Has anyone used Efudix (Actinic keratosis)?

[Goatblu]

I've been prescribed this to use for 4 weeks on a patch of skin on my shoulder (GP says its actinic keratosis).

Has anyone used it? If so, are the side effects really bad and did you have to keep the area covered when outside?

My friend did. Yes, lots of patients don't comply with treatment because it hurts. They give up partway through the course. It's one of those "gets worse before it gets better" things. It will look hideous and hurts like hell apparently. It's not an allergic reaction, it's supposed to look like that. Everyone will be horrified, even pharmacists if they've not seen it before. You can find pics on Google. It'll find ones nearby that you can't see and didn't know you had (but have smeared in cream) and kill those off too. It doesn't really affect healthy skin other than a bit of swelling, so any manky bits are previously invisible AK. Heals up fast after treatment and skin looks like it's had a chemical peel - fresher, younger, less wrinkled etc. Yes you'll need to cover it during and after treatment, it'll be raw during and fresh baby skin after, both extra prone to sun damage (the initial cause of AK). Sunblock and covering up is your friend, if you don't want a recurrence or others to sprout up elsewhere.

Agree with @Eastertidings - my DH just used it on a patch on his forehead and some on his temples. What he should probably have done is focused on a small area, then when that area was better gone to the secondary parts. instead he slapped a tonne of it all over his head for about a week. It scabbed over and was painful, he was covering it in plasters and wearing sunglasses and a hat to leave the house. But then after a bath the scabs washed off leaving fresh skin underneath. It’s wonderful stuff but follow the instructions exactly and if you’ve got an important event coming up perhaps start the treatment after that rather than before.

Thank you @Eastertidings. I know it's not going to look great but as I've only been told to put it on one small patch, I'm hoping it will be easy to cover. There is a lot of sun damage in the area though.

I hope your friend is now ok.

Thank you @StickyProblem. I'm hoping I can just use it on the small patch the GP looked at. That must have been very sore for your husband, I hope he's ok now.

I’ve used it a couple of times on my face, I found the best way of putting it on the area I wanted and not the good skin was to apply it with a cotton bud.
it can be painful and look unsightly but the results are good

I am currently using it on my face so very prominent. I naively didn't realise what it would look like so went back to the GP who assured me that it gets worse before healing the skin. I am having the dodge the sun all weekend, the GP told me that some patients don't follow on with the treatment because of how it makes the skin look.

Thanks @goatbluhe’s absolutely fine now, he’d had that patch for months and it’s fantastic that it’s gone. Hopefully it’s a bit easier on a small patch on your shoulder and you can keep it covered. As @Eastertidings said the cream kills damaged cells while leaving healthy cells, it’s fantastic stuff. Good luck!

Yes all fine now OP thanks for asking. Good luck with your treatment.

Yes,last year on my lip. It wasn't nice, I think it'll be much more bearable on your shoulder. I felt nauseous and tired too when using it.

I need to do this but have been putting it off (having googled the pictures). i would need to do my whole face, realistically - due to a very sunburned childhood (not in the UK).

Has the GP actually said you need to do your whole face?!

@largeprintagathachristie Do a small bit at a time is my advice. It will feel
fantastic to have made progress with it. My DH is the same - 1970s childhood plus fair skin means issues later in life. It’s great that this cream exists tbh.

Good idea @hennipenni, thank you. I hope you're healed and clear soon @havanesehope.

I hadn't even thought about more general side effects @TeaRoseTallulah, only the obvious skin ones!

I have a feeling I'll end up using it over a much larger area eventually @largeprintagathachristieas I have a lot of sun damage. I've got to use it daily for 4 weeks then revist my GP after 8 weeks so I'll see what they say then.

Thank you @Goatblu, all my fingers crossed for you as well 🤞

Third time for me. It’s on my nose this time. I have a bright red sore patch right where everyone can see it. Oh well, it’s better to use it than end up with a squamous cell carcinoma.

I hope it works well for you @Xcellentaligat.

Am I right I thinking that now I've been diagnosed with one patch that I'm likely to get more crop up in the future? And that I must now live the life of a vampire 😭

Yes. Basically it’s sun damage, so any part of your skin that’s been exposed to the sun could develop actinic Keratosis. All mine have been on my face. I had some on my nose, which just went away. Sometimes that’s what happens. My DH had some on his wrist which developed quite quickly into a SCC. He had to have it surgically removed.

Can anyone recommend a sunscreen with sufficient protection please?

Obviously I know I can't undo past and accumulated damage (if only I'd have even though about SPF as a child or young adult...) but I need to protect myself properly now.

In recent years I've tended to use SPF 20 on my body and 30 on my face.

What should I be using now? I can't stand the feeling of heavy creams and I have reacted a few times to certain ones so recommendations to stay safer would be appreciated.

How do you manage on holiday?

I’ve had to use Efudix on my face a couple of times. I found it unsightly but not particularly painful.

I use spf 50 cream on my face that my sister sends me from the Australian Cancer Council so no help to you sorry.

But last year I also used La Roche-Posay Anthelios Invisible Anti-Shine Mist Sunscreen SPF50 from Boots to top up through the day. Much easier than reapplying cream over makeup.

Having said that, the best defence is to wear a brimmed hat as much as possible.

Thanks @Desperatelyseekingreason. I'll look for a spray/mist because even though I don't always wear makeup, I don't like the feeling of creams on my face (and they seem to make me sweat more).

Can I ask what you do about the rest of your body? Or do you keep totally covered up?

I get my sister to bring me an spf 30 body lotion from the Australian Cancer Council. It’s not greasy like a lot of our sun creams. Pity we can’t get it over here.

I've found a couple of spf 30s that appear to be gel like or more liquid so I'll get those. Is SPF 30 high enough do you think?

I used it all over my face (I did sections at a time, not all at once). I looked a scabby mess but it wasn’t particularly painful. Wonderful results, I’d not hesitate to recommend it.

I had a solar keratosis on my nose couple of years ago. I didn't want to use the Efudix as it was on my face. I asked to be referred to Dermatology and consultant cryoed it for me in about 30 seconds. It's never returned and I make sure I use factor 50.

I'm not sure why cryo isn't more widely offered. Years ago my GP had a cryo clinic.