My Personal Experience with Actinic Keratoses
My Personal Experience with AKs
I already had signs of skin damage before moving to Oahu, Hawaii. On my arrival, I incorporated my business and, as part of the requirements, I had to provide health insurance to my only employee (me!) so I joined the Kaiser Plan. One of the windsurfers at Kailua Beach Park was a medical doctor with Kaiser so I selected him as my assigned physician. He expertly removed one AK surgically around 10 years ago. It was an easy procedure, healed quickly without scarring, and it's never come back. He also removed a number of AKs with cryotherapy. I found freezing AKs to be an easy procedure with minimal personal discomfort during the two week healing period. After moving to Maui, I continued with Kaiser. Last year, I had additional AKs on the scalp removed with cryotherapy. However, several didn't respond as expected and needed "more aggressive treatment"with Efudex (fluorouracil) Topical Cream 5%. I've just finished that treatment and it was like putting my entire scalp and forehead in a"Dark Ages torture rack" for almost six weeks ... and I really never want to do it again! During the Efudex treatment, I experienced constant burning, itching,"pins and needles", and "skin crawling"and most of the adverse reactions listed previously to one degree or another. Throughout the six week treatment program, the only relief I got from the pain and discomfort was taking a warm shower and sleeping ... so I took several long showers a day and fortunately, I could sleep well at night. During the second or "crocodile skin" stage of treatment, my forehead and scalp became so thick and tight I couldn't even raise my eyebrows! I tried several well-known moisturizers but they burned so badly I had to wash them off; I also tried a couple moisturizers from Shaklee Corporation and both gave temporary relief. Exactly 28 days after beginning the Efudex treatment, I entered the erosion stage and the discomfort became unbearable ... so much so I had to call my doctor at Kaiser who agreed I could go off the medication. The discomfort, however, continued unabated. Moreover, I didn't want to see anyone or have anyone see me.
EROSION STAGE showing shallow ulceration of the skin and some swelling
of the skin around the eyes. Sometime this swelling was severe enough
to partially obstruct vision.
Once healing started at the beginning of the sixth week, it progressed rapidly. At the beginning of the seventh week, the skin appeared almost normal and I could finally raise my eyebrows again. However, several small pimples I'd noticed under the hard crusty shell developed into boil-like infections after the final stage, but fortunately they cleared up within a week or two. Also, a couple of areas of redness near the hairline still persist but hopefully they'll completely go away soon.