Carac Cream for Actinic Keratosis

Community Member

We get a lot of questions here on SkinCancerConnection about the use of chemotherapy creams to treat skin lesions. In this post we are going to call upon the expertise of Doctor Lawrence Green, a practicing dermatologist, to answer a member question about the use of Carac cream for a skin condition called actinic keratosis. Actinic Keratosis is a type of precancerous skin lesion which can sometimes develop into squamous cell carcinoma, especially if left untreated. Dr. Green will be discussing the various treatments, including the use of topical creams to treat this skin condition.

Member Ben asks: Many medical references state that Carac is used for AK lesions on the face and anterior scalp. Has it been used effectively for AK lesions on the crown and sides of the scalp?

Dr. Green answers: Actinic keratoses (plural for actinic keratosis), also called "AK's" for short, represent cells on the surface of the skin with enough mutations in their DNA from long term sun exposure (through the sun's ultraviolet rays) that they appear as red, rough, scaly spots. These spots, because of their special skin DNA mutations, are considered precancerous, and if left alone for awhile have the chance of evolving into a skin cancer. Dermatologists prefer to treat all AK's because of their propensity to develop into an actual cancer if left alone. However, because these spots have only the uppermost level of skin that is mutated, they can be removed without cutting into the skin.

The most common treatment is to freeze them off by having the dermatologist squirt a very cold liquid nitrogen spray directly on the AK. If you have several to many AK's, dermatologists most often recommend creams to treat the AK's.

People with several to many AK's often have many other AK's that will come up eventually, and using a cream to treat one entire area of the body (i.e.. the face, the entire scalp, arms and hands) makes sense because both AK's that are present and AK's that are almost present can be eliminated. Some of the creams used are based on the chemotherapy agent 5-FU (Carac, Efudex, Fluoroplex are some examples of name brands), and another cream used is called Zyclara. Zyclara isn't a chemotherapy cream, as it works by getting our own immune systems to eliminate AK's by causing them to rash up.

Thank you Dr. Green for your answer

For more information about Actinic Keratosis and topical treatments for this type of skin lesion, please refer to the following informational articles and resources: