Efudex Treatment Before or After Revision of Mohs Repair

It may not matter much which one is done first all that much. I typically recommend my patients to begin Efudex in the fall or winter as the skin irritation from Efudex is aggravated by heat and sweat. If you choose to undergo revision before Efudex, the incision from plastic surgery will also have to be completely healed before beginning the treatment.

Efudex, 5-fluorouracil, in some instance has been shown to help scarring.  This is not commonly used, but is picking up steam in the laser research communities.  On the other hand, cleaning up the background precancerous damage would be a good idea so that the plastic surgeon has a cleaner surgical field.  

At the end of the day, it probably does not matter that much, but I would recommend that perhaps a treatment before would be a good idea, and if you have still some precancerous lesions afterward, you could have a low threshold for considering a second round of efudex.

Ultimately, I would confer with your dermatologist.