Nonmelanoma skin cancers, including basal cell carcinoma and squamous cell carcinoma, are common neoplasms worldwide and are the most common cancers in the United States. Standard therapy for cutaneous neoplasms typically involves surgical removal. However, there is increasing interest in the use of topical alternatives for the prevention and treatment of nonmelanoma skin cancer, particularly superficial variants. Botanicals are compounds derived from herbs, spices, stems, roots, and other substances of plant origin and may be used in the form of dried or fresh plants, extracted plant material, or specific plant-derived chemicals. They possess multiple properties including antioxidant, anti-inflammatory, and immunomodulatory properties and are, therefore, believed to be possible chemopreventive agents or substances that may suppress or reverse the process of carcinogenesis. Here, we provide a review of botanical agents studied for the treatment and prevention of nonmelanoma skin cancers. 1. Introduction Nonmelanoma skin cancer (NMSC) is common worldwide and includes basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Approximately two to three million NMSCs occur globally each year [1]. In the United States (U.S.), BCC is the most common form of malignancy [2, 3]. In 2012, two million new cases of NMSCs were estimated to occur in the U.S., with delays in treatment leading to significant morbidity [4] and deaths occurring in less than 1,000 [5]. Delay in treatment of NMSCs can lead to significant morbidity as well. Extrinsic and intrinsic risk factors contribute to skin cancer development including fair skin color, red and blond hair, and high susceptibility to sunburn [6]. Chronic sun exposure is also associated with skin cancer risk, especially for SCC [7]. Furthermore, chronically immunocompromised organ transplant patients have a higher risk of developing SCCs [8, 9]. Traditional recommendations for prevention of NMSC include generous use of sunscreens and avoidance of chronic or intense ultraviolet (UV) exposure. Conventional therapy for NMSCs involves surgical removal or directed topical therapies in the most superficial subtypes of？？NMSC. However, there is increasing interest in alternative, noninvasive treatments and preventative measures in recent years, specifically in the use of naturally occurring botanicals. Botanicals are a group of compounds derived from herbs, spices, stems, roots, and other substances of plant origin and may be used in the form of dried or fresh plants or extracted plant material [10]. They possess multiple
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