About me

I am 42 years old and had a small Basal Cell Carcinoma (BCC) removed from my nose.  Basal Cell Carcinoma’s are generally associated with over-exposure to the sun.  I’ve never been a huge sun-worshipper but, I do have quite fair skin and  tend to burn quite easily. In the past, my nose burnt quite regularly so I guess it’s not that surprising that I developed a Basal Cell.  Basal Cell Carcinomas apparently grow very slowly so no doubt mine has developed over a number of years. As you can imagine, it’s now factor 50+ sunscreen for me whenever I’m out in the sun!

I had my BCC removed by Mohs micro-graphic surgery – apparently, the most effective and advanced treatment for skin cancer today.  I have to confess, I found the procedure and recovery pretty traumatic so didn’t think to catalogue my experience or take photos at the time (though the images are engrained on my brain so not really required!) so you won’t find any of that here. You can read a little more about my post-surgery recovery here. However, I’d highly recommend reading this lady’s blog entries if you want to find out more about the process and one individual’s experience.

Through this blog, I share my experiences of using a topical ‘chemotherapy-style’ ointment called Efudix as a follow-up treatment to kill off any remaining pre-cancerous cells. Prior to embarking on my treatment, I spent some time surfing the net looking to read about others’ experiences and mainly came across blogs of people who have used Efudix to treat their entire faces; with some pretty scary looking results. So, I’m using this site to capture the effects of using the ointment just on my nose and hoping that the Efudix doesn’t have quite such a horrific impact on my skin.

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  1. Sonja Versluis
    November 29, 2011 at 8:21 am

    Hi Lisa,

    Thank you for all the information! I live in The Netherlands, am 44 years old, and I use the efudix since 26 november. Also on my nose, just like you….There is nothing to see, now, and I’m very curious( and worried) what will happen. I’m a bit more prepared now!
    I have pre-cancer cells on my nose ( in dutch: actinische keratose), and I was treatened twice with photo-dynamic-therapy. But that didn’t help enough.
    How are you now? Is your skin already the way it was?

    • December 1, 2011 at 11:24 am

      Thank for your comments Sonja. I’m sorry not to have replied earlier – I have not been updating my blog for the last couple of weeks but hopefully will start again next week. It’s good to hear from someone who is undergoing the same treatment as me. I’ve not heard of photo-dynamic therapy- what was that like?

      It took about a week until I started to notice the effects of Efudix – some itching and slight redness – so I expect you will start to see a change to your nose soon too.

      It’s quite scarey using Efudix and not knowing what to expect so I totally understand how you’re currently feeling. Wierdly, once you start to see the effects, you at least know it’s doing it’s job and even though the results aren’t particularly pleasant, it’s quite reassuring to know that you’re on the road to recovery.

      After stopping the Efudix, my nose got redder and redder – it looked very burnt but the scabbing stopped which was good. The good news is that my nose is finally much less red now and looks to be returning to normal! So, don’t expect your nose to suddenly return to normal once you finish using the cream – I think it is quite normal for Efudix to keep on acting until it has attacked all pre-cancerous cells.

      My advice would be to stick with the treatment and view it as a journey just as I have done – it’s not a pleasant one (not just physically – it’s wierd what it does to your emotions too!)but could be an awful lot worse. For me, I think the fact that I was treating my face made it feel worse some how – if I’d had to treat any other part of my body, I think I would have had a different emotional response; your face after all is what the world sees and people’s responses can be shocking! My advice to you would be to simply meet the gaze of anyone who stares at you once your nose starts to react – they soon look away and realise how rude it is to stare! I’ve also found myself telling everyone I know and meet about skin cancer as a coping mechanism some how.

      I wish you all the very best with your treatment. Do keep me updated on your progress. And, don’t forget, once you’ve finished your Efudix treatment you can be certain that all your pre-cancerous cells have been killed and you can get back to your normal life again. All the very best. Lisa

  2. Sonja Versluis
    December 2, 2011 at 12:54 pm

    Thank you for your comments and good advice! Its good to hear that your nose is so much better now! I agree with you that a treatment like this in your face is far more scary than, for example, on your arm.
    With de photodynamic therapy I was less concerned about my appearance: only the precancer-cells reacted, so the rest of my nose was normal. I then had to wear a sticking plaster on my nose, because there was no sun allowed for six weeks, on the treatened place.

    You asked what the photodynamic therapy was like: I had to go to the hospital, there I got cream on the precancerous cells, with a bandage over it. This cream makes the cells sensible for the special light-treatment). After that I had to stay in the hospital for 3 or 4 hours, I was not allowed to go outside because I abolutely had to stay out of sunlight. So I, and other “victims”, waited in a waiting room ( to read, chat, write christmas cards… 🙂 )After those 3 or 4 hours, the bandage was taken of, and then I got special light shining on my nose. (very warm, and dangerous for your eyes, so special glasses on my nose etc.)
    The light hurts a little bit, the precancerous cells “explode”. It felt like someone was pulling on the skin of my nose, with a lot of thin threads…..strange, but that is how it felt!
    After that there comes a wound,wich you can cover with a bandage.
    I think this treatment is less heavy than the efudix. But, also, not as thorough as the efudix. Efudix also attacks the cells the dermatologist can’t see, and hopefully we don’t have to use the efudix for years! While after the PDT the precancerous cells came back within 2 years.
    So, efudix for me. And every morning a worried glance in the mirror……
    I hope I explained the pdt enough, my english is not perfect…..and my exams in english were long ago……
    I wish you the best, and I’ll keep you informed about my progress!
    Sonja

    • December 3, 2011 at 3:45 am

      Hi Sonja

      Thanks for your explanation of photodynamic treatment – your English is perfect! It doesn’t sound like a very pleasant treatment. Even though your entire nose might react in some way to the Efudix (mine went red all over but only scabbed in parts), hopefully this treatment will feel less painful for you (I experienced more itching than anything else). Like you say, at least with Efudix, all pre-cancerous cells will be attacked and you’re not reliant on your dermatologist treating only what he or she can see. And even if your nose does go very red and scab like mine did (it may not – you may actually have less sun damage than me and only find you get small patches on your nose), you will hopefully find you can cover it with a small amount of make up as I’ve done – whilst my scabs were still visible, at least I’ve been able to camouflage the redness. Pscychologically, when you see your nose go so red, you immediately think it will be sore to touch so you won’t be able to put make up on it but, I found that as long as I did it gently it was fine.

      Once again, good luck with your treatment and please do let me know how it goes.

      Lisa

  3. SonjaVersluis
    December 12, 2011 at 8:53 am

    Hi Lisa,

    Here I am again….I used the efudix for 14 days now, and my nose is getting red……Some scabs appear, it itches, sometimes it burnes. Your information really helps a lot, I know what to expect now! There are a lot of red spots on my nose, I suppose that’s all actinic keratosis.
    I often got sunburned when I was young: I have a light skin, and I often went to the beach….not to lie down, but to swim, play, build sandcastles, etc.( And now I still really love to walk at the beach, swim in the sea, and build sandsculptures with my daughters. But last summer I was worried about more sun-damage, so I bought a special anti- uv hat from “coolibar…” )
    Did your dermatologist say you could use make up? Because I understood I could not, and of course, I will feel a lot more comfortable with a little bit of powder, for example.

    Until now, people did’t really see the redness on my nose, but now it getting more red, I’m more insecure. If that is the right word for it in english…..But, I have to face it!

    I saw your last picture. Your nose looks really good now! Quite a relief for you,I’m sure!
    I will let you know how it goes with my treatment. According to my dermatologist , when it’s christmas I will look like rudolf the reindeer…..nice man, isn’t he? ( a female dermatologist would never make a joke like that , I think….)

    Happy christmas!

    Sonja

    • December 12, 2011 at 1:14 pm

      Hi Sonja

      So glad to hear from you – I thought of you last night as I posted my last post and was wondering how things are going for you then I see your email in my inbox this morning!

      I guess this means you have one more week of treatment left which must be a good feeling. It sounds as though your nose is reacting in a very similar way to mine. I guess the patches are individual keratoses reacting to the Efudix – that was my assumption with mine but, I’m really not sure. As you’ll see, my nose went pretty uniformally red towards the end so I can only assume that means pretty much all my nose was sun damaged/had pre-cancerous cells. I don’t go back to see him until February but will ask him then because I didn’t ask him too many questions about the treatment when he first prescribed the cream. I think I was just too much in shock as had assumed that once I’d had the operation and healed, that was the end of it.

      I must admit, I never actually discussed make-up with my dermatologist. I shunned the idea in the beginning – because I was afraid it would irritate my nose even more – but, in the end, I just got so fed up and couldn’t face the idea of going out with it looking so hideous that I dabbed a bit of power on it. When it didn’t burn or irritate my nose in any way, I just decided to do it again whenever I was going out for a period of time as it made me feel better and a little less self-conscious. (If I was just popping out quickly to get a pint of milk say, I wouldn’t bother but would put a big peaked cap on and keep my head down!). I just kind of figured that there was nothing in the Efudix instructions telling me not to put anything over it once applied and, my dermatolgist had said that if I was to go out in strong sunlight (initially I’d been planning on a holiday whilst treating my nose), I should apply sunscreen over my nose. So, I thought that so long as I didn’t apply the make-up immediately after applying the Efudix, it would be fine as the cream would have had time to sink in.

      I know how you feel, it does make you feel rather insecure and self-conscious even if people don’t directly look at your or say anything. In fact, in some ways, I think it’s almost worse if people look at you out of the corner of their eye and immediately look away – it makes you feel like a bit of a freak. I can’t believe your deramatologist said you would look like Rudloph by Christmas. Like you said, a woman would never say anything like that! Just bear in mind that you’ve only got another couple of weeks to go and your nose should be almost back to normal. In fact, it’s easier once the scabbing has gone -much easier to deal with just a red nose. My nose tends to go red when I’m very cold or hot anyway and I think a lot of people’s noses do go red when it’s really cold outside so yours won’t be quite so noticeable!

      Like you, my nose sunburnt a lot when I was younger – simply from being outside, not necessarily sunbathing. I must confess, I didn’t think much of it at the time – rather naively, I just just thought ‘well, I’m fair skinned and that’s what happens unfortunately’. I didn’t think of the consequences many years later but then I guess we’re all more informed about the dangers of the sun now than we used to be and you can’t turn back the clock! I’ll certainly be looking into buying an anti-UV hat for next Summer. Thanks for the tip.

      Have a great Christmas and try not to let the Efudix and your nose get you down. Remember, you’re doing the right thing and this will soon all be behind you.

      Keep in touch.

      Lisa

  4. December 21, 2011 at 12:14 am

    My brother recommended I might like this website. He was totally right. This post actually made my day. You cann’t imagine simply how much time I had spent for this information! Thanks!

  5. SonjaVersluis
    December 31, 2011 at 3:36 pm

    Hi Lisa,

    My treatment is totally finished now, ( after 3 weeks using efudix, and two weeks using fucidin, a anti-bacterial cream), and my nose is looking surprisingly well!!! A big part of my nose did turn pink, red, and felt like a wound for some time, but I must say, the treatment wasn’t too bad……I only have doubts if the spot what it was all about is gone! But in february I have to see my dermatologist, so then I will know more.
    Ik hope your nose is almost back to normal too!( only when it’s cold, my nose turns red…)

    I thank you again for all the information, I am sure that helped me a lot. Just knowing what to expect is so important!

    Lisa , I wish you a very happy 2012!!!

    Sonja

    • December 31, 2011 at 4:19 pm

      Hi Sonja

      What a lovely surprise to hear from you – it’s really good to hear your update.

      I’m pleased to hear your treatment is over and it wasn’t too bad. I assume the fact that the Effudix effects you experienced weren’t too severe means that your nose wasn’t as badly sun damaged as you feared; which is good news and I’m sure you’re relieved to know. I’ve got everything crossed for you that your original actinic keratosis has been totally eradicated. Like you, I’m off to see my deramatologist again in February so we’ll have to exchange notes again then.

      Unless you were to look at me up close – or see me immediately after a workout! – you probably wouldn’t see anything unusual about my nose. It’s still ever so slightly pink and you can quite clearly see the outline of the skin I treated when I’m hot and my nose goes redder – you can really see the line between where I applied Efudix cream and where I didn’t. But, like I say, I notice it every time I look in the mirror before applying make-up whereas other people wouldn’t, and it really isn’t a great deal. I’m not unduly concerned as, my dermatologist did say that the more severe the reaction I experienced, the longer my skin would take to settle back to its normal appearance. Plus, it was always slightly redder than the rest of my face anyway – my dermatologist says I have Rosea which we will talk about potentially treating when I see him in the new year.

      So, it looks as though you and I are among the lucky ones – I’ve seen a lot of pictures of people who have had much more severe reactions to Efudix than we’ve had – and we’re now well on the road to recovery. I do hope you can soon put this whole experience behind you.

      Wishing you all the very best wishes for 2012 and I do hope you’ll let me know the outcome of your appointment in February. Keep in touch.

      Happy New Year.

      Lisa

  6. Leslie
    March 26, 2012 at 10:15 pm

    Hi,
    I’m 63 and I’m about to start treatment in two weeks, also on my nose. I’ve never been diagnosed with skin cancer so this seems pretty radical for the little patch I have on the tip of my nose and on the side But Doctors orders.
    Thank you for detailing your experiences with efudex.
    What I’m really curious to know is how long did it take for your nose to return to absolute normalcy. I’m an entertainer and I’m planning regrettably to take time off so it would be great info for me. Or did it always remain slightly red. Was there any scarring?
    Hope you’re still checking your emails.
    Again, I appreciate all of your posts.

    • April 4, 2012 at 9:17 am

      Hi. Sorry for the delay in replying, I’ve been offline for a while.

      My nose is totally back to normal now – should have posted an update before now but other things have got in the way – will post an updated photo shortly.

      It took about 6 to 8 weeks for my skin to totally return to its normal colour. Thought, that being said, it was very easy to camouflage with a bit of make-up much earlier than that as the redness dulled to more of a pinkness pretty quickly after stopping treatment. I simply dabbed on a bit of powder and gently removed it with a bit of face wash and water at the end of the day.

      And, in terms of scars, I have absolutely none from the cream and you wouldn’t know that I’d used Efudix at all. In fact, the scar from my Mohs surgery (that I had to remove the Basal Cell Carcinoma) is so subtle that people don’t even notice it. Just resist any temptation to pick/rub off any scabbing you might get during Efudix treatment and I’m sure you’ll be fine. Oh, and just make sure you wear a large brimmed hat to protect your face from the sun during treatment.

      Very best of luck during your treatment. I do hope that my blog posts illustrate that the impact of Efudix isn’t always as dramatic as some pictures you might see on the web. Yes my nose went quite red and I did have a bit of scabbing and itching but that was pretty much it – it’s more the inconvenience of slapping on the cream daily and thinking people will be giving you funny looks when you go out. But I think most of that is in our own mind’s – people are too busy going about their own business to notice us and you can always put on a bit of powder and wear a hat to shield hour face. I hope your experience is similar to mine – do let me know how you get on.

      All the very best.

      Lisa

  7. Leslie
    April 4, 2012 at 9:56 am

    Thanks Lisa, I really appreciate your feedback. It’s made me feel much more comfortable about the whole process.

    • April 4, 2012 at 3:36 pm

      Leslie, I don’t know whether it’ll help but I coped by thinking of the whole process as a journey, knowing that at the end of it my nose would be free of cancer. The Efudix treatment is merely an inconvenience which has a defined beginning and end – and, any redness, scabbing, itching or stinging you may experience (and who knows, you may not experience all or any of them) is simply the Efudix doing it’s job and one step closer to the end of your journey.

      I wish you all the very best with your treatment.

      Lisa

  8. Leslie
    April 4, 2012 at 5:14 pm

    Yes, that’s what I’m going to do think of it as an interesting journey as watch as all the changes take place.
    I’m an artist so a part of me does find the process/transformation very interested.
    thanks again

  9. September 20, 2012 at 7:41 am

    Thanks for sharing your experience. I’ve just finished efudix treatment on my upper chest (4 weeks) and face (1 week). Now healing but I’m confused as to the best post-treatment therapy. I’m using a mix of vitamin e oil, aloe vera and paw paw ointment as a barrier mixed with a little cortisone 1% (I’ll stop the cortisone in a few days to avoid the skin thinning side-effects). I’m also documenting my efudix experience hoping it will be useful to others http://www.heather-ellis.com/efudix.html

  10. Suse Powell
    January 2, 2013 at 9:24 pm

    Hello and thank you for sharing. Can you tell me the name of the dermatologist you saw for this Efudex treatment in San Francisco?

    • January 5, 2013 at 6:29 pm

      Hello Suse. Apologies for not replying sooner. I’m afraid I live in – and was treated – in the UK so unfortunately can’t recommend anyone in San Francisco. I wish you luck in finding a dermatologist and do hope your treatment goes well. Lisa

  11. Tess
    June 24, 2013 at 1:42 pm

    Hi, I haven just started using efudix cream on my nose and chest. Can someone please tell me after I have put the Efudix on do I put
    moisturiser on it or not at all while I am using efudix

  12. Yvonne
    July 26, 2013 at 5:44 pm

    I commenced Efudix 12 days ago on my nose due to pre cancer spots and I have been quite worried about the process after seeing some of the pictures of other people’s experiences. So far, the skin on my nose has not reacted that much and I am hoping it won’t be too bad but if it does end up really red and scabby….I will just have to deal with it. I asked my Dermatologist if I could cover my nose with a concealer and she said “yes” as long as I don’t do it too often. Well…..seeing that I cancelled all my social engagements and that the redness (so far) is not too bad, I have not had to wear any concealer on my nose even when I have nicked up to the supermarket to buy food.

    Thank you so much for your blog, Lisa. You have helped me feel a bit calmer.

    My best wishes to you and all the other people who have commented on this blog.

    Yvonne (Australia)

  13. Julie Breust
    August 23, 2013 at 11:07 am

    Thank you Lisa, I have really enjoyed reading your story. I am into week three on my forehead and nose, and I haven’t become as red as you did, perhaps I won’t. I now know I will be able handle the next few weeks while the Efudix does its job and the healing begins. Thanks again Julie Breust NSW Australia

  14. Kevin McShanag
    January 25, 2014 at 5:05 am

    Appreciate the feedback with this treatment. I have spent over 30years living in the tropics and now I am now suffering the consequences. I have reached just under two weeks of efudex treatment and my Doctor tells me I need another 2 weeks of treatment. I will try for another week but can’t see myself lasting the full 4 weeks. My face is a mess and shaving in the morning is particularly challenging.

    I venture out in the public at least once per day and I am getting used to the stares.

    Not sure if I should be using moisturising or anti bacterial face wash so would appreciate advice on this matter.

    Unfortunately I did not receive much information from my Doctor and whilst the information pamphlet received with the cream was useful I did not really know the extent of the treatment.

    I am counting the days until the treatment is finished and look forward to when I can look in the mirror and see a face clear of sunspots. Totally understand that if I had of taken proper care of my skin I wouldn’t be in this situation but as they say hindsight is a wonderful thing.

    Cheers

    KMcS

  15. Karen bolden
    September 9, 2014 at 2:29 pm

    Hello …. I am going to do the Efudix treatment this winter. I was planning to start the treatment the week of Christmas. Was wondering how long it takes for the redness and scabs to start.
    We always go out on New Years Eve and have family over for New Years Day dinner and don’t know whether I will be “presentable” or should I cancel.
    I too have been instructed to do my entire nose due to the fact they have been treating AK for years on me. Also I have 2 Basal Cells on my temple that have to be treated also.
    Doctor has been pleading with me do do this treatment foe years but I have procrastinated for being so damn scared to do it ….. But realize now it must be done ….

    • December 28, 2014 at 11:59 pm

      Hi I’m so sorry – I’ve only just seen your message so sorry not to have replied sooner. I hope you’ve commenced your treatment since your post and all is going well. I do hope that, like me, the anticipation of treatment and the effects are worse than your actual experience. I found I could disguise my redness and scabbiness a little with make-up (not sure if it was the right thing to do or not, but it made me feel better). Good luck,and keep focussed on why you’re doing it- it’ll help you deal with any discomfort.

  16. July 5, 2015 at 1:10 am

    Hi Lisa,
    I am using Efudex 2x daily on my face and now into my 27th day, horrible side effects nausea, headache, and extreme pain after 2 weeks, so stopped for 12 hrs and then continued. Also strange in the head, and dizzy at times.
    I have had many Mohs surgeries, so no more. A group of us being carefully monitored each week, so we can see how we all look, very supportive.
    I have used makeup once for 3 hrs but then washed it off.
    Thank goodness I am nearly finished!!
    Your blog is great and I am sure helpful to all, this is scary stuff.
    Cheers,
    Chris

    • July 7, 2015 at 7:38 am

      Thanks for your message Chris.

      So sorry to hear you’re having such a tough time and glad you’re nearing the end of your treatment. It really is a horrid treatment and treating such a visible area makes it that much harder to deal with. However, fingers crossed your skin I’ll recover fairly quickly and you’ll be able tompout all this behind you.

      All the very best.

      Lisa

  17. Peter Sherriff
    February 5, 2016 at 11:42 pm

    Hi Lisa,

    I’ve just finished using Efudex twice daily for 21 days on both sides of my face and temples. As everyone else has said, very red, sore and itchy but I was expecting this as I had read various blogs before using it.

    What I had not expected was that, for some strange reason, it gets even worse at night. I have not had a decent sleep for about 2 weeks because I wake up in the early hours of the morning with my face burning like crazy and itchy. Much worse than during the day.

    I found that by lying a damp face washer, folded in half so that my nostrils aren’t covered, across my face gave me a lot of relief. Initially I was using a cold pack from the freezer but found the damp face washer just as good.

    As I type this it is day 4 after finishing the treatment and it’s starting to feel a little better. Face doesn’t feel “as tight”, burning and itching easing and I think I’m starting to notice some normal skin colour starting to show in the middle of the red.

    Last night was the best sleep I’ve had for 2 weeks. Still woke up with some burning, but only on one of my temples and not the whole face as it had been. Just did my face washer trick and this quickly eased it.

    So, if there is anybody reading this blog having the same sleeping problem, try a damp face washer like I did. Hopefully it will give you the same relief it gave me.

    All the best to everyone!

    Pete from Australia.

  18. Deborah
    July 20, 2016 at 11:24 pm

    I’m just about to start using Efudix on my nose and have found your website really helpful. So thank you very much for taking the trouble to share your experiences.

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