Sun Damaged Skin & A Prescription for Picato

Sun Damaged Skin & A Prescription for Picato

Turning 50 has prompted me to put some well-needed focus on self-care. Of course, I hope that means more pedicures and a massage now and again but there are all kinds of other pieces and parts to self-care I’m considering. That’s a topic for many other posts I need to write but first up is a commitment to take care of my health and therefore an over-due annual check up happened just a few months following my birthday. With that came a lot of referrals to all of the specialty doctors I’d need to see. With my fair skin and a history of some skin “issues” (a basal-cell carcinoma at age 27 that left me not only concerned but also with 10 stitches down my nose a month before my wedding, for example). Since then, I’ve been told to keep up with my dermatology check ups and although I did have too long a lapse before this past visit, I have made that a priority over the years.

It wasn’t a huge surprise that my new dermatologist remarked that I had “extensive” sun damage on my face and chest which she commented gave her “heart palpitations” just looking at it. If there’s one thing you never want to hear, it’s that your skin gives your dermatologist that kind of reaction, considering you’re sure  she has certainly seen some of the worst conditions imaginable. So…

A few biopsies and a few prescriptions later, I agreed to work with her on a strategy to keep the skin protection to a maximum in hopes to keep the cutting out/off down to a minimum. Apparently, the protection isn’t just about more sunscreen more often, although that’s part of it. The prescriptions were a big part of the plan. This was the first time I had been encouraged (ok, instructed) to use a product to “kill my pre-cancerous skin cells”. It was agreed we’d begin on my nose and surrounding areas. And then I started googling Picato (the prescription gel) which, surprise surprise, freaked me out so bad, I was *this* close to not doing it.

Fast forward to now; post Picato Gel treatment and sharing my experience. I figured if I spent hours reading other people’s accounts of their experiences (which I am so grateful for because it helped me to know what I might expect) perhaps someone might appreciate a detailed play-by-play. Just in case. If medical pictures freak you out, feel free to click away. Although there’s only 1 shot that I would consider kind of gruesome, none of them are pretty.

Alrighty, here’s my Picato Gel story in pictures including tips and tricks I used that really helped me.

My cost : I used a pharmacy that my Dr. recommended with a coupon she gave me and it was $50 out of pocket. They shipped it to me overnight. It’s got to stay refrigerated, so keep that in mind.

Instructions from my Dr. :  Apply gel once a day for 3 days on my nose, inner cheeks and above my lip.

TIP 1: My Dr. suggested I apply the treatment each night and sleep with it on so I could wash it off in the morning (you’re allowed to wash it off after 6 hours). BUT, after reading countless testimonies that it burned so much you can’t sleep with it on, I opted to apply each morning at 9am so I could wash it at 3pm. I was able to stay at home the week I did my treatment and it worked out really well for me. Also, they were right. There’s no way I could have slept with it on. Yowza.

DAY 1

TIP 2: Take a pain reliever a half hour before application.

TIP 3: Coat your lips with Vasoline before you apply gel near your lips. This will act as a barrier between your lips and any gel that could get on them (I was told you not to get the gel on my lips). I used Lansinoh instead of Vasoline. Yes, the same Lansinoh that nursing mothers use. I use it for everything! It’s the ointment of the gods.

Read the instructions you were given well and heed the warning not to get the gel on anything that wasn’t instructed. Apply it with 1 finger and thoroughly wash your finger when you’re done. Keep AWAY from eyes and mouth/lips.

I felt little to no pain or burning on Day 1 until the evening (above). It just felt like a bad sunburn.

TIP 4: After the 6 hour treatment is up, rinse with cool water. It’s very soothing.

TIP 5: I applied Cetaphil to my face in the evening before I went to bed. One day 1, that worked to soothe it and the Cetaphil didn’t burn. People in the message boards swear by Aquaphor for post-Picato treatment but I tried a little and thought it made the area even more hot so I opted for Cetaphil.

DAY 2:

The application of Day 2 burned quite a bit. I forgot to take the pain reliever first and I was sorry. Right after I applied, I took Advil. By noon my one cheek felt like it was on fire. By the late evening the entire application site was covered in blisters. You can really see that in the right photo above. It didn’t hurt nearly as I thought it would at that point but it was really uncomfortable and tight. Gross alert: These blisters were watery and seeped fluid (eeew!) leaving yellow crust.

TIP 6 : After you’re allowed to rinse, use something to soothe your face. I tried a little Cetaphil again but it burned pretty bad (now that my skin was so damaged) so I switched to Lansinoh. Keeping the tight areas moisturized really helped keep the skin pliable so I could talk, eat and smile without cracking my skin. It wasn’t easy to apply, because it’s so thick, but I’m so glad I did.

DAY 3

Because I had blisters all over the application site on Day 3, I called my Dr. to be sure I should continue with the third treatment. I was told to apply the gel anyway. It REALLY burned during the application and within an hour was almost unbearable. Think blow-torch. For 6 hours. It burned really bad (which goes without saying) but I also got a bad headache and felt like I had sun poisoning. I had waves of nausea and chills for a few hours. No joke.

TIP 7 : DON’T FORGET PAIN KILLERS.

TIP 8 : I used a fan on my face which helped a little. I stood with my face in the freezer which helped a lot. I filled a big bowl up with ice and but my face in the bowl (hovering over the ice) and put a towel over my head. That helped too.

TIP 9 : Distract yourself. I was on Facebook trying to keep my mind off the pain. I think I was delirious. Oh my goodness, the burning!

Once I was able to rinse with cool water, the pain began to let up. By evening, it didn’t hurt much but it was uncomfortable. I used the Lansinoh treatment again (in generous applications) and would rinse, blot with a clean towel then reapply whenever it seems like the Lansinoh was absorbed.

DAYS 4-8

Day 4 wasn’t nearly as bad as Day 3 (because I didn’t have to apply) but it was still uncomfortable as the blisters started drying out.

TIP 10 : In the days following the treatment I took Benedryl to help with itching. Like with any burn, it can itch. I felt twinges and of pain and discomfort throughout the next few days.

TIP  11 : I started switching between Lansinoh and Neosporin throughout the days and at night before I went to bed. I’ve had good luck with Neosporin to help expedite healing wounds and it really soothed and seemed to help my healing. My skin was like sandpaper so it helped keeping it moisturized.

On Day 7 the blistered (now dead) skin started peeling off leaving pink, tender new skin. I started using Cetaphil again on Day 8 but didn’t even try to put any makeup on until Day 9 as the new skin felt very sensitive. It’s gotten better with each new day. Yay!

Next up, my Dr. wants me to my chest. I’m not sure what she will prescribe yet. Thankfully, I’ll be waiting until after the holidays for that. I am NOT looking forward to it.

If you have any thoughts, questions, tips or experiences of your own you’d like to share please leave a comment here. I’d be happy to hear from you!

Disclaimer: All opinions, experiences, and advice re: Picato and any other products in this post are my own. Please follow instructions provided by your own health care professional and consult them with any questions or complications you might have. Also, this is not a sponsored post.

6 Comments
  • kate
    Posted at 22:47h, 05 January Reply

    Im on Day 1…and already feel the burn Thank you for sharing your tips and pics!

    • Tracey
      Posted at 12:52h, 06 January Reply

      Ouch. Hang in there, Kate!

  • Sharon Cocking
    Posted at 06:09h, 08 January Reply

    My Doctor just today prescribed Picato. I did an Efudix treatment about 6 years ago and it worked wonders. I went to see the Doctor about something on my face and it’s a skin cancer and it’s getting cut out on Wednesday. Today she gave me a script for Picato. Like with Efudix I started doing research and reading people’s stories and came across your page about your experience. Efudix was a 20 day application if I remember and then it was still a couple of weeks before I could be seen in public. The Doctor said that Efudix had been superseded by Picato. I am amazed it’s just a 3 day application and that within as little as 8-9 days (everyone is different) you can look good enough to think about getting back into normal living outside the home. Thank you for sharing your experience.

    • Tracey
      Posted at 11:43h, 08 January Reply

      Thanks for your comment, Sharon. I have been given a prescription for a 30 treatment of a variation of Efudix too (she called it 5-FU), for my chest. I’m supposed to start it early this year but after my Picato experience, I’m NOT looking forward to starting it. I’m glad it’s on my chest and not my face but 30 days sounds impossible! I’m sorry you had to endure it. Good luck with your removal on Wed (that’s never fun!) and best of luck with your Picato experience.

  • シアリス100mg
    Posted at 18:37h, 09 January Reply

    happy happy happy

  • 蔵秘雄精
    Posted at 18:13h, 17 January Reply

    Thank you

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