The sun is not good for you.  At one time, maybe twenty or thirty years ago, a tan was stylish and chipper.  No longer.  Sun on your skin is your enemy and the enemy of your children and your pets.  You must fight the sun to the death before the sun kills you first.  Several years ago I had a red mark under my left eye.

My dermatologist took one look at it and said, “It’s nothing now, but I know what it will become.” He wrote me a prescription for Effudex.
Effudex, my doctor told me, was a “topical chemotherapy cream.” I was taken aback by the word “chemo” and he went on to direly warn me NOT to apply the Effudex cream on my red spot with my finger because, he said, “You’ll chemo your fingertip.”

My pharmacy didn’t have Effudex in stock so I had to wait a day to begin my treatment. My doctor told me to use a Q-tip to apply the cream but to “not put on too much. Just cover the red spot.” Have you ever tried to precisely place chemo cream on your face with a Q-tip over an area that is smaller than the tip of the Q-tip?

By the end of my treatment my tiny red spot had grown to the size of a quarter! The fault was all mine. Once you go “outside the lines” with Effudex, there is no going back to the original red mark because everything Effudex touches leaves a red mark! So there I was, day along day, increasing the size of my red mark bit-by-bit with my Q-tip.

It was hilarious if it wasn’t so serious.  I was nauseous for 90 minutes after each twice-a-day Effudex application. The stuff was strong. It sapped my strength. It made my red spot go away and made my doctor very happy. I still shudder at the memory of the smell.

My doctor also told me that with my hazel eyes and fair Nebraska skin, I must never go out in the sun without SPF protection: “there’s nothing good in the sun for you,” he says every time I see him and he always wants me to “wear dark sunglasses with full spectrum UV protection.”

My doctor likes, for now, any SPF product that has “Parsol 1789” and I found Neutrogena’s UltraSheer Dry-Touch Sunblock with SPF 30 to fit that bill:

Neutrogena UltraSheer

My doctor said any SPF over 30 is a waste of money. I love the Neutrogena because it is truly “Dry-Touch” and once you put it on it sinks into your skin and it leaves no shine, residue, or smell, behind! The newest thing is a sunblock product with “Mexoryl” instead of Parsol 1789. My doctor said Mexoryl is terrifically more effective than any other sun-block ingredient but, of course, you can’t purchase it legally in the United States.

I’ve known about Mexoryl for about four years and I am still waiting to legally buy it in America. You can buy Mexoryl products in Canada, but not the United States.

You can, however, go down to Greenwich Village in New York City and, in some of the better private pharmacies, purchase (under-the-counter) imported sun-block with Mexoryl.

You have to ask for it by name because the Mexoryl products aren’t displayed and you’ll have to fork over $60 cash to buy a small bottle.

There’s always a price for protection in New York!

My doctor told me your chances of getting skin cancer later in life triples if you had two serious sunburns as a youngster. I remember one especially severe burn I had while at university. My girlfriend at the time put “Sea Breeze” (do they still make that awful stuff?) on my burned back and shoulders and, almost immediately, my flesh crackled into chicken skin. It was nasty and it smelled like burnt flesh and it
didn’t “cool me down” like she thought it would.

Some people I know wear more clothes during the Summer than they wear during the Winter AND they use an umbrella when the sun is bright in a cloudless sky. I don’t go that far yet, but I do wear a hat to protect my face, eyes and ears (always put sunblock on your ears, especially the tops, they burn fast!) if I’m going to be outside for awhile and I lather on the sunblock every day.

The sun is not your friend, and it never really was, so don’t be taken in by the promise of its youthful, sunny, smile because you’ll pay for it in spades in later in the dark days of aging.


  1. I was just thinking about this yesterday. I heard someone talking about heading outside to get a “healthy glow.” In my case, there is no such thing. I just get an “unhealthy burn.”

  2. Hi JJ —
    Right! A tan is your body’s reaction a burn, no way around that one. 🙂
    My mother, who claimed to always tan and never burn, would pull me outside when I was young so I could “get some sun” and I would try to follow her lead but it would never work…
    I was always hot and uncomfortable and, I know now, ON FIRE!
    I’m all in favor of spraying on a tan if that is important.

  3. In Africa, the sunlight is our life.
    We dance in the sun for fun.
    Thank God your doctor got the cure.
    But, you panicked.

  4. I don’t call your response panic, I call it prudence. Living in the Caribbean has allowed me to see several older caucasian acquaintences come to terms with the result of years of sun worship. The sun can kill.

  5. Hi dorna!!
    Thanks for the real-life warning.
    Some skin types are more sensitive to sun exposure than others, but if we want to play it safe, we need to protect ourselves with clothing and sunblock when we go outside.
    One can get a sunburn in the Winter, too. 🙂

  6. I will be starting Effudex shortly. I will call my pharmacy first, thanks to you. I have several on my face. What will I look like (they are pre-cancerous). Do you have pictures? Thanks for any reply.

  7. Hi Kibbe —
    No, I don’t have any photos and you should not look bad at all.
    The areas you are treating may become a little pink but nothing terrible should happen that others can see.
    My issue with Effudex was it was hard to apply and it made me a little nauseous.

  8. I,m a redhead. A number of years ago I had a lot of precancerous cells on my lips. The Dr. offered either surger or effudex. I chose effudex. I put it on my lips for a two week period. It didn,t bother me to put it on but by the end of the two weeks my lips were very sore and weepy. It looked like a huge cold sore. But, it did the job.

  9. Ouch, ouch, ouch, val, val, val!
    You make me hurt all over!
    I can’t imagine putting that stuff on my lips.
    I’d rather be cut there than chemo-ed.

  10. David:
    I was just diagnosed yesterday with actinic keratosis.
    The doctor prescribed Effudex 5%. It is in the first
    stages, but I need to place it on my forehead, temples,
    above my upper lip, top of nose, and cheak bone area.
    This is to be applied for 3 weeks. Can you give me an
    idea of what stages I will go through, the healing
    process to look normal, etc?
    I’m worried – and I work in the public eye!

  11. Hi Kris —
    I don’t remember really having stages. I put the stuff on, the area became red — but not blindingly so — and that was it. For me there was no puckering or bleeding or scabbing or scarring and no one but me knew I was under the influence of Effudex.
    For my skin to lose the reddish color where the medicine was… — that took a little longer — maybe 4-6 months before it entirely faded.

  12. David,
    I’m thinking you must have forgotten… I just finished two weeks of 2X’s per day (on my whole face). My face is bright red with dark spots and it hurts like hell. It didn’t really get this bad until the last 5 days, but when I came into work people were shocked at how bad it looks. Everyone in my office or people I see on the street know something is going on big time with my face!!! Let’s be honest.

  13. I did 5 weeks with 5% solution on the top of my head. It didn’t seem to be too bad. Mostly redness, not too much pain. It did the job. I did 2 weeks 5% on my nose cheeks and forehead. It first turned really red then the spots appeared and the skin dried out kind of scabby. It did get to hurting really bad. It took about a week for the pain to stop. It looks really good now. You know what they say. “No pain no gain”

  14. Just finished my last effudex treatment last night. First week was a walk through the park. By the 9th day, the spot on my left cheek bone looked similar to a portwine stain (about the size of a two dollar coin — I’m obviously canadian!) and it began to blister. No lying here, it’s quite painful. I saw my doctor this morning and since I’m finished with effudex I can now apply a small amount of hydrocortisone cream which will help with the pain and the healing. It looks pretty bad now, but I was told by someone who reacted to the medication the same way I did that it heals quite quickly — no pain or ugliness after two weeks. Not fun, but better safe than sorry.

  15. I had 2 or 3 bad blistering burns on my forehead and elsewhere at the lake and snow skiing when I was a kid living in Seattle area … just turned 55 now. I have (Irish)freckled skin and red-brown hair.
    For the last 5 years I have had the AK’s ( Actinic keratosis )removed by freezing them off by both my General Practitioner and by Dermatologists in Spokane, WA. I moved to ARIZONA one year ago and my GP has said the Effudex will be a better solution. But he warned me I will look like I have smallpox…for awhile.
    Thanks for the info, I will have the worst time finding my bumps with a Q-tip…because I have poor fine dexterity and my bumps really can’t be seen because of so many freckles. I just did a mapping of my AK’s on my forehead and temple(near the eyes) and it appears to be about 4 areas of a nickel size each.
    I may have to see if there is some way I can have someone else apply the effudex at a dermatologists or something like that. I believe Medicare policy is to pay 100% of the cost (or at least no copay to me) for the freezing spot treatment done in the past several years.
    Thanks for the networking and advice.

  16. Hey hibob!
    Welcome to the blog and thanks so much for all that keen and helpful unformation! I am so glad to hear you are being proactive with your health!

  17. This is my third treatment with Effudex. The first two times were on my lips, this time is my entire face. I agree with the previous post about the lips looking and feeling like a very bad cold sore. Painful & oozy & crusty. I’m on day 8 with my face and so far nothing is happening — do you think I’m clean or will it start any day now?

  18. A friend of mine told me about Effudex and I saw her go through the process. I started using it myself because I have been burned very badly several times. I have fair skin with freckles and I have started noticing several age spots, etc on my face. The dermatologist said it was from the sun. I have been using the product for about a week now. I started out with general redness on my face. Now I have quite a few red spots on my cheeks and forehead. The area that especially bothers me is around my mouth and chin. That area is crusty and every time I open my mouth, it feels like the skin is cracking in the corners of my mouth. My doctor told me that this is nasty stuff and will make me look my face went through a meat grinder, but that it will be great afterwards. My friend’s face looks great. She said it feels much smoother now. I am told that this week of treatment will be worse than the first week. I also have gotten bad headaches and feel tired all the time. I am glad to hear that someone else has these symptoms too. I was wondering if it was related.

  19. I have just finished with my third week of effudex 5%. I am awake since 3am since my chest is itchy and burning like crazy. The bright red and scabby looking marks are nothing in comparison to this intense awful feeling. I feel like ripping my skin off. I am using Eucerin Healing Ointment as per the Dr.’s direction, but I don’t know if the healing is this painful for everyone. It only itched during the 3 weeks of usage, but now that I am done, it hurts worse! I would never use this on my face, it would look too awful for too long a period of time. If I had a month to stay away from the human race, no problem. I am sure it would work, but I work with the public, and I wouldn’t subject them to looking at my face if it would look anything like my chest. there are at least 30 scabs and they are super red and ugly. I have a hard time finding shirts for work to cover the area.
    I am happy to be healed, but its a hard month! they say it takes another month to heal. I can’t take it.

  20. Since effudex acts only on fast-growing cells (such as actinic keratoses), the effect will be different for different people. Some will get spots here and there, and some (like me) will be miserable the whole time. I’ve done it twice on my face, and I am entering my third round after a couple of years without. Knowing how it will affect me, I’m not real happy about starting the treatment, BUT I just had cancer surgery on my nose so now I know the effudex is preferable to surgical removal.

  21. It was suggested that I use aldara for my most recent spot on my nose that I have been concerned about. I have had the surgery on my nose for cancerous basil skin cells about 3 years ago and don’t ever want to again. I’m freaking out! The aldara has produced a painful red spot on the corner tip of my nose about the size of a dime and I’m thinking basil cells again. I had also been told to use the aldara on my first cancer and when I had used it, it completely ate out the newly healed spot where the dermatologist had removed the cancer. I had experimented with the aldara awhile back since I had some left and applied it to spots on my back which I had turn up after too much sun. It made them look like pimples and finally I quit putting it on them and they healed up and are now gone! My nose is really a scare though since I have already had my share of cancer cells.

  22. Someone very close to me is starting to use the topical chemo cream on her face. Is there anything that anyone has found to help with the pain and or anything that maybe was soothing?

  23. I used the Effudex for 2 weeks and nothing much happened. Then I went to see my dermatologist thinking I had no AK b/c nothing was happening. She said use it for another week.
    OH my GOD !! It hurts SOOO bad, I look hideous and I had to forbid my co workers from making me laugh. When I move my mouth my face cracks. It is gross. I can hardly open my mouth to eat, I need to take teeny tiny bites of food. A friend of mine gave me a steroid ointment to use for pain and it helps
    alot but it is a prescription. It is called Fluticasone. I asked the pharmacist if there was any OTC similar and she said no. I am so grateful to my friend who let me borrow his. My dermatologist wouldn’t write it for me, she said to use vaseline which turned out to be useless.
    I have finished the treatment and am now awaiting an end to the suffering.
    A coworker used this stuff a couple of years ago and she used to put her face in a sink full of ice water – I may give it try. I am desperate for relief. Last year I had a chunk of my nose removed for squamous cell so I am grateful for this horrible stuff if it keeps me out of surgery. Or worse.

  24. I’m scared now! I’ve read all of your situations and I’m really dreading the use of Aldara on a spot on my nose plus two small areas on my legs. I’ve hesitated to even get my prescription filled after reading whatever I can find about Aldara on the web. Sure sounds like horrible stuff! My Dr. quickly mentioned “we could freeze this…” but then jumped into talking about using Aldara instead. I dont want to look so scary either (!!), will I possibly be able to use a tiny bit of makeup/foundation on my nose to make it look less horrific..?! My Dr. didnt suggest using Q-tips to apply, should I?? Wow.. i have lots of questions.. and hesitations.. but I dont want cancer! He says it is precancerous .. actinic keratosis. I’ve had surgeries before for places near my hairline. Any opinions or suggestions are welcome! (And, YES.. the sun is my “enemy” now, too bad that we fair-skinned ones have to pay this way).

  25. Has anyone tried anything natural? Does anyone know what future harm can come by using either Aldera or efudex?

  26. I just finished 8 weeks of Efudex on my face, hands and arms. The last two weeks were the worse. My face got beet red, oozed, got scabs and broke open all the time. During the night, they broke open and I bled all over my pillow. It was awful, but I would rather do this treatmen than have surgery. I am putting hydrocortisone cream on the spots now, and it eases the pain immensely. I am a redhead with fair skin. I know that I will have to do this again, but, again, it’s better than surgery. Good luck to everyone.

  27. I think I may be headed toward the battery acid treatment. I have hard about 4 places on my face frozen and they’ve come back. Suppose that’s the next step? We were too preoccupied dealing with my malignant melanoma in the summer of 2005 then another basal cell carcinoma that came up on my chest in early spring 2006 to do anything further about these AK’s. Anyone get a BCC or SCC on their chest? All I can say is, if the breast implant scars look like my excision scar, heaven help us all. I think my dermatologist was a home ec class drop out. Something about a vision problem so bad she was unable to mend straight, seems like they said. Joking aside, I have a really, really nasty scar on my chest. Of all my 5 skin cancers, this is the worst.

  28. Hey! I usually go out without any sunblock cream on. If I didn’t have any serious sunburn and stuff like that before should I protect my skin from the sun by using this neutrogina thingy anyway? Thanks 🙂

  29. I have an appt to see someone else in a couple 3 weeks. Chest/shoulder scars, I am told can have propensity for become hypertrophic, thick, red, itchy. Trouble is, I have already had plastic surgeon revise this one, so this is supposed to be better already and it still looks like something I did at home myself. Both the first dermatologist and the Plastic Surgeon were women and I just don’t think they cared. I am a fairly youthful 52, do triathlons, still wear the same size clothes as I did in high school. The upcoming appts is with a male MD. Hoping for a different story, another treatment. I don’t think either of the women MD’s would have scarred the precious female breast and left it as they have my chest. Let you know what he says. Something has to be done for the burning and itching. Do like having red hair, however!

  30. Hi Cherry —
    I would always use sunscreen even if you don’t burn. The sun damages skin even if you are not aware of it and that damage builds up over time and that’s why so many older people have so many sun-related skin problems.

  31. I feel for you Kevin, and one would think — stereotypically, perhaps — that a woman would be more tender and concerned and caring about the body than a male merely because they, in many real ways, must be more conscious and earnest in watching and reading the intricacies of their bodies.
    I hope your new MD will do better for you — but part it it might just be the way your skin heals. I know that’s a big issue in elective eye surgery to correct vision. If your skin scars don’t heal right, or if they become keloids, your eyes might heal the same way and no MD worth anything would ever do eye surgery on anyone with “that sort” of skin.
    I look forward to your future report! 😀

  32. I realize this is an old post, but just in case someone reads it:
    I would suggest talking to your pharmacist and doctor about using a pharmacist mixed 1% F.U. solution rather than the Efudex. Not only does it work as well, and elicits a more mild reaction, but it only costs about $12 rather than the absurd $250-400 that the brand name Efudex costs.

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