A drug used to treat deadly cancers of the colon, pancreas and head and neck may be the next new wrinkle in wrinkle reversal -- if you're willing to put up with several days of unsightly and irritated skin.
For all but one of 20 subjects (aged 56 to 85 years old) at the University of Michigan in Ann Arbor, Fluorouracil, a chemotherapy agent formulated as a topical cream, improved the texture and look of sun-damaged facial skin after subjects applied it twice daily for two weeks, reports a study published in this week's Archives of Dermatology. The subjects' own assessments were seconded by the clinical observations of the study authors, as well as by a committee of dermatologists who reviewed photos of the subjects' faces, as well as by a molecular assessment of the patients' facial skin by researchers.
But make no mistake about it: The 13 men and seven women who underwent the Fluorouracil treatment were having no day at the spa. Twelve of the 19 subjects who completed the skin regimen reported that the treatment was very or moderately uncomfortable, bringing to the skin's surface many more irritated, scaly patches of pre-cancerous skin lesions than had been evident before treatment.
As the subjects endured itch, redness and fiery irritation, however, a biochemical analysis of their skin cells revealed they were mobilizing for an epidermal renewal. The building blocks for new layers of skin, including Type I and Type III pro-collagen, shot up. By Week 6 following the beginning of treatment, fine wrinkles appeared to relax -- a change that continued to progress at 10 and 24 weeks after treatment. By Week 10, subjects' skin was judged to be significantly softer -- and got softer still 24 weeks after treatment. Darkened "age spots" lightened as did the yellow tinge of sun-damaged skin.
"The remodeling of the dermal matrix, which follows the inflammatory phase of wound-healing, is the mechanism for the improved appearance of photo-damaged skin," the authors wrote. By all accounts, the Fluorouracil cream had injured the subjects' skin, calling forth the body's natural defenses to rebuild it.
"The observed biochemical changes are typical of a wound-healing response," wrote the authors.
Flourouracil has been used since the mid-1960s to treat actinic keratoses, the scaly, patchy, rough skin lesions that are a sign of sun damage and considered the earliest stage in the development of skin cancer. For cancer patients taking Flourouracil as systemic chemotherapy, physicians have noted for many years that after an initial outbreak of red, patchy skin, patients' skin texture changes to resemble the skin of someone decades younger.
Despite complaints about skin irritation and redness, 17 of the subjects in the University of Michigan study said they'd try the treatment again for cosmetic improvement of their skin. And 11 even said they'd pay for it out of their own pocket. The study was funded by Valeant Pharmaceuticals International, one of several generic pharmaceutical companies that manufactures Fluorouracil.
-- Melissa Healy