Day 4 - Starting to see some red areas

Just starting to see some reddening now and feeling a very slight irritation.  It's hard to see in the pictures, but there is a line between the whiter area on the top of my head where I previously used Efudex (10-15 years ago) and the redder area on my forehead, presumably because the previous treatment already removed much of the sun damage on the top.

Looking like a mild sunburn

Might be significant damage here

AK on cheek is reddening

Areas just appearing on forehead

Unlike some of the other people who have posted their Efudex experience, I have never really liked being in the sun. But in the 1950s and 1960s there didn't seem to be any real sunscreen. Instead they had "sun tan lotion." So every year when I went to the ocean with my parents I would get sunburned so bad that I would feel on fire on the ride home and then the burned skin would peel off over the next week. (Sound familiar?) I also spent two summers painting houses, one working on road construction, and one as a letter carrier - all without much protection. So I think most of my skin problems now are related to sun exposure before I was 20. There have been a few more recent  exceptions, like the time I hiked to the top of Yosemite Valley and forgot to wear sunscreen -- or even a hat! Ouch!

I now do bike rides which sometimes last from before dawn until after dusk. But I use Coppertone Sport SPF 50 sunscreen, which is truly amazing stuff. I apply it once in the morning, and even after sweating all day long, it keeps on working and I don't get even a hint of sunburn.

Anyway, the next few days should reveal how much sun damage actually exists on my face. Maybe just a few isolated areas? Halloween is tomorrow, so it's too bad that I didn't start this a week earlier. I could go to a party without any additional mask needed.

Day 1

The Efudex is supposed to be applied twice a day, which I will do at around 4AM and 4PM. I apply it to all of my scalp and face that is not covered with hair or beard. A mirror helps see the part of the bald scalp that extends down the back of my head. I tried to be sure to include the skin right above the moustache because I think I have been missing that spot with sunscreen and it seems to always be red over the past year or so.

Nothing will probably happen for the next few days, so I'll wait for a change before another post.

Day 0 - Before Efudex

This is what I look like before the Efudex treatment:

Area where I previously used Efudex

This is the AK on my left cheek that I hope will "light-up" and be destroyed by the Efudex. There is a small keratin pillar or horn that grows out of the red patch for a few months, then dissappears to be followed by another one in a different location within the patch. Two attempts to freeze it with liquid nitrogen failed. The cat came back after each attempt.

AK on my cheek with keratin pillar

Background

I'm currently 59 years old. Over the past 15 years I've had three basal cell carcinomas (BCCs) and three squamous cell carcinomas (SCCs) removed from various places on my face, leg, arm, and shoulder. About 10-15 years ago I used Efudex on my scalp to remove actinic keratoses (AKs) that result from sun damage and are considered pre-cancerous with a small probability of turning into SCC.

When I recently had a red scaly patch removed from my arm that turned out to be SCC, I noted that it had looked very similar to the red scaly patch that was developing on my left cheek over the past year or two. And since getting a patch cut out of my cheek sounded much less pleasant than a patch out of my arm, I asked my dermatologist if another round of Efudex might be worthwhile. She gave me a prescription and originally suggested putting it just on my scalp and left cheek. But I decided to use it on my entire face and scalp, as well as on an AK on my ear. After all, the right cheek has been exposed to the same amount of sun as the left one. And one of the neat things about Efudex is that it only "lights up" sun-damaged skin. So it seemed a waste not to determine (and fix)  the whole pattern of sun damage on my face.

I can't really remember much about my last experience with Efudex except for people staring at the red blotches on my scalp. I don't remember it being especially painful and my dermatologist says that it shouldn't hurt. But every other blog I've seen talks about it hurting alot. So we'll see what happens this time. Hopefully, adding my experience with Efudex to the others that have been published will help other people know what to expect.