No Detectable Improvement in Photodamaged Skin From Course of Topical 5 Fluorouracil Interview with:

Kaveri Korgavkar, MD Department of Dermatology Brown University Providence, Rhode Island 

Dr. Korgavkar

Kaveri Korgavkar, MD
Department of Dermatology
Brown University
Providence, Rhode Island What is the background for this study? What are the main findings?

Response: Photodamage refers to premature skin aging from long-term UV exposure. Topical fluorouracil cream, typically used in the treatment of actinic keratosis, has been suggested for use in treating photodamage due to clinical and histological findings. However, in our ad hoc secondary analysis of a large randomized clinical trial, a standard course of topical fluorouracil did not result in detectable improvement of photodamage. What should clinicians and patients take away from your report?

Response: The primary strength in this study is a large sample size in a randomized clinical trial of participants with severe photodamage. Our finding may suggest a true lack of effect of topical fluorouracil on photodamage. However, it may also be attributable to limitations in current photoaging scales. Most photonumeric scales focus on rhytids; fluorouracil may impact other manifestations of photoaging due to its mechanisms of action. What recommendations do you have for future research as a result of this study?

Response: The development of photonumeric scales that include manifestations of photoaging other than rhytids, such as hyperpigmentation, lentigines, telangiectasias, and volume loss, should be considered.

No disclosures or conflicts of interest. Thank you for your contribution to the community.


Korgavkar K, Lee KC, Weinstock MA, for the Veterans Affairs Keratinocyte Carcinoma Chemoprevention (VAKCC) Trial Group. Effect of Topical Fluorouracil Cream on Photodamage Secondary Analysis of a Randomized Clinical TrialJAMA Dermatol. Published online September 06, 2017. doi:10.1001/jamadermatol.2017.2578

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.


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Last Updated on September 8, 2017 by Marie Benz MD FAAD