Topical treatment

Learn about the topical drugs available in the treatment of skin cancer

You’ve been diagnosed with skin cancer and you’re scared of undergoing a surgery, so you decide to find out if there is an alternative treatment.

Did you know that there are topical application drugs that can effectively solve your problem?

Verónica Ruiz dermatologist in Barcelona specialized in topical treatments

I am dr.
Verónica Ruiz

Throughout my 15-year professional career as a dermatologist, I have successfully used topical drugs to treat a great deal of superficial skin tumor lesions with good cosmetic results.

In my opinion, it is a good therapeutic alternative if we select the most appropriate skin lesion.

Topical chemotherapy as an effective alternative in the treatment of skin cancer

If you have a superficial skin cancer and want an effective solution, without scars and with good cosmetic results, this type of treatment may be the right one for your problem.

By applying a cream daily for about 1 month, you can get the results you are looking for.

Learn how topical treatment works in the treatment of skin cancer

Current topical treatment options include 5‐fluorouracil (5‐FU), imiquimod, diclofenac sodium, and piroxicam. The goal of these therapies is to remove the cancerous and precancerous cells and also prevent the development of skin cancer in the future.

This type of treatment may be optimal in patients with multiple superficial lesions.

These are
their differences



5-FU is approved for the treatment of Actinic Keratoses (precancerous skin lesions) and superficial skin carcinomas. It works by preventing cell multiplication. This drug is usually available as a cream in different concentrations (generally between 2-5%) and it is applied on the lesion 1 or 2 times/day for a period of 1-2 months, depending on the type of lesion to be treated.



Imiquimod is an immunomodulator also approved for the treatment of actinic keratoses and superficial basal cell carcinoma. Cure rates at one year range from 60 to 80%. This drug is available as a cream at a 5% concentration and it is applied on the lesion once a day, 3-5 days/weeks for a period of  4-6 weeks, depending on the type of lesion to be treated.


Diclofenaco and piroxicam

Diclofenac and piroxicam are anti-inflammatory drugs that act through the inhibition of a molecule (cyclooxygenase 2 (COX-2) enzyme), which plays a key role in cell proliferation. The global efficacy of these topical agents is less than those previously mentioned (5 -FU and imiquimod), although it is well tolerated and easy to comply with. It is usually indicated as a maintenance therapy to reduce the number of precancerous skin lesions.

multiple studies support the need to treat cancerous fields rather than individual actinic keratosis in order to reduce future tumor development.

Frequently asked

The treatment with 5-FU and imiquimod usually comes with  signs of skin inflammation, not only in the area of the treated lesion but also in the adjacent apparently healthy skin. Within a few days of starting treatment, intense erythema (redness), swelling, superficial wounds and some local pain or discomfort usually appear.

If the inflammation is very intense and bothersome, the patient is recommended to take breaks from applying the cream for a few days until the reaction improves. Patients should avoid direct sun exposure during the treatment.

Yes. If the inflammatory reaction during the application of the cream is very intense, you can stop the application of the cream for a few days until the reaction improves and apply moisturizing creams or even a mild topical corticosteroid to alleviate local symptoms.

It is recommended to avoid direct sun exposure during treatment and apply sun protection when you have finished the treatment.

Yes. Most precancerous lesions and superficial skin carcinomas appear on skin that has suffered from chronic sun damage. Complete removal of this sun damage is difficult to achieve. Therefore, it is necessary to carry out a long-term follow-up since new lesions may appear in the same treated area, sometimes requiring several treatment sessions