Efudex or Carac Cream for Removing Brown Spots?

Question

I have tons of brown spots on my face, chest, arms and legs from living in Hawai for 35 years. I've had some laser treatment which are very effective, but expensive.  Recently, a friend with the same condition used Carac cream and her brown spots disappeared.  I know all about Efudex, but can it also be used for cosmetic removal of these brown spots?

Sanusi Umar, MD · Answer

Many age spots are usually harmless and may be lightened with skin-bleaching treatments or removed with laser treatments. However, prevention is still suggested to limit their appearance. Using sunscreen of an SPF 30 or higher daily, limiting sun exposure and avoiding tanning beds are three of the best options.

	Skin bleaching is one of the most common treatments to address uneven skin tones. Over-the-counter (OTC) and prescription topical products may assist age spots. Hydroquinone is often incorporated into creams to whiten skin. It inhibits tyronsinase, an enzyme that controls melanin production. It is currently available in the United States as an OTC topical 2 percent hydroquinone cream or by prescription at 4 percent. For Efudex or Carac cream, both topical products may work on your friend but not on you. Since you have already had effective laser treatments, this may be your only route for extensively sun damage with age spots. It’s unwise to use another person’s prescription for anything, regardless if it’s effective on your friend. Schedule an appointment with your dermatologist for the most cost-effective options for your treatment.

Ron Shelton, MD · Answer

Benign brown sun spots, referred to as lentigines (plural for lentigo) and slightly raised seborrheic keratoses tend not to respond to this cream. Precancerous actinic keratoses are usually red and rough but some are slightly tan or brown and they do respond to both Carac and Efudex. It is wise for you to be examined by a dermatologist prior to you trying your friend’s cream, to make sure you don’t have any precancerous condition of which you should be advised.

Joshua L. Fox, MD · Answer

Age spots do not usually respond to Efudex or Carac. There is a common misconception that all face spots are the same. For a nonmedical person they may look identical. However, dermatologists are experts in skin condition can differentiate harmless spots vs. harmful lesions. It is highly recommended to consult a dermatologist. In any event, you should never use someone else’s prescription creams like Carac and Efudex, which often cause blistering and scabbing, without your dermatologists’ scripts.

Efudex or Carac Cream for Removing Brown Spots?

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