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Topical fluorouracil 5% cream fails to improve photoaging

Patients treated with a course of fluorouracil 5% cream experienced no significant improvements in parameters associated with photodamage caused by long-term ultraviolet exposure, according to recent findings.

The study included 932 U.S. veterans accrued from the Veterans Affairs Keratinocyte Carcinoma Chemoprevention Trial between Sept. 30, 2011, and June 30, 2014. Eligible participants had a recent history of two or more keratinocyte carcinomas.

In a secondary analysis, two independent dermatologists viewed 3,042 photographs from 281 participants who had been assigned the fluorouracil 5% cream or placebo. They assessed the photographs at baseline, 6 months, 12 months and 18 months using the Griffiths scale, Allergan forehead lines scale, melomental folds scale and crow’s feet scale.

Creams were applied twice daily to the face and ears for 2 to 4 weeks, with participants undergoing 28 to 56 total doses.

Between baseline and 6 months, the investigators observed no statistically significant changes in photodamage as assessed by the Griffiths scale (² = 0.01; P = .93), Allergan forehead lines scale (² = 0.18; P = .67), melomental fold scale (² = 0.03; P = .87) or crow’s feet scale (² = 2.41, P = .12).

Similar outcomes were reported at 12 months in the Griffiths scale (² = 1.39; P = .24), Allergan forehead lines scale (² = 0.64; P = .43), melomental fold scale (² = 0.12; P = .73) and crow’s feet scale (² = 1.07; P = .30).

Results remained consistent at 18 months in all four study parameters.

The researchers suggested that the reason fluorouracil 5% cream did not impact photo damage to the skin may be because of a true lack of effect in photodamage or limitations to the photonumeric assessment.

“The development of photonumeric scales that include manifestations of photoaging other than rhytids, such as lentigines, hyperpigmentation and telangiectasias, should be considered,” the researchers wrote. – by Rob Volansky

Disclosures: The authors report no relevant financial disclosures.