Efudex Treatment Before or After Revision of Mohs Repair

Question

I had Mohs surgery by a dermatologist with the repair being done by a Plastic Surgeon 7 months ago. The dermatologist is suggesting the efudex treatment to address pre-cancer issues on my face. However, the Plastic Surgeon has stated that a revision will need to be done on the flap due to trap door deformity. My question is which procedure should be done first - the revision or the efudex?

Daniel I. Wasserman, MD · Answer

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.

Larisa Ravitskiy, MD · Answer

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 Treatment Before or After Revision of Mohs Repair

Answers (2)

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