Topical Treatment

At Skinspots, our team provide you with education and support through your Topical treatment journey.

Skin cancer is caused mainly by sun / UV radiation damage over all the sun-exposed skin.  Repeated damage results in damaged DNA (Mutations) of the skin cells.  These cells might die off or continue to grow as patches of mutated/damaged skin.  With further exposure, these damaged areas gain more mutations and, in the end, become cancerous tumours. 

Chronically sun-damaged skin is made up of patches of normal and abnormal skin. These are often precursors to discreet cancerous tumours. Discrete tumours are normally removed surgically.  This patchwork of different levels of mutated, sun-exposed skin is best treated by treating the whole skin area as a field treatment, e.g. an entire limb.

It is important to treat the background damaged skin to prevent future tumours and avoid surgical interventions. Because skin cancers mostly develop from the superficial skin layers, treating these large areas can be done with ointments as topical treatments.  

The most used types of Topical treatments are:

Efudix (5-Fluorouracil)

Imiquimod

PDT (Photodynamic treatment)

Efudix (5-Fluorouracil)

This chemotherapy medication cream selectively destroys sun-damaged/ mutated cells in the skin whilst sparing normal healthy skin cells. 

A typical course of treatment would last four weeks with the following effects:

Week 1

Mild redness or minimum reaction.

Weeks 2 to 3

Red, crusted, possibly uncomfortable.

Weeks 3 to 4

The skin appears to be blistering and/or peeling; this signifies that the abnormal cells are dying.  By the end of week 4,  treatment is often completed. However, some patients may require further therapy. Following treatment – Skin may be pink for 1 to 10 weeks.

Imiquimod

Imiquimod triggers an immune response in the areas applied.  The immune cells then proceed to kill and remove the virus-infected or cancer cells.  This is usually a very effective treatment for many superficial skin cancers.

It results in a reaction similar to Efudix and PDT, selectively targeting the abnormal skin and sparing normal skin.

PDT (Photodynamic treatment)

With Photodynamic therapy (PDT), an ointment called photosensitizing agents is applied to the skin.  This ointment is accumulated more in cancerous and pre-cancerous cells.   Bright light activates the ointment and causes the formation of free radicals that damages the cells, killing off the abnormal cells.

Studies have shown that PDT can work and surgery or radiation therapy in treating certain kinds of cancers and pre-cancers. It has some advantages, such as:

• It has no long-term side effects when used correctly.
• It’s less invasive than surgery.
• It can be targeted for a specific spot or used as a field treatment.
• Unlike radiation, PDT can be repeated many times at the same site if needed.
• It is usually little, or no scarring after the site heals.
• But PDT can only treat areas where light can reach.

Your Dermoscopist will talk more about which type of Topical treatment is right for you at your appointment.