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  • Writer's pictureJean-Paul Abboud, MD, PhD

The Power of 5-Fluorouracil (5-FU) in Aesthetic Medicine: Reducing Scar Tissue for Improved Outcomes

As an oculofacial plastic surgeon, I strive to help my patients achieve the best possible aesthetic and functional results. One of the tools I frequently use in my practice is 5-Fluorouracil (5-FU), a medication with powerful applications beyond its traditional role in cancer treatment. In this blog post, I’ll explain what 5-FU is, how it works, and how it can significantly improve scar tissue, enhancing both appearance and quality of life.

What is 5-FU?

5-Fluorouracil, commonly known as 5-FU, is a chemotherapy drug that has been used for decades to treat various cancers. It belongs to the category of medications called antimetabolites and works by disrupting the DNA and RNA synthesis in rapidly dividing cells, which helps to slow down their growth. This property makes 5-FU effective not only in oncology but also in the field of aesthetic medicine, particularly for scar reduction.

How Does 5-FU Work in Scar Treatment?

5-FU targets the enzyme thymidylate synthase, crucial for DNA replication. By inhibiting this enzyme, 5-FU reduces the proliferation of fibroblasts, the cells responsible for producing scar tissue components. When injected into scar tissue, 5-FU helps to modulate fibroblast activity, reducing excessive scar production and promoting scar remodeling.

What are the Side Effects of 5-FU?

Side effects of intralesional, subcutaneous, or topical applications of 5-FU are rare, but include: mouth sores, poor appetite, watery eyes, sensitivity to light, and skin reactions (including dry, peeling skin, darkening of skin, and nail changes). However, serious adverse reactions to 5-FU are typically only seen with intravenous use. Side effects are almost always reversible and go away after treatment.


The Role of 5-FU in Aesthetic Medicine

In aesthetic medicine, 5-FU has been used for treating hypertrophic scars, keloids, and other problematic scars as an “off-label” non-approved use. Here’s how it can make a difference:

  • Softening Scar Tissue: 5-FU injections help to soften and flatten raised scars, making them less noticeable.

  • Reducing Tethering: For scars that tether or restrict movement, 5-FU can release these adhesions, improving both function and appearance.

  • Improving Texture and Appearance: By modulating collagen production, 5-FU can enhance the overall texture and color of the scar, leading to a more aesthetically pleasing result.



Case Study: Transforming Scars with 5-FU

One of my patients, a pedestrian struck by a car, sustained severe facial bone and orbital fractures. After undergoing reconstructive surgery by another plastic surgeon, she was left with long scars that pulled her lower eyelids down and tethered them onto her cheekbone, causing significant discomfort, dry eyes, and eyelid malposition.

To address these scars, I initiated a series of 5-FU injections. The goal was to soften the scars and release the tethering. Over several sessions, the 5-FU significantly reduced the tightness and thickness of the scar tissue. Gradually, the scars became softer, and the tethering effect diminished. Ultimately, the patient’s eyelids regained a more natural appearance and function, dramatically improving her quality of life.

before and after 5-flurouracial (5-fu) injections for scar reduction

Why Choose 5-FU for Scar Reduction?

5-FU offers a minimally invasive option for improving the appearance of scars. Its ability to target and modulate fibroblast activity makes it an effective treatment for a variety of scar-related issues. Whether used alone or in combination with other treatments, such as laser therapy or surgical excision, 5-FU can help achieve smoother, more natural-looking skin.

If you’re struggling with problematic scars and want to explore your treatment options, I encourage you to schedule a consultation. Together, we can develop a personalized plan that leverages the power of 5-FU to help you achieve the best possible results.



Dr. Abboud is an oculofacial plastic surgeon in San Diego who is an expert on cosmetic eyelid surgery. He is board-certified by the American Board of Ophthalmology (AAO) and is a member of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS).

For more information about treatment of scars or to schedule a consultation with Dr. Abboud for personalized advice on eyelid surgery, call our office at 858.356.2647


These are images of actual patients of Dr. Jean-Paul Abboud. They are shown for informational purposes only and are provided with written patient consent for use on this website. Please do not copy or distribute images/videos. Each individual’s treatment and/or results will vary, and no guarantee is stated or implied by any photo or statement used on this website.

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