Solaraze or Klisyri not working - when to switch to Efudix or PDT
Solaraze and Klisyri are alternative treatments for actinic keratoses, and may cause milder reactions than Efudix. If keratoses remain or come back quickly, Efudix or photodynamic therapy are usually more effective.
Solaraze
Solaraze (diclofenac gel) is applied twice a day for 60 to 90 days. It often causes a milder reaction than other treatments, but in my experience it often proves ineffective or the keratoses recur.
Klisyri
Klisyri (tirbanibulin) is applied once a day for five days to a defined area. It causes an inflammatory skin reaction that settles over a few weeks.
Stronger options
- Efudix: applied once a day for about a month, with a marked inflammatory reaction that settles over a few weeks.
- Efudix with Dovonex: a shorter, four-day combined treatment.
- Photodynamic therapy: treats a whole area of sun damage at once, with a good cosmetic result.
- Cryotherapy: for individual keratoses.
A spot that does not respond
A spot that has not responded, or that is thick, tender or growing, should always be examined by a dermatologist to rule out skin cancer.
Treatment not working?
I can check any spot that has not cleared and recommend the most effective treatment for your skin.
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Test yourself: how well can you recognise skin cancer? Try Dr Lynch's skin cancer recognition quiz - real lesion photographs with instant feedback - or read the visual guide, How to Recognise Skin Cancer.
