The chemotherapy medication fluorouracil (Efudex, Carac) appears to reduce potentially precancerous skin patches and improve the appearance of sun-damaged skin.
After fluorouracil treatment, procollagen protein, a collagen precursor was increased. Collagen is the major protein in skin and it is present in lower amounts in photo-damaged skin. In addition, collagen is fragmented and damaged in aged skin.
Topical fluorouracil causes dermal remodeling resulting in improved appearance and there will likely be the additional benefit of a restorative effect from sun damage.
This may provide further motivation for these patients to undergo the rigorous treatment. It is possible that for some patients topical fluorouracil may have an important role against photo-aging.
For others, however, it may not be cosmetically acceptable given that a standard course of therapy may last two to three weeks and the ensuing reaction can persist for several more weeks. Undoubtedly, there will be patients who desire a therapy such as topical fluorouracil for cosmetic purposes given the relatively low cost of this therapy compared with ablative laser resurfacing.