Fluorouracil (cream)

Easy-to-read medicine information about fluorouracil cream – what is it, how to use fluorouracil cream safely and possible side effects.

Type of medicineAlso called
  • Belongs to a group of medicines known as anti-metabolites
  • Efudix®
  • 5-Fluorouracil cream
  • 5-FU cream


What is fluorouracil cream?

  • Fluorouracil cream is used to treat sun-damaged skin, pre-cancerous skin lesions such as actinic keratoses (also called solar keratoses), squamous cell carcinoma and for the treatment of superficial basal cell carcinoma.
  • It works by blocking the growth of abnormal cells that cause these skin conditions.     
  • Fluorouracil cream is also sometimes used to treat other skin conditions such as viral warts.

How to use fluorouracil cream

  • Apply a thin layer of fluorouracil cream with a cotton bud to the affected area only.
  • Wash your hands thoroughly after applying fluorouracil cream, even if you have used gloves.
  • How often and for how long you should use fluorouracil cream will depend on your skin condition and which part of your skin is affected. Fluorouracil cream is usually applied once or twice a day, for 3 to 4 weeks when treating actinic keratosis and squamous cell carcinoma, and for 6 weeks when treating superficial basal cell carcinoma. Sometimes longer courses may be used. Your doctor will recommend a specific treatment schedule for you.
  • If you are asked by your doctor to apply fluorouracil cream once a day, you should apply it in the morning. If twice-a-day application is recommended, then apply it in the morning and late afternoon; do not apply just before bed because it might get on your sheets.
  • If you have widespread sun-damage divide the affected area into smaller areas and to complete treatment in one area before moving on to the next. This will help make the treatment reaction more tolerable. Your doctor will provide further advice about this.
  • Always use your fluorouracil cream exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much fluorouracil cream to use, how often to use it, and any special instructions.

Special instructions

  • You can apply moisturisers and/or make-up as part of your usual skin care routine, after 20 minutes of applying fluorouracil cream.
  • Do not apply apply fluorouracil cream on broken or sunburnt skin.
  • Take care not to get the cream in your eyes and nostrils or on your lips.
  • Avoid spending lots of time in the sun, or swimming — this might cause a skin rash. Also be sunsafe by wearing clothing and or a hat to cover the treatment site, and use sunscreens.
  • Only cover fluorouracil cream with a plaster if advised to do so by your doctor, otherwise leave the treated area uncovered. Covering the treatment area with a plaster is likely to induce a more severe skin reaction. When treating superficial basal cell carcinomas, however, covering the area with a plaster is often recommended.

Possible side effects

Like all medicines, fluorouracil cream can cause unwanted side effects, although not everyone gets them. Often unwanted side effects improve as your body gets used to the new medicine.

Side effectsWhat should I do?
  • Skin redness
  • Skin peeling
  • This is quite common when you first start using fluorouracil cream
  • Usually the area will get red after 3 to 5 days and may peel after 10 to 14 days
  • Tell your doctor if this becomes very uncomfortable or very sore
  • Changes in skin colour at the site of application
  • Sleeping problems
  • Temporary hair loss
  • Abnormal taste in the mouth 


  • Tell your doctor if troublesome  
  • Allergic reaction such as skin rash, itching, swelling of the lips, face, and mouth or difficulty breathing such as chest tightness, or wheezing
  • Tell your doctor immediately or ring HealthLine 0800 611 116

Learn more

The following links provide further information on fluorouracil cream:

Medsafe Consumer Information Sheet Efudix 
Fluorouracil cream (Efudix) Patient Information Guide SafeRx, Waitemata DHB
5-Fluorouracil cream DermNet NZ

Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr J Bycroft. Health Navigator NZ Last reviewed: 21 Oct 2015