Chemotherapy skin cream reduces sun damage, wrinkles

A skin cream containing a chemotherapy medicine that treats precancerous skin patches also reduced sun damage and wrinkles on the faces of 21 people who used the drug, a study found.

Researchers saw improvements over 24 weeks in dark spots, yellow skin tone and hyperpigmentation, according to the study in the June issue of Archives of Dermatology. The cream contained a common chemotherapy medicine, fluorouracil, which also caused the skin to become red and irritated, making it peel as it worked to eliminate unhealthy skin, study authors said.

Doctors use cream with fluorouracil, which is available as a generic and under the brand name Efudex, to treat skin lesions caused by intense sun exposure. Those spots, called actinic keratoses, are considered to be precancerous. Lead study author Dana Sachs said she's not sure if fluorouracil would reduce wrinkles in those with healthy skin and a study is needed to answer that question.

"From our study, we can only say that it works for moderate-to-severe sun damage," said Sachs, an associate professor of dermatology at the University of Michigan in Ann Arbor. That benefit also comes with a drawback.

"You really need to see that inflammation and irritation in the skin in order to see that improvement," she said. "This is a tough treatment."

This was the first study to show that fluorouracil cream improves sun-damaged skin, which includes dark spots, hyperpigmentation and sallow complexion as well as wrinkles.

Researchers examined 21 healthy people ages 56 to 85 who had actinic keratoses and sun-damaged skin. The participants applied fluorouracil cream over their entire face twice a day for two weeks.

They were examined for six months after the study started, when researchers found the average number of precancerous skin lesions dropped to 1.5 from 11.6.

Within 10 weeks of starting the cream, 19 of 20 participants said the sun damage to their skin was improved. Also, 16 of 19 said their wrinkles were improved, including eight who called that benefit "mild."

Overall 12 of 19 patients reported the treatment was uncomfortable, though 17 said they would be willing to undergo the therapy again, according to the authors.

Sachs said fluorouracil works to reduce the signs of sun damage by increasing the levels of a precursor to collagen, which rebuilds damaged skin. The cream may not be a good choice for everyone.

"For people who are out in the limelight or for professionals, it could be very hard to go to work and attend social functions if you have a lot of redness and scaling. It is a drawback because that lasts for several weeks," she said.