- Best Results1-2 cycles
- Treatment Recovery2-3 months
- Procedure Time1 minute
- Skin SpecialistGP
- Duration of ResultsVariable
- Back to WorkVariable
Solaraze gel is a topical treatment for sunspots-actinic keratosis. Though overseas studies have shown mediocre results in the clearance of solar keratosis, the actual efficacy in Australia is very low. It can be a useful adjunct to reduce recurrence of sunspots after PDT, lasers or other topicals.
FactsFacts on Solaraze Gel
- This formulation consists of a nonsteroidal anti-inflammatory called diclofenac
- Application frequency is in the morning & evening for up to three months
- Solaraze has the least amount of inflammation compared to other topicals
- Solaraze is not favoured by dermatologists as it has a low efficacy for clearing sunspots
- This is a fluffy treatment, best used in low-risk sun damage patients
What is Solaraze Gel?
Solaraze is an anti-inflammatory gel that has been approved for the treatment of sunspots or solar keratosis. Compared to other topical agents such as Efudix & Aldara, Solaraze must be applied much longer.
What types of sun damage responds best to Solaraze Gel?
Mild sun damage in low-risk patients. Solaraze is best for non-hypertrophic, flat, early, mild solar keratosis -actinic keratosis in non-immunocompromised patients who have too much time on their hands (probably applies to those who prescribe it as well).
To be fair, I occasionally prescribe this as a ‘mop up’ treatment after lasers or PDT, or as a prophylactic topical for actinic keratosis.
How do you use Solaraze Gel?
As with all medications, read the PI (product information). Your GP with an interest in skin cancer or your dermatologist will give you specific instructions that goes something like this-
- Apply a thin layer up to twice a day for 2-3 months
- Modulate your dose amount & frequency depending on your skin’s reaction
- Give them a call if you are unsure about stuff
What aspects of your history are important prior to using Solaraze?
Your GP or skin cancer doctor would like to know-
- If you have a bun in the oven (pregnant)
- Have asthma
- Have any skin issues including dermatitis or you have super sensitive skin
- Any allergies to NSAIDS (as diclofenac is an anti-inflammatory)
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How do you store this medication?
Keep it from heat & direct sunlight, an ideal place is the fridge. Everything lasts longer in the fridge; from cheese to Solaraze.
What happens if you forget to apply Solaraze?
Don’t stress. You can make it up by adding another application or day at the end. Don’t double the application amount.
What are the side effects of Solaraze?
Side effects of diclofenac (Solaraze) is less compared to Efudex, however can include-
- Inflammation, irritation, pain, tingling or blistering at the site of treatment
- Contact dermatitis, eczema, swelling, itchy & dry skin
- Hypersensitivity or painful sensation when the skin is touched
- pins and needles
- Rash, sometimes blistering or scaly
What is the meaning of combination field treatments for solar keratosis?
The current literature supports the use of combination therapy for sunspots. Solaraze can be used as a ‘mop up treatment’, following field treatments such as PDT, laser assisted PDT & fractional laser resurfacing.
An example is twice a day application of Solaraze for a total of 12 weeks to isolated solar keratosis, starting 4 weeks after laser assisted PDT. in reality, I hardly prescribe Solaraze as other treatments including Efudix & Imiquimod are more effective.
Which is better Efudex or Solaraze?
Efudix or 5Fu is better, however it has more side effects including-
- Erosions, itch etc.
It is well accepted amongst dermatologists that Efudex ranks as one of the best methods to clear sun spots, albeit a long & protracted recovery period of 2-6 weeks.
What is more effective, Solaraze or Aladra?
Aldara is more effective, however it is hard to modulate the inflammatory response. Common Aldara associated side effects include-
- Flu like symptoms
- Exaggerated responses
- Marked inflammation
- Prolonged redness
Autoimmune disease activation can happen, but is rare
Which is better - PDT or Solaraze?
PDT or photodynamic therapy is better, especially laser assisted PDT. Here are the reasons-
- Faster treatment time
- Better clearance of sun spots
- Faster recovery
- Address some cosmetic issues
The main disadvantage of PDT is the cost, however this treatment is covered under DVA.
A more cost effective PDT solution is called daylight PDT.
How do lasers compare to Solaraze?
Lasers produce much better outcomes when it comes to clearance of sun spots in addition to improving cosmetic concerns such as wrinkles, pigmentation & skin laxity. Recovery from laser resurfacing ranges from 4 to 10 days.
How do chemical peels compare with Solarze gel?
Medium to deep peels are much better than Solaraze as they clear more sun spots in addition to improving skin quality.
As a guide, Jessner -TCA peels;
- One session required
- 7 day recovery
- Conducted under partial sedation
- Improves sun damage & wrinkles
Is simple Vitamin B3 more effective than Solaraze?
It seems so, depending on the literature you read. Niacinamide or Vitamin B3 is an effective treatment for managing actinic or solar keratosis. It can reduce the burden of new sunspots & reduce pre-existing ones by up to 35% after two months of therapy. The ideal dose is 500 mg B3 twice a day. This means that B3 is 50% more effective than Solaraze. Additionally, B3 can also reduce some forms of BBCs & SCCs.
*Nicotinamide at 500 mg daily can improve sunspots by up to 35%.
Who to see for Solaraze Gel?
Best see a skin cancer GP, or a non-specialist who ‘specialises in skin cancer’. Most of my colleagues will not use this topical gel, exceptions below.
Davin’s Viewpoint on Solaraze Gel
I was involved in the final trials of diclofenac in Europe in 2001-2002. Clinical efficacy depends on the papers referenced. Typically, efficacy ranges between 20-35% over the vehicle (hyaluronic acid). It is not that this topical does not work, the argument is the probability of clinical efficacy in the management of clinically significant solar damage.
Possibly diclofenac is best for mild solar keratosis – think the average punter living in Northern Europe. In contrast, the actinic-solar damage in Australia is much more severe, hence the lower clearance rates.
I prescribe Solaraze in three clinical situations. Firstly, if you had a documented clinical response to this medication, secondly as a ‘mop up’ following more effective field treatments such as fractional laser or PDT, & thirdly as off label chemoprophylaxis in patients with aggressive sun damage (I prefer pulse Efudix for this group).
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