Skin cancer reduction strategy

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After many years in the Sun,  skin becomes can become rough, blotchy and eventually forms crusty lesions known as solar keratosis. Each solar keratosis may have up to a one in 20  chance of becoming a baby skin cancer (intraepithelial skin cancer) in 4 years, and a further up to one in 20 chance (so one in 400  all up) of becoming something nastier (e.g. a squamous cell carcinoma). Some people may have hundreds and hundreds of solar keratosis on their skin but have a relatively low conversion into skin cancers where as other people may only need a crop of a few dozen solar keratosis to grow into multiple skin cancers.

For this reason we treat solar keratosis as a way to prevent nastier skin cancers from growing. Repeating treatments every few years is probably the best way at keeping cancerous from growing out of these solar keratosis.

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How to reduce solar keratosis
 

Morning sunscreen daily, regardless of going inside or outside - reapply at lunch time to be extra safe

50% reduction in precancerous over 4 years

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Insolar vitamin B3- 500mg Morning and Lunch

23% reduction in non-melanoma skin cancers within 3 months as well as 18% reduction in per-cancerous lesions within 12 months (study)

Benefit stops as soon as stop taking

Efudix (old faithful) - 80-90% clearance of precancerous lesions each course
costs about $60
takes about 1-4 weeks to work
takes another 2-4 weeks for the crusting to settle
can remained flushed for several months after this
small percentage of slow or non-responders

one course of treatment does not reduce the risk of a basal cell carcinoma however it will reduce the risk of squamous cell carcinoma for at least one year but less than four years (study) .: to have an ongoing benefit it may be necessary treat every one to two years.

best to avoid during summer

EFUCAL - 80-90%
can only get made at compounding chemists
costs about $120-$150
takes 4-8 days to work
takes about 2 weeks to settle
only treatment shown to reduce risk of squamous cell carcinoma growth as well as number of solar keratosis
higher degree of slow or non-responders (in my opinion)

best to avoid during summer

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Metvix - 80 - 90% clearance of precancerous lesions

costs $500-700 dollars per treatment
treatment takes only 4 hrs
quite sore for a few days
peeling usually settles in 3-7 days
flushing usually settles in 1-2 weeks
can't titrate treatment intensity mid-treatment

best to avoid during summer

Cryotherapy (the cold spray) - 70% clearance
quick and easy (for me) but painful for you
only treats areas we spray unlike the above creams which will treat tiny microscopic precancerous changes
more likely to scar
it's always a good time of year to do cryotherapy

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