Chemotherapy cream for skin cancer

Chemotherapy is a type of anti cancer drug treatment. It uses anti cancer (cytotoxic) drugs to destroy cancer cells.

Different chemotherapy drugs work in different ways. They mainly kill cancer cells by disrupting the way they work. To treat skin cancers, you might have chemotherapy as a cream (topical treatment) directly on to your skin cancer.

It is very rare for doctors to use chemotherapy through a drip into a vein, to treat skin cancer.

Chemotherapy cream (topical)

The chemotherapy drug fluorouracil (5FU) comes in a cream called Efudix. You spread the cream on your skin. This is called topical chemotherapy. It treats the cancer cells where you apply it. Very little of the drug is absorbed into the rest of your body. 

It is only used for cancers affecting the top layer of skin (superficial skin cancers). So you might have it to treat:

  • some thin basal cell skin cancers (BCCs)
  • Bowen's disease (squamous cell carcinoma in situ)
  • actinic keratosis, which might develop into a squamous cell skin cancer

You put the chemotherapy cream on your skin cancer yourself. Hospital staff will show you how to do this so you can do it at home.

Usually you apply the cream once or twice a day for 3 to 4 weeks. Depending on where the skin cancer is, you might have waterproof dressings to put over the cream to keep it in place. 

The cream can make the skin red, sore and inflamed. Some people's skin reacts more than others. To relieve discomfort, your doctor or specialist nurse can give you another cream containing steroids, if needed. 

Your skin should heal completely after one to two months. Contact your advice line if you’re worried about the side effects you are experiencing.

Actinic keratosis 

If you have actinic keratosis on your face or scalp you might have a cream called tirbanibulin. 

  • British Association of Dermatologists' guidelines for the management of squamous cell carcinoma in situ (Bowen's disease) 2022
    Morton CA (and others)
    British Journal of Dermatology .2022; 188, Issue 2: Pages 186-194

  • Non-melanoma skin cancer: United Kingdom National Multidisciplinary Guidelines
    C Newlands and others
    J Laryngol Otol. 2016 May; Volume 130(Suppl 2): Pages S125–S132

  • Guidelines for the management of actinic keratoses
    D. de Berker and others
    British Journal of Dermatology, 2017. Volume 176, Issue 1 

  • British Association of Dermatologists Guidelines for the management of adults with basal cell carcinoma
    I. Nasr and others
    British Journal of Dermatology, 2021

  • Profile of Tirbanibulin for the Treatment of Actinic Keratosis
    B Berman and others
    Journal of Clinical Aesthetic Dermatology, 2022. Volume 15, Issue 10 

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
13 Nov 2020
Next review due: 
10 Nov 2023

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