010

TREATMENT OF ACTINIC KERATOSIS/SCCIS WITH 5-FLUOROURACIL CREAM

1. Actinic keratoses (AK’s) are pre-cancerous rough scaly spots caused by chronic sun exposure. Squamous cell carcinoma in situ (SCCIS) is an early skin cancer, also usually caused by chronic sun exposure. A common treatment used for both is a topical medication called 5- fluorouracil (Efudex).

2. The cream is applied directly to the affected area with a fingertip twice a day for 2-6 weeks. For the first 10 days, you will probably not notice much change in your skin. After this time the skin will redden and you may feel a burning sensation. Also, your skin may ooze and become dry and flaky or scabby. These are normal reactions to the treatment and indicate that the medicine isworking. These reactions to the treatment will fade and clear within 10-14 days after the treatment. Your doctor will determine the proper length of treatment.

3. The following information may help to make your experience more comfortable:

• Plan your treatment for a time of the year when you will have fewer social engagements. • Part of the discomfort that some people feel during the treatment is the result of the skin drying out. Often a thin coat of petroleum jelly or a mild lotion will relieve the discomfort. • You may apply make-up to the red areas during the treatment period. • During the healing phase, your doctor may prescribe a cortisone cream to help reduce the redness and inflammation. • Minimize your sun exposure during the treatment period as the medication makes the skin sun-sensitive. Apply sunscreen of at least SPF 30 if you must be exposed to the sun.

4. Most Important: Do not discontinue treatment if you are experiencing uncomfortable effects. Call your doctor to discuss methods to manage your discomfort or to arrange follow-up if needed.