5-Fluorouracil Cream (Efudex®, Carac®).
This chemotherapy cream has been used for decades for the treatment of actinic keratosis, which are pre-cancerous growths. It is also FDA approved for the treatment of non-facial superficial basal cell carcinomas (ones that are not on the face). Treatment results in mild to severe skin irritation, appearing as redness and crusts. Treatments are usually for 2-3 weeks on the face and 3-5 weeks on the body, arms, and legs. Recently, combining this cream with a synthetic Vitamin D3 cream can reduce treatment times to 5-6 days with less irritation that using the 5-FU alone. It is at least 88% effective for the treatment of superficial basal cell carcinomas, which is lower than other treatment modalities, but heals with no scarring. Treatment may result in skin discoloration (slight pinkness, lightening or darkening) and can be permanent.
In general, the cosmetic results are better than nearly all surgical modalities and usually less expensive. This cream is not recommended for the treatment of other types of basal cell carcinoma or squamous cell carcinoma.