Fluorouracil Skin Treatment - Before, During, and After

By TheAdventureTravelers

1 min read

This video is filled with some light-hearted humor to kind of take away the scariness of what happens when you use Fluorouracil.

This video takes you along on my journey of 24 days using the Fluorouracil (also known as Fluoroplex, Tolak, Efudex, Carac, and Adrucil) as a topical cream chemotherapy treatment. It can treat rough, raised areas of heavily sun-exposed skin (actinic or solar keratoses). It can also treat skin cancer (basal cell carcinoma).

Efudex is Fluorouracil topical cream 5%. It is used to treat areas of actinic keratosis and superficial basal cell carcinomas or skin cancers. I had to use the cream on my face twice a day for two weeks. The side effects were the unsightly red coloration, an occasional mild burning, and itching towards the end of using the cream the itching became more and more annoying.

My transformation is not as bad as others, however, I wanted to show viewers the reactions and what helped and what didn't work along with my Fluorouracil treatment.

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.

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Burnagain Member
Great forum-I live in the tropics in Australia, and am on my 3rd Efudix journey at 70. Sure it won't be the last. One thing I learned from the first go in the top end of Oz was to not do it in the hot months. Much easier to go outside in the cooler months for those second and third weeks of treatment. Did one round when living in Mexico City, and the cool climate seemed to make it easier. Thanks for this forum and good luck to y'all.
1. April Pulliam Member
 <inline-mention username="Burnagain" user-id="4165998"/> You are exactly right about treating in the cooler months. It makes such a difference in comfort level! I hope you are getting some great results! Wishing you all the best! April, SkinCancer.net, Moderator
Burnagain Member
Thanks <inline-mention username="April Pulliam" user-id="2086092"/> I was scanning this forum for views on a couple of things I ve been pondering. One, does the ability of your skin to repair itself when you remove the AKs this diminish in proportion to the number of times you have used Efudix? Two, does the application period vary depending on the magnitude of your affliction, or is it related to the relative sensitivity of the area being treated? Or none of the above? On this occasion it seems that part of the area stripped went into meltdown quicker than others, and at the same time was more sensitive than those other areas. Also less blotchy, a full on, uniform red. Keen to hear others views on these mundane topics. Cheers and thanks again.
1. April Pulliam Member
 <inline-mention username="Burnagain" user-id="4165998"/> You raise some really great questions. While I can't answer them specifically, I am going to tag Dr. <inline-mention username="Ben Wiese" user-id="2086759"/>. He is one of our advocates, and he is a skin cancer specialist. I am hoping he can step in and answer your questions. I can say that my treatment times have varied based on my dermatologist's assessment of my AKs. The first round I did was four weeks long and I applied twice daily. One of my subsequent rounds was only set for three weeks twice a day, and I reached erosion well before the end of the third week. The second time I treated my chest, I had a blotchy reaction much like the one you described whereas the first treatment was red through and through and extremely painful. ...and I don't think your topics are mundane at all! Great questions! Thank you for being part of our community! April, <a href='https://skincancer.net' target='_blank'>SkinCancer.net</a>, Moderator
Ben Wiese Member
Hi <inline-mention username="April Pulliam" user-id="2086092"/> and <inline-mention username="Burnagain" user-id="4165998"/>, good questions. Using the topical agents to kill actinic keratosis is like going for a dental clean every 6-12 months. There is luckily no maximum number or dose for using 5FU. The application period varies, depending on your skin type and what you would be able to handle. As you guys know, the s/e are the most difficult to manage. PDT is a much easier and faster treatment, but unfortunately also much more expensive. As a side note, make sure to completely stay out of daylight when using 5FU due to photosensitivity. I hope this helps. Dr. Ben Wiese 
1. alexavecchione Community Admin
 Hi <inline-mention username="Ashley Maddox" user-id="4731620"/>! I wanted to jump in and share with you our topical chemotherapy content hub, which hosts a variety of different articles on this topic. This may be helpful to look through, if you haven't already, to seek more information about topical treatment: <a href='https://skincancer.net/topical-chemotherapy-guide' target='_blank'>https://skincancer.net/topical-chemotherapy-guide</a>. Hope all is well! -Alexa (SkinCancer.net moderator)
2. Ashley Maddox Member
 <inline-mention username="alexavecchione" user-id="4661987"/> I will do it! Thank you. Much appreciated.
Burnagain Member
Thanks <inline-mention username="Ben Wiese" user-id="2086759"/> Dr Ben, <inline-mention username="April Pulliam" user-id="2086092"/> good to get that validation. I also found that on this occasion ridding myself of an AK on the nose made my nose redder than usual, with those pesky little veins making their presence known. There was no discomfort with the nose. Just the forehead. Crikey! Also managed to get a script for Desowen, which I think is very good for the healing stage. Not widely used in Oz yet, but available in a lotion. Cheers...
Somerville52 Member
I'm a bit late to this conversation but have a question! I'm in UK and have recently been diagnosed with three small AK's, what a steep learning curve at age 75 🤔. I'm at the healing stage of using Efudex 5%. My query is that you all seem to be using twice a day for a month, here I was told twice a day but for only two days a week but for a month?!?! Not only my doctor a friend had the same instructions from her doctor. It's worked I just wondered, I'll ask at my next appointment.
1. April Pulliam Member
 <inline-mention username="Somerville52" user-id="4725221"/> ...such a great question. Instructions for applying Efudex do seem to vary from one patient to the next and one doctor to the next. It seems that most of us are told to apply the cream twice a day for 3-4 weeks. Others, like you, are told to use it less often over a longer period of time. I can't say for sure, but I think sometimes instructions vary due to the severity of the damage and the location. I am glad you are past the worst of it all and have entered the healing phase. I am sharing an article on the healing phase. I might come in handy over the next few days. https://skincancer.net/life-with-skin-cancer/efudex-side-effects-tips Wishing you all the best! Keep us updated on your progress! April, <a href='https://skincancer.net' target='_blank'>SkinCancer.net</a>, Moderator
Somerville52 Member
Thank you so much there is much to learn! Lot's of most interesting information here that no doubt I'll read several times. I am healing well now but know all too well the burning, my cheek cracking when I smile and the itching which to me signifies healing so bearable 🥰. Thanks again UK Liza
lisag Member
I am a good couple of years past my efudex treatment and it was the worst round I’d ever undertaken. I have used it 3 times and it was by far the most painful of the treatments. At one point my throat swelled making breathing difficult. On a recent visit to my skin specialist I’ve now learnt that I can be treated in only a week because of the addition of vitamin D. I have a script ready if needed. I don’t ever really want to go through what I did previously. It was a miserable time. <img src="/content/images/2022/06/18/2e4985d130e68498ff802152266531fe_medium.jpeg" alt="This was about 3 weeks in treatment. " class="uploaded-image"/>
1. April Pulliam Member
 <inline-mention username="lisag" user-id="2096662"/> ...I completely understand what you went through. Efudex can be such a beast. It sounds like the addition of Vitamin D is a great alternative! If you decide go through with this treatment, please let us know how it goes! Thank you for sharing with the community. April, <a href='https://skincancer.net' target='_blank'>SkinCancer.net</a>, Moderator
lisag Member
Thanks April I will.
marshall5825 Member
April Can you use a head covering when going outside to keep sun off head when using Fluorouracil
1. April Pulliam Member
 <inline-mention username="marshall5825" user-id="6182007"/> ...I would definitely recommend covering up when you are using this cream. Your skin will be much more sensitive, and it's not likely you will want to feel more heat than you are already feeling. Protecting your skin is always important, but it's even more important when you are in the middle of treating with Efudex. Hats and scarves come in very handy during treatment. I hope you get some wonderful results and healing goes smoothly for you! April, <a href='https://skincancer.net' target='_blank'>SkinCancer.net</a>, Moderator