Cryotherapy (liquid nitrogen)
Cryotherapy involves freezing the skin to -190o resulting in destruction of the tumour and surrounding skin. It is suitable for superficial forms of basal cell carcinoma and squamous cell carcinoma. Cryotherapy is a quick, cost effective technique with good cure rates. Cryotherapy does involve some initial discomfort and will form a scab that will heal over one to two weeks. Cryotherapy does not normally cause scarring, but can leave a white mark.
5-Fluorouracil cream (Efudix)
This is a topical cytotoxic agent used to treat superficial forms of basal cell skin cancer and squamous cell skin cancer. The cream is normally applied twice a day for a period of two to three weeks. There may be some variation to this regime, depending on the extent and location of the superficial tumour. It will irritate the area and can result in quite marked discomfort and inflammation. However, if used under supervision and used for the appropriate length of time it is an excellent form of treatment for superficial skin cancers. It has a good cure rate in the appropriate circumstances and leaves a good cosmetic result.
Imiquimod crème (Aldara)
Imiquimod acts via the immune system to stimulate the body’s immune cells to clear superficial tumours. It is most suited for superficial basal cell skin cancer. Application for superficial basal cell carcinoma is normally five times a week for six weeks. There may be some variation on this regime, depending on the size and/or location of the tumour. It results in a variable inflammatory reaction, which can be quite severe on occasions. The reaction is normally most obvious in the first two to three weeks. Occasionally a systemic reaction with a flu like illness can occur. Treatment with Imiquimod has good cure rates. The cosmetic result also is good.
Photodynamic Therapy (PDT)
This is a technique involving application of a photosensitising cream prior to exposure to light leading to destruction of superficial tumours. It is most suitable for superficial basal cell and squamous cell carcinoma. A topical photosensitising cream is applied to the area, followed by exposure to a light source. The phototoxic reaction destroys the cancer cells. The reaction forms a scab, which normally takes four to seven days to heal. Some pain can be associated with the technique. Clearance rates are good with this treatment and cosmetic results are excellent.
Curetting is a technique performed under local anaesthetic and involves scrapping the surface of the skin with a curette. This is suitable for superficial skin cancers. The appropriate lesion for this technique should be carefully selected and advice will be given by our dermatologists. After the area has been curetted, it leaves a graze like area that is then cauterised to stop the bleeding. The scab will generally heal within one to two weeks. The cosmetic results are generally good and the recurrence rates are low.
Superficial radiotherapy is used in squamous and basal cell cancers. This can be a very useful technique in the appropriate situations, with good long term clearance rates and cosmetic results. Our dermatologists can help with the assessment of the suitability of lesions for radiotherapy.