Topical fluorouracil stimulated wound healing improving the look of damaged skin

The use of topical fluorouracil to treat actinic keratoses reduced the mean number of actinic keratoses per patient, but also improved the appearance of photodamaged skin.

In an open-label, 24-week study, 21 participants aged 56 to 85 years from the department of dermatology at the University of Michigan were assigned to 5% topical fluorouracil cream twice daily for two weeks.

Skin biopsies were taken at baseline and weeks one, two, four, six 10 and 24.

Coarse and fine wrinkling, tactile roughness, lentigines, mottled hyperpigmentation and sallowness all improved from baseline to week 24 (P<.05). The dermatologists assigned participants a global severity rating at the beginning and end of the study. The mean score was 5.38 at baseline and improved to 4.63 at week 24 (P<.05).

Two sets of facial photographs were evaluated by three dermatologists who were not involved in clinical assessment. Dermatologists assigned a global severity photoaging score to both sets of images. For the first set of images, they used the score to identify randomly ordered images from baseline and week 10. For the second set, they identified randomly ordered images from baseline and week 24.

They scored the images at an average of 5.19 for baseline and 4.93 for week 10 (P=.005). The second set of images was scored at 5.06 for baseline and 4.76 for week 24 (P=.002).

Additionally, 20 participants completed a questionnaire at week 10. Overall, 45% rated their precancerous lesions as much improved, 50% rated them as mildly or moderately improved and 5% rated them as not changed. Sun damage was reported as mildly, moderately or much improved by 95% of participants.

Although 63% of participants reported treatment with fluorouracil to be uncomfortable, 89% claimed they would undergo treatment again.

Sachs DL. Arch Dermatol. 2009;145:659:666.