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Topical Medications for Skin Cancer

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By Editorial Team

3 min read

Reviewed by: HU Medical Review Board | Last reviewed: May 2025 | Last updated: May 2025

Topical medicines are medicines that are applied to the skin. Topical medicines for skin cancer and precancer come in the form of creams, gels, and liquid solutions.1

The recommended dosing frequency and treatment duration differ for each topical medicine.1

What kinds of skin cancer can be treated with topical medications?

The following are types of skin cancer that can be treated using certain topical medicines:

Actinic keratosis

Actinic keratosis is a type of precancer, an abnormal patch of skin growth that can lead to cancer. While not all actinic keratosis growths will become skin cancer, they should be treated as soon as possible because they could become squamous cell carcinoma (SCC).2

Basal cell carcinoma

Topical medicines are not as effective as surgery or radiation for basal cell carcinoma (BCC). Therefore, they are typically only used for low-risk BCC when other therapies are not possible.1

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Types of topical medications for skin cancer

Here are the 4 most commonly used topical medicines to treat certain forms of early-stage skin cancer (skin cancer lesions that are small and have not spread past the top layer of the skin) and precancer:1

  • 5-Fluorouracil or 5-FU (Carac®, Efudex®, Fluoroplex®)
  • Imiquimod (Aldara™, Zyclara™)
  • Diclofenac (Solaraze®)
  • Tirbanibulin (Klisyri®)

Fluorouracil

5-Fluorouracil, or 5-FU (Carac®, Efudex®, Fluoroplex®), is a topical chemotherapy drug. Cancer develops when cell division becomes uncontrolled. 5-FU works by interfering with cell division, causing the cells to die.1

When 5-FU is applied to the skin, it kills tumor cells on the skin surface. It does not reach cells in deeper layers of skin or inside the body. This means that fluorouracil works best on abnormal cells at the skin surface. It also means that side effects are mostly limited to the treatment area. Few side effects occur elsewhere in the body.1

Imiquimod

Imiquimod (Zyclara™, Aldara™) is in a class of drugs called immune response modifiers. This means that imiquimod activates your own immune system to kill the cancer cells. It can be used for certain basal cell skin cancers as well as actinic keratosis.1,2

Diclofenac

Diclofenac (Solaraze®) is a nonsteroidal anti-inflammatory drug (NSAID). It can be used to treat actinic keratosis. It is usually applied 2 times a day for 2 to 3 months. While it may take longer to work compared to other topical chemotherapy drugs, it typically causes less severe side effects.1,2

Tirbanibulin

Tirbanibulin (Klisyri®) is a topical medicine used to treat actinic keratoses on the face or scalp. It is usually applied once a day for about 5 days. Be mindful to avoid the mouth and eye area when applying.1

What are the potential side effects of topical medications?

All topical medicines can cause skin irritation. Side effects vary depending on the particular drug used. Potential side effects can include:1

  • Redness
  • Burning or stinging
  • Itching
  • Dryness
  • Flaking or peeling
  • Soreness or tenderness
  • Oozing
  • Crusting
  • Swelling
  • Blistering
  • Rash
  • Increased sensitivity to sunlight

Skin reactions in affected areas are worse with some topical medicines compared to others. Your healthcare provider should show you which areas of your skin to treat and how to apply. Discuss your concerns and preferences with your healthcare provider. Together, you can select a treatment that works best for you.1

Other things to know

Treating early-stage skin cancer with topical medicines has several potential advantages:1,2

  • Little to no scarring
  • Can administer treatment at home
  • Treatment option when surgery would be difficult to perform

Potential disadvantages of topical medicines include:1

  • Irritation at the treatment site during and for a few weeks after treatment
  • Not effective for everyone
  • Treatment duration can be weeks or months
  • Inconvenience of daily medication application
  • Need to avoid direct sunlight during the treatment period

Follow your provider’s instructions for frequency and duration of use, and do not discontinue use without discussing with your healthcare provider first.

Before starting a topical treatment option, patients should tell their doctor about all medications (prescription and over-the-counter), herbal supplements, and vitamins they are taking.

Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.