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My experience with efudex

Efudex is a topical lotion that finds and kills pre-cancerous skin cells. When you have a small spot the dermatologist is concerned about, he usually blasts you with liquid nitrogen. But when it’s a larger area, you get efudex.

It was invented by a Dr. Dex and named by his patients.

Okay, I made that up.

Anyway, here’s what happened to me during my treatment. Captions are below the pictures.

This was the first day of treatment. Nothing happens for a while.

After a week, I looked like this.

After two weeks, it was getting pretty nasty and itchy.

Three weeks. Getting worse all the time.

Four weeks. At this point I should note that my doc said I was having a mild to moderate reaction to the treatment. So some people get it a lot worse than this.

After four weeks I stopped the efudex and started using hydrocordisone to calm down the irritation.

I had hoped things would clear faster than this. This is week five — one week after I stopped the efudex.

Six weeks. Still red, but not quite so sore and itchy.

By this point I didn’t need the hydrocortisone cream any more.

Eight weeks out, things are almost back to normal.

So, kids, wear your sunscreen and a hat. You need vitamin D, so get out in the sun, but keep your exposure regulated. Don’t get burned.

Talkback x 19

  1. RootCzar
    19 February 2012 @ 6:46 pm


  2. Mark
    24 April 2013 @ 12:54 pm

    Just been told to use this. The area is smaller than yours, seems like you needed to treat the entire forehead!!
    Better than cancer I suppose.

  3. Greg Krehbiel Greg Krehbiel
    24 April 2013 @ 12:56 pm

    Yes, it is better than cancer.

    There is another medicine that my dermatologist asked me to use recently on the top of my head. It didn’t have nearly as ugly a reaction, and I only had to use it for three days. I can’t remember the name of it, but I’m sure your dermatologist would know about it. You might ask if there are other options before starting efudex!

  4. Dave
    23 October 2013 @ 10:57 am

    Greg – the name of the 3 day medicine is Picato. I tried that first. Efudex is second.

  5. Greg Krehbiel GregK
    23 October 2013 @ 11:00 am

    Right. That’s the one. It’s a much easier regimen!

  6. jim
    7 December 2013 @ 3:38 pm

    Hi. I’ve been applying (once a day) Efudex for two weeks now with little reaction. My condition is very simila to that of yours. How heavy did you apply the cream?

  7. Greg Krehbiel Greg Krehbiel
    7 December 2013 @ 4:01 pm

    Hi Jim. I don’t recall anything special about it how much. Just the way I’d do sunscreen or something like that.

    I’m pretty sure the severity of the reaction depends on how much sun damage you have.

  8. jim
    13 December 2013 @ 7:34 pm

    Thanks, started applying it heavier and am now getting a good reaction.

  9. Phyllis P
    8 January 2015 @ 5:09 pm

    I started using the generic Fluorouracil 5% on 1/1/15. Doctor showed me a spot on my chest and when applied, the reaction spread, then applied it all over chest. It has been a week, and it started showing signs in 4 days. It hurts and itch drives me crazy.
    On the same day, had some spots on my nose and when applied it started spreading, so decided to apply it all over. Concern is that it will get in my eyes. Also applied it to both ears and one reacted right away redness and swelling. The itch makes it difficult to sleep, so I take a Benedryl 25 mg. and am able to get 4 hours sleep, wake up itching like crazy. Get up and take another Benedryl for itch and makes me sleepy. I called my doctor regarding the itch and was told to take Aquaphor after a few minutes putting on the treatment ointment.
    It’s now been a week since I started, and the itch is still horrendous, What I don’t understand is that you start with just a couple of spots and it ends up all over spreading like wildfire.
    I am still looking for something to help the itch.
    Any suggestions?

  10. Greg Krehbiel Greg Krehbiel
    9 January 2015 @ 9:39 am

    Phyllis, have you asked your doctor about hydrocortisone cream? That’s my only recommendation. I hope it gets better for you!

  11. Tracey
    3 March 2015 @ 5:16 pm

    First time I used Eufudix (UK sp) on my nose it only reacted a little, but after I saw my friends reaction which was an angry red and black I decided to redo mine thinking I must not have used it properly. This time it’s about the size of a 50p coin. I’m also treating one on my leg which was a tiny spot which has turned into an ugly red raw beast that has scared the heck out of me and I’m thankful I know what they look like. I’ve stayed another three spots which are all reacting. Mine itch just after the cream goes on and I know I shouldn’t, but I put bandaids on them for the first couple of hours to stop the cream getting in my eyes.

  12. Ben
    14 March 2015 @ 2:08 am

    Greg, Thanks for the generous personal report and vivid photos! I used Effudex (5% 5-fluorouracil) several months ago for a small patch of Bowen’s Disease (in situ squamous cell carcinoma) I.e., skin cancer that is not spreading. 6 weeks treatment, with no discomfort (on the inside of my upper arm!) Took another week or two for the thick scabbing to fall off, and when it did the condition was pronounced cured!

    Now I’m using it on my forehead for a few spots of precancerous keratosis, and after two weeks it looks just like yours at two weeks. I’ve decided it’s just too raw and distressed to continue, so I’ve stopped and hope it will have done the job. Reluctant to use cortisone since I figure that might slow down the healing if it suppresses inflammation – but not sure about that.

  13. Greg Krehbiel GregK
    14 March 2015 @ 8:00 am

    Good luck, Ben. I hope the treatment has worked.

  14. sue
    3 June 2016 @ 12:53 am

    Been using Efudex cream for 5 days and not seeing anything is this normal

  15. Greg Krehbiel GregK
    3 June 2016 @ 8:57 am

    I believe so. It takes a while before there’s any effect. Good luck.

  16. Janice
    6 November 2016 @ 11:59 am

    I just finished efudex treatment on my forehead. I quit after completing day 19. My reaction was intense. I had fluid buildup under my eyes in the cheek area and somewhat swollen eyes. My forehead was very sensitive and raw. I am now day 2 recovery, still swollen but sensitivity is much less.

  17. Greg Krehbiel Crowhill
    7 November 2016 @ 6:20 am

    Janice, I’m sorry to hear you’re having such a harsh reaction. I hope you’re consulting with your dermatologist. Efudex is awful, but skin cancer or worse.

  18. melly
    19 April 2017 @ 4:04 pm

    I couldn’t get by without Efudex. Have removed so much crud over last 20 years!! There are many ways to use it…you can start, go till you feel like you want to stop, then return to it again, rather than torturing yourself with a full multiweek regimen. A plastic surgeon told me I should do my whole face every 3 years, which I would never do, but I regularly treat sections of my face, arms, shoulders, scalp. I pretty much am always doing my nose. I’m 67, paleface, with a history of skiing, outdoor swimming, boating, and trying my darndest to get a tan. Fortunately only two basals, that I know of (I’m sure I’ve taken out lots of superficial basals with Efudex).

  19. Greg Krehbiel Greg Krehbiel
    20 April 2017 @ 8:51 am

    @melly, thanks for that. I’ll talk to my dermatologist about your approach.

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