Efudix+Dovonex protocol

| 6 min read

About Efudix

Efudix, also known as fluorouracil, is a topical cream used in the treatment of pre-cancerous and cancerous skin growths, primarily actinic keratosis and superficial basal cell carcinomas. It works by interfering with DNA synthesis destroying rapidly dividing cancerous cells.

When using Efudix, there will be a local inflammatory reaction on the skin with redness, soreness, and peeling, which indicates that the medication is actively targeting abnormal cells. As treatment progresses, the affected area may also become swollen, weepy and crusty before eventually healing, Please click on the following button to review images of efudix reactions so that you know what to expect:-

Examples of efudix reactions

You should apply efudix only to the areas advised by Dr Lynch. You may find that you experience inflammation in other areas even where you have not applied the cream to.

Rarely you may have a severe reaction or allergic reaction to the cream, this can cause ulceration, altered skin pigmentation and scarring. If you have concerns about the severity of the skin reaction you should contact Dr Lynch. As for any medication it is essential to read the information leaflet that comes within the packaging and contains a full list of all recognised side effects.

How to use efudix

Whilst the evidence is strongest for a full 4 week course of efudix this can be very inconvenient for patients and a shorter course lasting only 4 days has been proposed. This combines efudix with topical vitamin D (dovonex) which boosts the action of the efudix. Efudix and dovonex used in this way are “off licence”, and we continue to learn more about efficacy and potential risks, however an increasing number of dermatologists are finding this approach to be effective and more convenient for patients.

• Apply both efudix and dovonex creams twice daily for 4 days with a clean fingertip.
• When the area becomes inflammed bathe the area with water, dab the skin dry and apply vaseline (petroleum jelly) daily. The vaseline that you apply should be newly opened and free from potential contamination from fingertips.

Risks of efudix

• Increased sensitivity to sunlight: Treated areas can become more sensitive to sunlight. You should be very careful with sun protection.
• Allergic reactions: Although rare, some individuals may develop allergic reactions, such as rash, itching, or swelling.
• Local skin reactions: Severe reactions can include blistering, peeling, and painful erosion of the skin at the treatment site.
• Infection: Open sores and skin breakdown could potentially lead to bacterial or viral (e.g. herpes virus) infection.
• Eye irritation: Accidental exposure to the eyes can cause severe irritation and damage.
• Changes in skin color: Treated areas may experience changes in pigmentation, becoming lighter or darker. Usually this resolves with time but rarely it can be permanent.
• Scarring: Scarring is rare with efudix, but there is a very small risk that you develop a visible scar that may be raised/dipped/keloid or lumpy.
• Systemic absorption risks: Although rare, there is a possibility that fluorouracil can be absorbed into the bloodstream, leading to systemic effects such as nausea, vomiting, or diarrhea.