Efudex: This, Too, Shall Pass

I’ve had moments of panic, and I am sure you have as well. I’ve panicked when I’ve been pulled underwater by a strong wave. I’ve felt what can only be described as my heart beating in my throat as I prepare to speak before a gymnasium full of my peers. I have, on more than one occasion, sucked in my breath and felt my face begin to burn as the thought hits me that I may have just locked my keys inside the house. The good news? All of these are fleeting and the most intense part of the discomfort, thankfully, passes almost as quickly as it begins.

And then there’s Efudex.

Feeling alone during treatment

The first year I was told to use Efudex on my chest to treat actinic keratoses, I had no idea what to expect. Beyond being told to expect the feeling of a bad sunburn, I was at a loss and left to fend for myself. (That alone is a valid reason to panic.) Each day brought something new as the cream began to irritate my skin, redness spread, and the burning and itching took hold. All of those things I felt I could handle fairly easily.

Then came the true test.

Skin's reaction to Efudex

If you have ever had the misfortune to treat your skin with Efudex, you likely know all too well what I am about to describe. At some point (it varies from one patient to the next), the skin seemingly realizes it needs the cream. When I say it needs it, I mean it all but begs for it.

The skin reacts as if it is being deprived and does its best to make you aware of the fact that it wants more. The skin becomes tight; it draws up and hardens, threatening to crack open at the slightest movement. More often than not, it makes good on those threats and seeps or bleeds a bit when the skin splits in the harshest days of treatment.

Vicious cycle of pain

The first time I treated, I applied the cream to my chest from just below my collar bones to the top of my breasts. (Years of having cryosurgery in this area had led my dermatologist to suggest using Efudex to rid a large area of the recurring precancerous lesions at one time.)

When I hit panic mode, I was approximately two and a half weeks into a four-week course of treatment. If I moved from lying in bed to a vertical position, I was met with excruciating pain across my chest. Every nerve I had was on high alert, and I lived in fear each morning of not making it to the bathroom before my chest split wide open. Once the cream was in place, everything calmed down, and I was able to go about my day until my skin dried out and the vicious cycle started over. The panic never really left me.

Fearing the inevitable

There is this fear that gripped me and put me in a kind of mental stranglehold each time my skin began to dry out and tighten. A feeling of helplessness flooded my thoughts, and I wanted to scream. I panicked--a blatant feeling of desperation as I wanted the entire ordeal to end. My breath would quicken, and I wanted nothing more than to cry, “Uncle!” Treating my chest was difficult, but treating my face brought new levels of frenzy.

Surviving the temporary, yet intense discomfort

During the summer of 2017, I recall trying to describe for my children the panic. I told them I felt as if I had on the most hateful mask ever created. I found myself, during the most painful and panic-stricken moments, sitting and taking deep breaths as I tried to forget where I was and what I was feeling. Believe it or not, it helped.

What helped more than anything was remembering the entire ordeal would indeed come to an end. You see, the first time I used Efudex I didn’t believe this. I was sure I had permanently scarred myself. I could see no end to the throbbing, tightly drawn flesh. Not knowing what to expect led to weeks of regret, frenzied thoughts, and despair. But, folks, it did end. I survived it and learned a lot from the experience.

Feeling panicked, and knowing it would pass

I have treated yearly with Efudex since 2015 and have grown accustomed to its emotional toll--it’s not pleasant, but it is indeed temporary. Granted, it took me a couple treatments to reach the point where I could say, “I’ve got this.” It is not for the faint of heart, but it is entirely possible to overcome the initial feeling of overwhelming panic as Efudex begins to do its dirty work.

No matter how intense the feelings of dread and fear, you are completely entitled to your own moments of panic. Above all else, know that the feelings of anxiety pass and you will, without a doubt, return to normal--a new and improved normal.