Treating Actinic Keratosis With Solaraze (Diclofenac) Topical Cream

Solaraze gel is a skin-use only (topical) prescription medicine used to treat actinic keratosis, a common precancerous skin condition caused by prolonged and repeated sun exposure. The gel can be used on all areas of the body.

Solaraze is just one type of treatment for the dry, scaly lesions of actinic keratosis (AK). Options include cryosurgery (freezing), curettage (scraping), shave removal, laser therapy, chemical peels, photodynamic therapy, and topical (applied to the skin only) creams such as Aldara (imiquimod), Picato (ingenol mebutate) and Calcitrene (calcipotriene) combined with fluorouracil, and Solaraze (diclofenac, diclofenac 3% gel, diclofenac sodium). 

How It Works

Although the exact way it works is not completely understood, it is classified as a nonsteroidal anti-inflammatory drug (NSAID), just like aspirin and ibuprofen. NSAIDs inhibit a molecule in the body called cyclo-oxygenase-2 (COX-2), which in turn reduces the synthesis of a hormone-like substance called prostaglandin. Sun damage and AK have been linked with raised prostaglandins in the skin.

Three clinical trials were conducted that led to the approval of diclofenac gel by the Food and Drug Administration (FDA). A total of 427 patients with five or more AK lesions on their scalp, forehead, face, forearm or hand were treated with either diclofenac or a dummy (placebo) gel for three months. Thirty days after the end of treatment, 30% to 50% of the AK lesions were completely cleared, double or triple the number seen in the dummy gel group. The best results were seen with AKs on the face.

Another study tested the effect of diclofenac on AKs that had already been treated with cryosurgery (freezing). The results were even better: 46% of the patients saw all of their AK lesions completely cleared, compared with only 21% of the patients who didn't receive diclofenac after cryosurgery.

Solaraze is not for everyone. Tell your healthcare provider about all of your medical conditions before starting to use diclofenac gel, including if you:

• Have an active ulcer
• Have liver problems
• Have kidney problems
• Have had a previous bad reaction to aspirin, ibuprofen or other NSAIDs

How to Use Diclofenac

Solaraze gel should be gently rubbed on your lesions twice a day. The amount needed depends upon the size of the lesion, but be sure that enough is applied to adequately cover each lesion. Your healthcare provider may recommend that you treat a general area with Solaraze, rather than just specific lesions, which may help clear lesions that are not yet visible.

Your practitioner will likely recommend you use Solaraze for 60 to 90 days. However, your lesions may not heal completely until 30 days after you stopped using it. If you see that some lesions are not responding to the gel, see your healthcare provider.

Side Effects and Warnings

In clinical trials, the most common reactions reported involved the skin and were generally mild to moderate in severity. These included:

• Itchy rash
• Dry skin
• Skin peeling
• Redness

Most of these reactions went away when the therapy was discontinued. It is important to avoid the sun and tanning booths while you are using diclofenac gel since it causes an increased sensitivity to sunburns. It should not be applied to open skin wounds, infections or other skin problems, or come in contact with your eyes. Children should not take diclofenac, and do not use this product if you are pregnant or nursing.