Topical Therapy for Vulvar Pre-Cancer

Topical therapy means the drug is a cream or ointment put right onto the cancer. This is a way to treat vulvar intraepithelial neoplasia (VIN), but it's not used to treat invasive vulvar cancer. Topical chemotherapy for VIN does not work as well as laser treatment or surgery.

One choice is to apply the chemotherapy drug, fluorouracil (5-FU), directly to the skin of the vulva. This is called topical chemotherapy. Chemotherapy applied directly to the skin as an ointment will cause local irritation and peeling. This is normal and is part of the local destruction of cancer cells. Other medicated ointments suggested by your health care team can help relieve the discomfort of this treatment.

A second drug that can be used topically is called imiquimod. This drug comes as a cream to be applied to the area of VIN. Imiquimod is not a chemotherapy drug. Instead, it works by boosting the body's immune response to the area of abnormal tissue. This treatment has improved VIN, and in some women, it has made VIN go away completely. It can cause irritation and pain in the treated area.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

American College of Obstetricians and Gynecologists’ Committee on Gynecologic Practice; American Society for Colposcopy and Cervical Pathology (ASCCP). Committee Opinion No.675: Management of Vulvar Intraepithelial Neoplasia. Obstet Gynecol. 2016;128(4):e178-182.

Grimes C, Cunningham C, Lee M, Murina A. Use of topical imiquimod in the treatment of VIN: a case report and review of the literature. Int J Womens Dermatol. 2016;2(1):35-38.

Last Medical Review: November 3, 2017 Last Revised: January 16, 2018

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.