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Efudex/Dovenix reaction on my lower lip

I was diagnosed with actinic cheilitis ( keratosis on my lower lip) and my dermatologist prescribed Efudex/Dovenix. He said I should use it twice a day for 5 days on my lower lip. I hardly had a reaction, just a little burning, but the white film on my lower lip remained the same. I was going to go back to the doctor and tell him this was not working, but I saw that the prescription said use 5-7 days so I decided to use it an extra 2 days for 7 days and applied a little more. Burning increased and I began to see the whole film on my lip dissipate.

Once I stopped using Efudex/Dovenix, I began to get scabs fornm on my lower lip ( about 2/3 of my lower lip) and a yellowish oozing coming out from my lip with slight bleeding under the skin. I began using Vaseline during the day. The problem I am having is that most of the scabs fall off when I eat or even when my upper lip touches my bottom lip. Then the yellow oozing starts and the scab begins to form, but some of the scabs don't hold. I feel like I am going around in circles. It has been 5 days since I stopped treatment, and I am getting frustrated with the scabs falling off my lip. I cannot brush part of my teeth or use any silverware to eat. When I do so, scabs come off and I begin the process all over again. I can drink soup out of a cup and eat chicken/fish because I use my fingers to put it in my mouth without touching my lip. How will my lower lip heal if a scab cannot stay on for more than a day? The pain is not to bad. But the skin is very raw in part of my lower lip and burns a bit when the scab comes off. Then the pain goes away when I put on vaseline and the process starts all over again Any suggestions?

  1. Hi - thank you for sharing your experience with us. I can understand the problem you're having with post-Efudex scabbing and how this could get in the way of everyday activities. Have you spoken to your doctor about this? Perhaps they would have some recommendations on how to handle the scabbing. I wanted to share a few resources we have that may be helpful to read through. The first is an article on healing after Efudex ( and the second is our topical chemotherapy hub ( I hope other community members who have experienced something similar are able to chime in as well. Please keep me posted on how you're doing! All the best, Alexa ( moderator)

    1. I went to my dermatologist and he told me I had a bacterial infection and he prescribed Mupirocin 2%. I am currently on day 9 of a 10 day treatment and all the scabs were finally removed today. Some of them were pretty huge, hanging over to my upper chin. My next appointment is in 6 weeks to determine if the Efudex/Dovenix treatment worked. My dermatologist said it is to early to tell. My lower lip gets pretty white at times and then goes away when I put on the Mupirocin. I am keeping my fingers crossed. The bacterial infection was worse than using Efudex/Dovenix. Have no idea what caused the bacterial infection. My guess is it was a side effect of Efudex/Dovenix, which I thought I tolerated pretty well, but I guess not. The problems started after I stopped using Efudex/Dovenix. After tomorrow, I will use Vaseline/ Aqaphor for 6 weeks and pray. What else can I do?

      1. ...I am so sorry this happened to you. Efudex is difficult enough without complications from an infection.

        I have heard of patients developing infections during treatment. I often wonder if these infections are from simply having such a large area of raw skin exposed to the elements. It seems logical that infections would happen more easily.

        I am glad you are treating it now and, hopefully, the worst is behind you. I would suggest that you keep using the Mupirocin as the doctor ordered and Vaseline and Aquaphor as long as the skin feels irritated, itchy, and tight.

        It can certainly feel like your skin will never return to normal, but it will. I never had white patches following treatment, but the redness definitely concerned me. It took a while to realize that the redness does fade and your skin looks new and healthy again.

        I am including an article on the lingering redness.

    2. My lower lip is definitely on the mend. I stopped the Mupirocin a couple of days ago and started using Aqaphor throughout the day and I am seeing improvement. The white streaks I was seeing toward the end of the Mupirocin treatment goes completely away when I use Aqaphor so I think it has something to do with my lower lip being dried out. I am back to eating whatever I want with silverware. My lower lip is a bit red and burns slightly once in a while, but goes away completely when I apply Aqaphor and there are no more scabs whatsoever. My lower lip looks bigger. I feel I have turned the corner and will make a full recovery. I can now brush my teeth by my lower lip and the tooth paste no longer burns my lip. I think I got the bacterial infection, which was much worse than the Efudex/Dovenix treatment because Efudex lowers one's immune system for fighting infections.

      1. I am so glad to hear you have turned the corner! It sounds like everything is headed in the right direction now. I know the relief you are feeling at being able to do the most basic everyday activities without discomfort--that makes such a difference.

        Please keep us posted on your recovery! We would love to hear about your results!

        April,, Moderator

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