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.


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.


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 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.

  • 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!

    • Mandy stone
      Posted at 14:25h, 20 March Reply

      Thanks for sharing!I’m starting my cream tonight and have to work the next 2 days!not going to lie I’m scared!!! Don’t want to use it but I know I have to!

      • Tracey
        Posted at 19:23h, 04 April Reply

        Mandy, I was scared too but I’m glad I just did it. There’s never a good time but once it’s behind you, it feels so much better! Crossing my fingers you had an OK experience.

  • 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

  • Melissa Newman
    Posted at 07:28h, 17 March Reply

    I’m getting ready to start my PICATO treatment and I am so very grateful that I found your “PICATO Experience”. My dermatologist told me to do it when I had some “down” time. I sorta laughed because I don’t even know what that is. I thought I could start it and still teach; however, I’m now thinking that is NOT a good idea. I’m going to get some Cetaphil, Lansinoh, and Neosporin before I even touch the medication. Thank you for the pictures!! Your account and the photos in various stages helped. A lot!

    • Tracey
      Posted at 19:22h, 04 April Reply

      Melissa, I hope you have your treatment behind you now! Crossing my fingers it went well for you.

  • Tracy Z
    Posted at 10:17h, 01 April Reply

    Hello – The pictures were MOST helpful to me… thank for posting them. I am on day 4 and last night was my third nigt of applying. Today (day four) is defintely the worst. My face is exactly like yours with the exception of my forehead and chin is also red and burned as i applied it there as well.. It almost feels like a chemical burn… which I guess is what it is many ways.
    My entire face is swollen feels completely burnt and raw areas, scabs, and peeling. My eyes were almost felt swollen shut yesterday and this am. I am using bags of frozen peas in a towl gently placed on my face to help the cool. I have a small fan (nail fan) that i have been using as close as I can get it for the past 2 days. I just take it with me everywhere I am sitting. It is a lifesaver for me. I slept with it on my nighstand as well blowing cool air.

    I wanted to add that my dermatologist subscribed Biafine cream for me to use. I did my chest with Picato a few weeks ago as test before my face and it was just as terrible. At least I knew what i was getting into. The Biafine helped my chest so much and am using it on my face hoping it heals more quickly.

    This is not where I purchased it and don’t know anything about….. I got my at the dermatogists office but here is a link to show you:

    I let 6-8 hours pass with the picato then when I washed my face I applied hte Biafine. I will continue using in a few times a days from here on out while healing.

    • Tracey
      Posted at 19:25h, 04 April Reply

      Thank you so much for your input, Tracy. I STILL haven’t done my chest. After doing my face, I chickened out! Glad to know about Biafine cream. I hadn’t heard of it. Thanks again and I hope you’re feeling better now!

  • Robyn Stroud
    Posted at 16:01h, 12 April Reply

    Thank you so much for sharing your experience!!! I’m treating my four head, Day 2 and I am vey blistered. Pain is fine but I look hideous !!

    Thanks again!

    • Tracey
      Posted at 09:49h, 24 April Reply

      Hope you got through it all ok, Robyn! Thanks for your comment.

  • Jules
    Posted at 23:14h, 29 April Reply

    Thanks for sharing your experiences ….I have used Picato on one small area on my face, was very red, swollen and within hours a huge blister formed on the whole area I used the gel, I was very concerned, I’m on day 2 and not sure I want to put the third day’s application on because I’m worried it will scar…..any advice?

    • Tracey
      Posted at 11:55h, 30 April Reply

      Jules, sounds painful! I felt the same way about putting on the last days treatment too. I called the Dr and about it after day 2 and she said it was normal to have those blisters (for some people) so I decided to continue on for the 3rd day. I don’t have any scarring but my face is still gets reddish (like after the shower) in the spots where I put the gel. I would suggest you call your Dr and tell them how extreme your reaction was just to double check with them. GOOD LUCK!!

  • Mary A
    Posted at 10:44h, 13 May Reply

    Hi Tracey,

    I’m starting the PIcato next week. Can you tell me about the Cetaphil you used, was it the skin cleaner or the moisturizing lotion I’m assuming it’s the cleaner! Also, were you happy with the results of the Picato, would you do it again?

    • Tracey
      Posted at 22:34h, 13 May Reply

      Hi Mary, I used the Cetaphil lotion. I didn’t use any cleanser at all during the process. I just rinsed with cool water, patted my skin dry and applied lotions. Once my skin healed, it was really soft and smooth. It still is fairly soft BUT I think because of the extent of the sun damage and my age (I’m 50) it hasn’t made a big difference in how my skin really looks. I have a follow up appointment soon so we’ll see what my Dr says. I was told to use a treatment on my chest for a month if I remember correctly(!?!?!) but I didn’t have the courage after the face treatment. I’ll get to my chest eventually. Ugh. GOOD LUCK TO YOU!!!

      • Mary A
        Posted at 19:55h, 16 May Reply

        Thanks so much Tracey!

  • Cay Snow
    Posted at 19:22h, 18 May Reply

    Thank you for your post! I am just healing from my Picato treatment. I could NOT bring myself to do the third application. Like you, I had chills and felt nauseous. It was horrible. But now that I am at the pink skin stage and the blisters are gone, I wish I had gone ahead and done the third application. I have a dermatologist appointment next week and will have to break it to my doctor that I did not finish the entire course. I have three AK’s on my face. I think I would rather just have them frozen off…

  • Tracey
    Posted at 17:15h, 17 June Reply

    Thx so much for the info. My Rx cost $586.00! How’d you get it for $50.00?!

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