Efudex: What's This About Erosion?

If you are reading this right now, you are more than likely new to Efudex. I am not a betting gal, but I’d be willing to wager you are somewhere around your third week of treatment, and you’ve recently come across “erosion” in a Google search. Like most of us who have been prescribed Efudex, you find that term to be pretty daunting - frightening, even. It’s my sincere hope that this article will answer some of your questions, help you understand what the Efudex erosion stage may feel and look like, and give you hope.

What is the Efudex erosion stage?

Erosion is the end of your Efudex treatment. This is the point at which you and your doctor will together decide to cease application of the chemotherapy cream. Simply put, the cream has done all it can, and it’s time to begin healing.

What does it look like?

Since most Efudex users experience redness and irritation, I will start there. Erosion, for me, means that the entire area I am treating is bright red but contains much darker spots where the actinic keratoses are most concentrated. These darker spots tend to pucker and may even begin to scab. Skin that has reached the erosion phase, in my experience, is no longer soft or supple looking. It appears stiff and hard - mask-like, if you will.

What does it feel like?

The question of the hour! I think I asked myself this before I ever thought to ask what it would look like. Google searches of Efudex images told me more than I wanted to know about skin cancer and the results of Efudex treatments. It was pretty clear to me that I would be red and inflamed. I wanted to know if it was possible to feel that the end had finally arrived.

Erosion, on the face, feels like having a mask on your face that you can’t remove. The same goes for the chest. The cream absorbs more and more quickly as the days go by, and the treated area stiffens, tugs and pulls when you move, and this can cause the burning sensations to temporarily intensify. It’s during erosion that I feel much better sitting as still as possible. Erosion makes daily life and work activities difficult. During erosion and the first couple days of healing, just bending over sometimes made my chest feel as if it were splitting open - it wasn’t, but you could have fooled me.

Look for seeping during the erosion stage

One of the key characteristics of erosion and what I watch for most is weepy skin. I have to say it is the most unsightly part of treatment, but I am always glad to see it; it means I am heading into recovery. Generally speaking, around the third or fourth week (patient instructions vary by case and doctor), seeping can occur.

Clear fluid will escape the dry irritated skin through tiny cracks and can make its way to the surface. The seeping is cool. I don’t mean that in the way we have all come to know “cool.” I mean it feels cool. I can’t count how many times during treatment I was just sure I had fluid on my face only to touch it and find it was dry. Somehow, and don’t ask me how, the seeping feels like it happens under that mask of dry, red, scabbing skin. On occasion, upon waking, I have found drops of clear to yellowish fluid on my pillow and sheets. I knew, then, it was time to stop.

One day at a time

I know. I know. None of that sounds hopeful or positive. Your dermatologist thinks you can handle it, and so do I. Three to four weeks sounds like an eternity, but it passes more quickly when you know what to watch for. Keep in mind, only your doctor can tell you when enough is enough. Communicating via telehealth is one way to make sure your doctor can judge how far you are from erosion and ultimate healing. One day at a time, you’ll do it. Hey, chances are really good, you are almost there now! Pat yourself on the back because you are a warrior!

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