Wear your sunscreen, or, three weeks with Efudex

Scott Warnock,

Summer’s here, and I’ll get right to it, kids: Wear your sunscreen!!

Scoff as you will. You’re young. Your skin is elastic and cushy. You’re going to have a baby-bottom smooth epidermis forever.

I too thought that back in the day–as much as I thought about it all–through the 70s and into the 80s when as a lifeguard down the shore, I sat there sunscreen-less most days getting seared.

Well, turns out that last year my dermatologist found precancerous cells on my face. She recommended treatment with Efudex (fluorouracil [5FU] cream), a topical regimen I would follow for several weeks at home.

I stalled for about seven months because I had seen the effects of this treatment thanks to the selfless work of the undisputed Internet Queen of Efudex: Mags Murphy from Ireland. Mags carefully documented her journey with fluorouracil for the benefit of all. (Spoiler alert: Mags is way tougher than me.) I would need to be in hiding for a while.

To try to do my PSA part, following is my Efudex saga. Here I was on day 1 with my normal visage (take it or leave it):

Day 3, I was still in novelty treatment mode: I’m doing this weird self-care thing! (Mainly you see yet another great use for polyhedron dice; that’s a 12-sider–Weezer would be proud):

By day 7, my face was changing, but not drastically enough for people to avoid mentioning it. I even played tennis. This was the “What a red face you have!” stage:

Even at day 9, it was still a lark. People I saw did switch from “What a red face you have!” to “funny” comparisons with monsters and devils. Despite wac-a-mole itching around my face, my main feeling was that I was accomplishing something:

Then came day 11. Everything changed. Significant discomfort and pain set in. I had scaling and scabbing, especially on my chin; turns out, even though I had been using sunscreen on my face for more than a decade, on top of that earlier life damage I neglect to protect my chin, and that’s also an area a hat doesn’t cover well. The mouth-nose triangle was cracking like bad land; Vaseline offered minor solace. I had to attend a meeting at work, and people lied, which I appreciated: “You just look like you have a bad sunburn“:

Day 14.… judge for yourself. My face was burning and now foaming, man. I kept shaving to avoid itchy whiskers, but it was an ordeal. A tough psychological aspect of this treatment is that at this point you are doing this to yourself, so twice a day I was self-applying lava. Mags had said she couldn’t do much, including sleep, after this point, and I wondered how I was going to do another week. It was rough (I even lost the will to use a polyhedron die)…

… but, that day, a reprieve! I had been communicating via portal with my dermatologist, sending these photos. She asked if I wanted to keep going. Trying not to snivel (I didn’t mention that my wife saw me and said, “Normally you’re a handsome man…”), I told her it was up to her! My dermatologist wrote, “I’m calling this for you” and added the oddly satisfying words: “The extent of destruction done is significant so we have accomplished a great deal.” Ah, the accomplishment of destruction! I asked my wife to pick up prescribed hydrocortisone and mupirocin creams, and I applied them immediately.

It wasn’t over. The pain subsided, but the itching increased. Days 15 and 16 were in many ways the worst: The days of the maddening, unlocatable itch, and after showering it looked like someone smashed a pus-filled water balloon on my face. Still using combo hydrocortisone and mupirocin, I again suffered through a shave, which alleviated some itching, at least on my chin.

When you’re doing something like this, you want incremental, noticeable progress. On day 17, things were better, but I had been waking up with mystery lacerations, nearly a dozen. I wrote to the dermatologist, “… my skin is cracking, especially when I wake up–lots of small abrasions” (I did break out a 20-sider):

By day 19 I was turning the corner, even if I looked worse:

I was winding it up on day 22. My skin was healing, and it was noticeably smoother (I ran out of dice):

Mags went through treatment until day 23! Mags, you’re still the champ–you crushed me. But like you, I’m spreading the message and telling all the kids: Wear your sunscreen!

Scott Warnock

Scott Warnock is a writer and teacher who lives in South Jersey. He is a professor of English at Drexel University, where he is also the Associate Dean of Undergraduate Education in the College of Arts and Sciences. Father of three and husband of one, Scott is president of a local high school education foundation and spent many years coaching youth sports.
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