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Can Fluorouracil Cream Improve Signs of Photoaging?

Photoaging is the early aging of the skin as a result of prolonged UV-exposure. In a recent study, researchers investigate the effects of fluorouracil 5% cream on photoaging.

Photoaging presents with signs such as liver spots, wrinkles, spider veins, loss of elasticity, and hyperpigmentation. This premature aging of the skin is the result of long-term UV radiation. UV radiation exhibits many mechanisms that affect the skin, such as the formation of free radicals and direct injury of cells. A recent secondary analysis of a randomized clinical trial was published in JAMA Dermatology, to investigate the effect of using topical fluorouracil 5% cream on photoaging.

The use of fluorouracil systemically has shown an enhancement in skin texture and a decrease in wrinkling. Fluoroacil has been used successfully to treat some skin conditions, such as actinic keratosis. The mechanism by which topical fluorouracil works is that it causes damage to the top layer of skin, referred to as the epidermis; this triggers skin remodelling, wound healing, and collagen formation.  Fluorouracil’s skin healing pattern is similar to that seen in laser therapy and chemical peels for photoaging. This is the first study to investigate the use of fluorouracil topically as a cream in treating photoaging.

The researchers assessed 3,042 photographs from 281 individuals at baseline, six months, twelve months, and eighteen months using photonumeric scales. The majority of individuals involved in this study were male, white, and had a mean age of 71 years.

Unfortunately, this study did not show that topical fluorouracil 5% cream can improve the signs of photoaging. However, the authors of the study do argue that this finding may be due to the lack of efficacy of topical fluorouracil. It may also be due to the lack of robustness of the photonumeric scales used to assess the skin. The authors highlight that new photonumeric scales should be considered in order to identify other signs of photoaging. These scales can then be used to assess treatments such as topical fluorouracil.

Written by Jade Marie Evans, MPharm, Medical Writer

Reference: Korgavkar K et al . (2017). Effect of Topical Fluorouracil Cream on Photodamage Secondary Analysis of a Randomized Clinical Trial. Available: Last accessed 15th Sep 2017.



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