Unfortunately, most studies completed to date are either inconclusive or inadequately performed, making recommendations for skin cancer treatment difficult.
Fluorouracil / Efudix for skin cancer
Recent studies have shown that field treatment with 5-fluorouracil (Efudix) cream can reduce the development of skin cancers in the short term. This is for those with extensive actinic field damage.
A side benefit is that this treatment also improves the cosmetic appearance of the skin in some people.
At Skintel, we make use of Efudix field treatments for those we consider to be appropriate.
Nicotinamide for skin cancer
Nicotinamide, or Vitamin B3 was a promising candidate for protection against developing skin cancer.
A 2015 study published in the New England Journal of Medicine suggested that it could reduce the risk of SCCs by 30% and BCCs by 20% for those considered at high risk.
Other appealing considerations were that it is cheap, widely available and is ‘just a vitamin’ giving it wider appeal amongst the general population.
Unfortunately, subsequent analysis and reviews have called into question the study’s methodology and the beneficial effect of nicotinamide. Others have also suggested that nicotinamide may promote ageing. While we were initially keen to use nicotinamide, we have become more hesitant to recommend it after these developments.
Metformin
Metformin is a cheap, oral medication widely used for the treatment of type 2 diabetes mellitus (T2DM) as well as a few other conditions.
Some preliminary studies have suggested that metformin may reduce the risk of skin cancer development. While this revelation may be surprising for some, the theory is that metformin acts through the sirtuin pathway to reduce cancer development but may also be anti-ageing.
Further studies are required before we can recommend metformin for routine use.
