My Efudex Arsenal: Arming for the Aftermath
Last updated: April 2023
Efudex, a topical chemotherapy, is commonly prescribed by dermatologists to fight actinic keratoses, and with that prescription comes a plethora of questions. Some of the most frequent questions I have been asked as a regular Efudex user are, “What do you use to ease the pain and itching?” and “How do you cover the redness?” These are somewhat loaded questions as side effects, degree of irritation and pain, and overall discomfort can vary greatly from one patient to the next.
Over the last four years, I have experienced basically the same array of side effects whether I have treated my face, my chest, or spot treated smaller pinpointed areas identified by my dermatologist as problematic. During the weeks when I am applying Efudex twice daily, I experience prickling and itching which intensifies with each subsequent application along with a burning sensation on the affected skin. Over-the-counter Tylenol and Benadryl are helpful for the increasing pain and constant itch. My dermatologist is one who recommends that no other products be applied to the treated areas during treatment other than water and a mild soap or facial cleanser. My cleanser of choice is Cetaphil.
It’s not over...even when it’s over
If you have seen photos of patients in the throes of Efudex treatment or watched videos of patients as they describe the pain and frustration of coping with side effects, you may find it difficult to believe that stopping treatment would be worse--it is. It is so much worse. As the skin grows accustomed to not receiving the cream, it begins to act out. The burning and itching magnify and, depending on the area being treated, it can become all but impossible to move freely without pain. Having a selection of products and procedures on hand in those critical hours after the last application is crucial for the patient’s well-being--both physically and mentally.
An arsenal at your fingertips
My go-to products for the 3-5 days following my last application are fairly simple to find and easy to use. I use these whether I have treated my face, chest, or small areas.
Vanicream Lite Lotion
I use Vanicream products because they are free of dyes and perfumes and don’t further irritate the already raw skin. (Note: Virtually any product applied to clean, treated areas will more than likely burn for several minutes when first applied. Subsequent applications aren’t likely to be as uncomfortable.) I use Vanicream liberally throughout the days and weeks as healing begins to speed up.
Cetaphil is another mild product which makes cleaning the area much less difficult.
Ice packs/cool rags
Bringing down the level of heat rising within and keeping the area moisturized is important in the days following treatment. I alternate ice packs and applications of Vanicream lotion.
Toning down the redness
Once peeling has taken place, the skin beneath is new and, if treatment was successful, free of actinic keratoses. That area will remain red and tender for several weeks, and the overall pink tone may be present for a few months. When I am ready to begin applying more than just a moisturizer to the skin on my face following treatment, I reach for some standard products that help tone down the redness beneath my makeup. Not one to spend big bucks on makeup products, I opt for some easily obtained and reasonably priced items that can be found on Ebay for even less with a little searching.
Studio Perfect Photo-Loving Primer by NYX
- This green color correcting cream is essential for getting the red skin ready for a layer of foundation or powder. I was skeptical the first time I applied it as it is thin and still allowed me to see the red skin beneath. I was completely sold when I finished the rest of my makeup application and could barely see a pinkish hue peeping through.
Super BB #InstaReady Beauty Balm by Physician’s Formula
This is my alternative to foundation and contains a broad spectrum sunscreen of SPF 30. It glides easily over the green color correcting cream and gives my new tender skin an added layer of protection against the sun. (The sun can easily and quickly irritate newly-treated skin.)
Super CC Color-Correction + Care CC Powder by Physician’s Formula
I don’t use thick layers of concealers or wear heavy layers of powder, but I do depend on this product to dust away the shine. I have found that new skin tends be oily, and this powder addresses that issue well. In addition, it also has an SPF of 30.
Super Power Sunscreen Mousse Broad Spectrum SPF 50
Likely the most expensive item I use on my skin, this sunscreen is a fantastic product. It is lightweight and dries quickly. I use it daily on my chest, and I have found it doesn’t in the least irritate healing skin. Like all of the other products, it can be found on Ebay with a quick search.
No product can take the place of a support system unified by a common bond. Turning to fellow users of Efudex and asking their advice on the dos and don’ts is one of the most beneficial things I have ever done. When you can make a connection with people who have been there and are currently there, you will have made a connection for life. Don’t be afraid to ask if what you are doing has worked for someone else. Don’t hesitate to question the effectiveness of a product you are considering trying. If I have learned nothing else from treating skin cancer with Efudex, I have learned that someone else out there can answer my questions, and I am never wrong for asking.
Do you sunscreen in the fall?