Topical Therapy

If your skin cancer is confined to only the top layers of the skin (determined by a biopsy), then topical therapy may be appropriate. These superficial cancers include some squamous cell cancers in situ, also known as Bowen's disease, and superficial basal cell cancers. In situ means that a lesion is confined to the epidermis, the top layer of skin. Topical therapy is not appropriate for more aggressive skin cancers.

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Imiquimod (IMQ) and/or 5-fluorouracil (5FU) are two such topical creams for skin cancers. IMQ works by stimulating your body's own immune system to destroy cancerous cells (topical immunotherapy). 5FU works as a topical chemotherapy, preventing rapidly dividing cells from growing. Both creams cause significant redness and inflammation and need to be used for many weeks to be effective. Occasionally, these creams may be recommended in addition to surgery for maximal success.

The advantage of topical treatment is the relative lack of scarring compared with surgery. Treated skin is less sun-damaged in appearance than skin treated with other methods, such as radiation, and putting cream on the area treats nearby precancers at the same time. Skin may look red, raw, and inflamed for the duration of treatment. If you do not follow the wound care prescribed, then your skin may develop itching, burning, infections, and pain. This treatment, which you apply at home, is usually avoided in the hot summer months because heat and humidity can be uncomfortable on inflamed skin and the therapy makes your skin extra sensitive to sun.