# Actinic Keratosis - a topical cream Rx treatment



## levity (Oct 31, 2011)

_(Note - the web is NOT the best source of medical advice, but I thought it would be worthwhile to call attention to a relatively new treatment for certain skin cancers, especially actinic keratosis that invariably pops up in the 50+ crowd. A lot of riders don't seem to be aware of it. As the saying goes "Ask your doctor"!)_

If you're like me you get a lot of sun exposure on your face, arms, and legs. The best way to prevent skin damage is to cover up and use sunscreen. Still, over time UV damage can accumulate and actinic keratosis (AK) is common to those who spend a lot of time outdoors. AKs can turn into cutaneous cell carcinoma so they should be treated as early as possible.

In the past 5-fluorouracil (5FU), an inhibitor of DNA synthesis, was used alone topically to treat various skin cancers. The extended time required (2-4 weeks) often resulted in "angry" red blistering skin due to effects on slow growing normal cells as well as rapidly dividing cancerous cells. In as 2017 publication Cunningham et al. showed that co-application of the immune stimulator calcipotriol/calipotriene with 5FU allowed shorter treatment times (4 days) and had less effects on normal skin while being a highly effective immunotherapeutic regimen. I've used this combo to treat AKs and small squamous carcinomas on my face, arms and legs for over a year and found it to be very effective. It's easy and painless, and cancer cells scab up and slough off in 6-10 days to be replaced by healthy normal cells. The 40g and 60g tubes of cream shown in the pic below contain enough to last 1-2 years. Both are inexpensive and are covered by most insurance plans in any case (I had a $5 co-pay for each).

A physician's prescription (Rx) is required. If your dermatologist is not familiar with this treatment refer him/her to the following article:

Trevor J. Cunningham, et al. (2017)
"Randomized trial of calcipotriol combined with 5-fluorouracil for skin cancer precursor immunotherapy"
J Clin Invest. 127(1) pp. 106-116. 
https://doi.org/10.1172/JCI89820.


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## 73cuda (Jul 23, 2007)

Sounds like Picato...you apply to skin for 3 days in a row.The skin blisters and peels. I wonder if the stuff you posted would work better. Will ask my doc when I see him next time as I am a skin cancer grower myself. Thanks for the info !


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## KRob (Jan 13, 2004)

Thanks for the info. I’ve had AKs burned off my face two or three times over the past 20 years but have always resisted using the Flourouacil cream because I didn’t want to go through the red scabby face phase, despite having the Rx from the dermatologist. 


Sent from my iPhone using Tapatalk


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## cjcrawford (Jun 2, 2008)

Thanks for the info. I have been using the Flourouracil on and off and would love to shorten the treatment. I also try and freeze just about anything I see popping up! I'll investigate. I have insurance but a $6k deductable and the last time I checked the Picato and Flourouracil has a ridiculous price. Time to reinvestigate...


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## H0WL (Jan 17, 2007)

I see my dermatologist 2x a year and she just freezes off all AKs. I've had many an AK frozen off my face over the last 25 or 30 years after a lifetime of sun exposure. 

What's the benefit of this over freezing AKs?


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## levity (Oct 31, 2011)

A significant benefit is that the cream combo can attack small pre-cancerous or cancerous growths that are not easily spotted visually. By spreading the cream over a suspicious area you can knock these out before they progress further. If you apply it broadly to an area that has obvious AKs and hence sun exposure there is a good chance you will see additional undetected spots show up.

Also, once you have the Rx you can apply it at home without an office visit and get them taken care of early. Of course, you should see your dermatologist for regular check-ups or whenever something worrisome shows up.


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