Six years ago, I had the dubious pleasure of living with red, raw, burning, itching, cracking, scaling hands for a month.
Now, finally–I have dreaded this for years–it is time for my face to endure the same treatment.
But not only that…my forehead, the back of my neck, my hands, and my arms, up to my tee-shirt sleeve. I don’t have to do it all at once, and I may live to regret this decision, but I intend to just bite the big bullet, and get it all over with at once. Six weeks from now I will be glad I did. Three weeks from now, I may be seriously questioning my sanity.
The condition is Actinic Keratosis, and pre-cancers too numerous to treat one at a time. The treatment is Efudex (fluorouracil, also sold as Carac) cream, applied twice a day for three weeks. The side effects are nasty, and will last several weeks beyond the end of application of the cream.
I have expected this journey I am going to share with you…part of this…and to some extent, have dreaded it for years.
I owe it to my fair skin, my love of the outdoors, and the fact that I was born about 10 years before the term “SPF” and the word “sunscreen” became part of our collective summer lexicon.
When I was a boy, and my family went to the beach, it was either Coppertone or Sea & Ski. Of course my parents knew that sunburns could be painful, and did their best to take care of my siblings and me in that regard….but the damage was done.
Fast forward to my early thirties…during those years, I lost two friends, John and Joe, to malignant melanoma, both leaving wives and sons. I began making somewhat regular visits to the dermatologist, and started learning about skin cancer.
Fast forward again, to my early forties. I had been a somewhat regular patient in my dermatologist’s office for about ten years, and nearly every visit had resulted in several new “spots” being either frozen off or cut off and biopsied. Most of those spots were benign, quite a few were basal cell, and two were squamous cell.
On one of those visits, my dermatologist gave me a prescription for Efudex and asked me to put it on the backs of my hands twice a day for three weeks. He explained that Efudex was a topical chemotherapy, and that it would “kill” many, many pre-cancerous spots before they could progress to the point that they had to be surgically removed.
In concept is sounds great. In practice, “it isn’t hell but you can see hell from there.”
I did my research. I learned that Efudex is brand name for fluorouracil, sometime referred to as 5-FU; another brand name is Carac. Technically these drugs are in fact chemotherapy, but they won’t make you nauseous or cause you to lose you hair. What they will do is make the treated area of your skin look and feel completely miserable for several weeks.
And that, in fact, was my experience, with my hands.
I have switched to a new dermatologist, and he has recommended that between now and my next visit six months from now, I treat the back of my hands again, but also my forehead, the back of my neck, and my arms, from my wrists to a few inches above my elbows.
Given my apparent love for beating myself up, I am going to do it all at once, and get it over with.
8 responses so far ↓
Eileen // May 9th 2008 at 9:44 pm
Hi Fritz,
FYI-I have read that efudex causes headaches. Many people complained about it.
P.S. I am impressed. This is as far as i have gotten so far. There are many links to click on while reading. This might take me all night, but a good read I am sure.
Eileen
Kim // Jun 2nd 2008 at 12:15 pm
Hi Fritz,
WOW. I’m so glad I found this blog. You are really crazy doing so many areas at once. I am also fair, freckly and am working on treating my chest area for the 2nd time. Only I am using a cream called Aldera. Man am I itching like crazy. I’d love to send you a picture and correspond with you. You poor man, you are so brave. Please email me and I will send you a picture.
Kim
Patricia // Nov 17th 2008 at 5:17 am
I am sitting here with my cream which was prescribed for the treatment of my precancerous lesions on my face and arms. I work in the emergency department as a nurse and am concerned about missing too much work. I will be at an increased risk of infection when my skin is in an inflammed condition due to the type of work I do. I am also a big chicken and can’t seem to get started with this. I am trying to determine the best time to start so I will be out of circulation when it is most convenient for me, I am thinking about January or February.
Cindy // Dec 21st 2008 at 1:40 pm
Hi Fritz:
I am sure that by now (Dec.2008), you are happy, healed and as handsome as ever. I want to thank you for your journal, as today is the first day of my journey.
I will read the entire site and probably cling to your optimism and sense of humor for support. I am past the age of vanity and old enough to have substantial damage…..so off we go!
Cindy
JP // Dec 30th 2008 at 4:44 pm
Fritz, thanks for your blog. I am a 50 year old male who had a small basal cell lesion pop up on my face 9 months ago. I procrastinated until 1 month ago (out of fear!) and I am now 15 days post Efudex treatment (2 times a day for 14 days on my face only). I am also fair skinned and never used sunscreen (until now lol). My pictures look exactly like yours. The redness is just about gone and I look “normal” again. My big question is this - I developed 5 noticeable pockmarks left from the treatment (1 in the basal cell area plus 4 more). Did you have any at all? I was just curious. I’ve never seen anyone else mention this.
Mark // Sep 30th 2009 at 12:59 am
Thank you for this blog. I just applied my first efudex dose on my face and have twice a day for 10 days to go through. I’m doing it just after having my bandages removed from a double MOHs BCC removal surgery that was closed by a plastic surgeon. I figured I’d get it all over with at once but really appreciate pictures and a day-by-day account of what to expect
Grace // Dec 21st 2009 at 12:26 am
Thanks so much for posting this blog. I’ve had years of dermotologist visits, each resulting in many spots being nitroglycerened off or biopsied and surgically. Most have been basal cell, but 2 have been squamous. I have some more crusty spots starting on my face, and I switched dermatologists. This one prescribed Efudex on my face for 3 week, then on my chest for 3, arms for 3 and hands for 3. I am in day 16 of the face treatment (you have chutzpa to do all at one time!!). I have 5 more days of pain and stinging, and have had some doozy headaches. It’s pretty ugly right now. I guess I’m just writing to thank you for writing your experience. It helps so much!!!
amy // Feb 13th 2010 at 10:18 pm
OMG! this treatment sucks…I hurt so badly..needed Loratab in order to sleep..I only used the lotion for 7 days on my chest
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