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a large spot of efudex has a sad face but smaller spots look slightly less miserable

Spot Treatments: Easing into Efudex

If my guess is correct, you are here because your dermatologist has used the “E” word. And if you have researched Efudex for any length of time, chances are high you are now petrified about your pending treatment and have many more questions than answers. Truth be told, no two patients respond exactly the same way to the cream and you should not let photos and testimonies scare you away from a treatment that can have a positive impact on your skin in the long run.

Large areas vs. small ones

Keep in mind as you continue your search-and I know you will-you are likely seeing more pictures of large treatment areas than small ones. Also keep in mind that treating large areas such as the entire face, your chest, legs, or arms will yield vastly different results in terms of side effects than spot treating small, more contained areas. As with any treatment prescribed by a physician, it is important to discuss the options and weigh the pros and cons with your doctor before beginning application.

Spot Treatments

Spot treating with Efudex, for me, is a completely different animal than treating large areas. I have treated my face and my chest and, having done so, found that I much prefer spot treating. Treating large areas does rid my skin of multiple precancerous spots at once, but the side effects make for one rough ride. Side effects such as nausea, fatigue, itching, burning, and generally feeling rundown and emotionally drained are magnified when I apply the cream to large areas twice a day over a three to four week period.

When possible and given the go-ahead from my dermatologist, I opt to treat small areas no larger than a half-dollar. In certain instances, I apply the cream to an area roughly twice that size in both length and width. While sticking to a pinpointed area, twice a day, I apply the specified thin layer of cream after I cleanse the area and allow it to dry. Whether the treated area is on my face, chest, or back, I can move about more freely and avoid the discomfort of struggling to eat and the frustration of having fabric rub against irritated and, sometimes, raw skin.

Minimizing side effects

In addition to allowing me to move about more freely, applying Efudex in smaller areas seems to cut down on the number and intensity of side effects I typically experience. The nausea I usually battle is reason enough for me to opt for spot treatments. I can’t say that I never experience a sick feeling while spot treating, but I can say without a doubt that I do not feel sick for weeks on end while coping with appetite loss.

Easing in

Easing into Efudex, with your doctor’s advice, is a good way to steel yourself for what may be down the road-many skin cancer patients are repeat users of Efudex. Not every patient is required to treat large areas at once, but spot treating will give you an idea of what to expect on a larger scale if your turn comes. Don’t wear yourself out perusing Google images for Efudex photos. Take one step at a time. Talk with your doctor, voice your concerns, and find out if spot treating is the right path for you.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The SkinCancer.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Tony-B
    2 months ago

    As I missed the window for a second Metvix treatment (Winter) I was prescribed Efudix. The dermatologist said I had two superficial basal cell carcinomas that might respond to treatment by Efudix. The plastic surgeon wanted to cut and skin graft.

    Eight weeks later, both basal cells have disappeared.

    Why surgeons always want to cut and graft is beyond me when superficial BCCs can be treated by other means. Money in their pockets I guess.

    Yes Efudix hurts a little and itches like mad but it is only for a short time. Well worth the discomfort to get the required end result.

  • April Pulliam moderator author
    2 months ago

    @tony-b…It sounds awkward to put it this way, but I’m glad you missed that window of opportunity! It looks like it opened a door for another. You’re right. Efudex is rough. It hurts. It itches, and it is so very uncomfortable. In the end, it’s more than worth the struggle.

    I generally hear cases where patients have been prescribed Efudex for precancerous spots. I’m glad you had such great results with some already identified as basal. That surgery would have come with an extended recovery time as well.

    Thanks for sharing your experience with us. I encourage you to write more about it in our community section (I provided the link below) if you feel comfortable doing so. I know there are many people curious about the impact of Efudex on diagnosed basal.

    https://skincancer.net/stories/

    All my best! April, Skin cancer.net, Moderator

  • jthorens
    2 months ago

    Have you used efudex to treat superficial basal cell carcinoma? If so, how many weeks of treatment did you do and was it successful

  • April Pulliam moderator author
    2 months ago

    @jthorens…great question. I have not been prescribed Efudex for spots that have been biopsied and identified as basal. All of my treatments have been prescribed after my dermatologist points out numerous actinic keratoses on my skin. Usually these spots are clustered together or cover a large area like my chest. These are precancerous spots that may develop into skin cancer.

    It looks like you posted your question just under a community member who did have luck treating basal though. I’m hoping we both hear back from @tony-b either here or in the stories section on our site.

    Treating basal cell rather than having surgery sounds like a great option to me.

    Thanks for posting this question! Keep us posted on your treatment plan and the results! April, Skin cancer.net, Moderator

  • Tony-B
    2 months ago

    Love this forum and the help it gives everyone.

    In the UK we have the NHS, a fantastic benefit to everyone but it has long gone past it’s original design and needs drastic overhaul. In my area, if you are diagnosed with actinic keratosis, basal cell or squamous cell carcinomas you are first directed to a plastic surgeon rather than a dermatologist. My GP tried to circumnavigate this issue but it was not possible; the system is the system and must not be tampered with. (Administrators rule the roost in the NHS).

    Plastic surgeons only want to cut, carry out biopsies and stitch back skin grafts. My head was beginning to resemble a patchwork quilt. I am not stupid as the surgeons like to think and started researching my options. I demanded to see a dermatologist and told her I wanted to discuss ALL of the options, not just cut and stitch.

    We agreed a treatment of Photodynamic Therapy using Metvix which proved very successful. My head looked like it had a mass attack of large measles as the chemo cream attacked the pre cancerous cells. It hurt and itched for a short while but after four weeks it looked really good except for a few areas. These proved to house two basal cell carcinoms and possible a squamous carcinoma. As I previously reported, it was too late in the year (winter) to carry out a second treatment (a long story for another day) so the dermatologist recommended a treatment of Efudix as she hoped it would also treat the basal cell carcinomas as well.

    Bottom line is that yes it hurt a little and itched like mad. My head lit up yet again like a mass attack of giant measles but it has all calmed down and the basal cell carcinomas are gone.

    I would rather have treatment by this method for my actinic keratosis/carcinomas anytime rather than have a knife happy surgeon cut and paste on my head. Some people have bad experiences with Efudix but as they say, no gain without pain and t is only for a few weeks. (time depends on patient and dermatologist).

    Hope this helps.

  • riley0003
    6 months ago

    I had serious side effects even when treating a tiny area (size of a quarter) on my face. I will never use this stuff again. The pain was unbelievable. I do believe a few people have fewer side effects but 99% of the people I know who have had to use it have hated every second and most have had to discontinue usage because they got so ill and were in so much pain.
    Susan Riley

  • April Pulliam moderator author
    6 months ago

    @riley0003…I’m so sorry spot treatments were so uncomfortable for you. Efudex generally produces numerous side effects no matter how small the application amount though they may be less intense. I completely agree with you on the pain. There’s no way to avoid the itching, burning, and stinging of Efudex. Luckily there are some alternatives like blue light therapy which produces similar results without the lengthy application time.

    I hope you are doing well now and completely healed! Hugs, April, Skincancer.net, Moderator

  • ericagc
    6 months ago

    Very timely & helpful article with one caveat: I have just finished a 1 week efudex treatment on my lips. This is my 4th treatment over the years, and it really does help! That being said, I ALWAYS get a staph infection on my lips such that I request oral antibiotics whenever I start a course of treatment. It saves a trip to Urgent Care, & although I wait to see symptoms begin, I should probably just begin the 14 day course of Keflex right at the time I begin the topical efudex.

  • ericagc
    6 months ago

    Hi, Nina, I tolerate the antibiotics OK, and when one has a staph infection, one NEEDS to treat it! I have not treated other areas alone without simultaneously treating my lips with efudex, but last summer when I did my nose & lips, my nose did not seem to be infected. I’m guessing that the oral cavity may be more prone to infections. I know how miserable this treatment is, BUT I would prefer to do this periodically (prophylacticly) BEFORE having an actual Ca diagnosed. Mohs, as good as it is, would still likely leave disfiguring scars which would not likely be cosmetically satisfactory without a plastics revision (& even then, lips are dicey).

  • Nina M moderator
    6 months ago

    Thanks for sharing more of your perspective, @ericagc. I can see how you’d want to do it preventatively – I think that’s some of what April’s thinking is too. Especially, as you say, to avoid surgery and reconstruction on the lip area and also the nose.

    – Nina, SkinCancer.net Team
    Want to connect with the community? Join us on the Community page: https://skincancer.net/community/.

  • Nina M moderator
    6 months ago

    @ericagc, thank you for this point! I haven’t heard about this before, so I’m glad you’re opening the discussion. Does your body tolerate the antibiotics okay? It sounds like you have a strategy, even if it’s very bothersome to deal with both treatments at once.

    – Nina, SkinCancer.net Team
    Want to connect with the community? Join us on the Community page: https://skincancer.net/community/.

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