Fluorouracil (varients include Fluoraplex, Efudex) - Some doctors prescribe Flourouracil for DSAP. This drug was actually designed for actinic keratosis. AK cells grow faster than DSAP and this drug only targets fast growing cells. Thus by itself, I don't believe that Flourouracil kills off DSAP cells as would be the goal. Instead DSAP just gets "irritated" and red.  My opinion is that by itself this drug is an aggravating waste of time for DSAP.

I am told via emails from patients that doctor(s) at UCLA as well as on the East Coast are now prescribing a combination of Retin-A and Efudex for DSAP. Apparently this combination causes the "skin eruption" necessary to kill off DSAP cells, whereas Efudex alone does not cause the eruption. I have yet to receive any feedback from patients as to the effectiveness of this combination.  As with any treatment that causes a harsh reaction I suggest only trying a test spot first to see what happens, especially long term. My opinion is to avoid this treatment also because I don't understand how the long term end result would be any different than freezing.