Topical Fluorouracil to Improve Sun Damage

Topically applying fluorouracil, a chemotherapy treatment,  may not only reduce potentially precancerous skin patches, but also improve the appearance of sun-damaged skin, according to research from Dana L. Sachs, MD; Craig Hammerberg, PhD; Yolanda Helfrich, MD; Darius Karimipour, MD; Jeffrey Orringer, MD; Timothy Johnson, MD; Ted A. Hamilton, MS; Gary Fisher, PhD; and John J. Voorhees, MD; of the University of Michigan and Sewon Kang, MD; of Johns Hopkins University.

The research article, "Topical Fluorouracil for Actinic Keratoses and Photo-aging," published by Archives of Dermatology, showed how 21 healthy subjects, ages 56–85 years, with actinic keratoses and photo-damage, were treated with a twice-daily application of fluorouracil cream for two weeks.

According to the abstract of the paper, one day after the final treatment, gene expression of the effectors of epidermal injury (keratin 16), inflammation (interleukin 1β), and extracellular matrix degradation (matrix metalloproteinases 1 and 3) was significantly increased. In addition, types I and III procollagen messenger RNA were induced at week four (seven-fold and three-fold, respectively); type I procollagen protein levels were also increased two-fold at week 24, and actinic keratoses and photo-aging were significantly improved.

As reported, topical fluorouracil causes epidermal injury, which stimulates wound healing and dermal remodeling resulting in improved appearance. The mechanism of topical fluorouracil in photo-aged skin is said to follow a predictable wound healing pattern similar to that of laser-treated photo-aging.

-Archives of Dermatology

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