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!

      • Heather Devlin
        Posted at 13:12h, 20 October Reply

        A Fan to face is 100% needed on Day 3. The second I turned away from the fan, I could feel my face cooking.Day 3 was the challenge.On day 3, I spent the 6 hours laying still with my face in front of a fan with HGTV on in the background. There is no way someone should go through this without a fan.

        • Tracey
          Posted at 10:16h, 01 November Reply

          Totally agree, Heather! It’s amazing how much a relief the fan can be. The colder the air blowing on the burns, the better! Thanks for your comment.

      • Dianne
        Posted at 05:28h, 08 November Reply

        I have picato to use on my face but i have a spot on my leg would i be able to use this on my leg. I know its different strengths for face or body.

    • 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.

      • Jacqueline Austin
        Posted at 10:55h, 15 December Reply

        Hi, thanks for sharing…I am about to start my second treatment..I jad piccaddo…a couple of years ago.It was excruciating,unbearable but I made it through and was totally healed in a week, on my chest…This time I told my dr I could not do it again, he had prescribed Efidux this time , but after researching…it lasts somlong, whats your opinion on the two ? Thank you so much!

        • Tracey
          Posted at 12:23h, 30 January Reply

          Jacqueline, I was perscribed Efidux for my chest but was so traumatized by my Picata treatment I never used it. But since my last visit, my Dr perscribed Picata for my chest. I’m not proud to saw I haven’t used it yet! (I’m a chicken!) : )

  • 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?!

    • Tracey
      Posted at 11:24h, 19 July Reply

      I’m not sure about the cost but my Dr. gave me a coupon. I have seen people mention the cost anywhere from over $1000 down to $50. I have no idea why there is such a wide range-it seems so strange (and unfair)!

      • Rachel Krauss
        Posted at 06:25h, 03 January Reply

        I was able to get mine for $20 with a coupon card at Starting day 2 today-I was not at all prepared for the burning yesterday and washed my face after 2 hours. After reading your experience, I will be better prepared for day 2.

  • mandy jolley
    Posted at 06:33h, 11 July Reply

    Hi Tracey,
    I’m completely freaking out after reading comments.
    I’m on my first day but i have applied to my lip. I’m sure I was told I could do so. shit shit shit. I had to do my forehead and parts of my cheeks.

    • Tracey
      Posted at 11:25h, 19 July Reply

      Mandy, I hope by now you’re through your process! I sent you an email but didn’t hear back. Sending you all the best!

    • Susan
      Posted at 19:21h, 12 September Reply

      My doctor specifically prescribed mine for my lip. I read in the directions that it wasn’t supposed to be used on the lips, but when I called my doctor’s office, I was told that I was to use it on my lip.

      • Tracey
        Posted at 09:41h, 06 October Reply

        Susan, how did it go? I’m hoping the strain they gave you worked well on your lip and didn’t cause too much trouble for you.

      • Terry Sykes
        Posted at 10:25h, 19 October Reply

        Not sure how old this post is but I will relate what my doctor told me to do. It says CLEARLY on the directions several times to not get this near your eyes. That is one of the places I was told to put it. On my lower eye brow next to the corner of my eye! After I read all of the instructions I thought she was crazy. Her reaction after I expressed concern was ” just don’t get it in your eye!” As it was June when I got the medication I decided to wait a while before starting the treatment. I work out doors and didn’t want to take a chance on sweat washing it in my eye. Well I have waited as long as I can as it is now mid Oct. and the medication expires in November. I started the first treatment today. I had blisters all over within the first three hours. { can hardly wait for day two and three.

  • Renae
    Posted at 17:24h, 17 July Reply

    I have just applied this for the three days and today have a Dr appointment as on the side of my face where I used it I can not see out of my eye due to the swelling, My eye is stinging and weeping constantly and I did not put it in it or wipe it. The gel dried for 3 hours before bed.
    The sites where the gel has been applied blistered but way outside the application area (as in placed a 2mm application of gel and a 2cm wide blister occurred).
    Headaches, nausea, feeling ordinary and looks horrendous. I accept that it was going to not look good, but did not expect this reaction. Be careful if you usually react strongly to other drugs (like I do). You may have a severe reaction like I have.
    I have used a cream in the past and it took longer but was far more manageable than this. I am meant to start a new job in 4 days, teaching of all things, if it doesn’t improve quickly I will scare the poor kids! I thought the worst would be over by the time I had to start and just be able to cover the redness but I have weeping holes in my face!!!!

    • Tracey
      Posted at 11:27h, 19 July Reply

      Oh goodness, Renae! I am so sorry you had such a terrible reaction. I had read from others about the eye swelling. Did you apply at night? I wonder if there’s more of a risk that way because the treatment might run into unwanted places during sleep? I certainly hope you’re feeling better and that you can start your new job soon (if not already)! Good luck!

  • Sharon Alexander
    Posted at 06:10h, 18 July Reply

    Hi Tracey,
    I have been prescribed Picato also for my face. I had a skin cancer cut from my face a few weeks ago. I am a little nervous about using this preparation. I understand everyone’s reactions may differ to some degree. Thankyou for sharing your experience with using Picato. Numerous thoughts have flooded my mind, like, will I scar?, will the redness disappear?, how long will I need to heal?, how long will I need to be away from work? (I am a school teacher).
    Thankyou again for sharing your experience and for the tips.

    • Tracey
      Posted at 11:30h, 19 July Reply

      Hi Sharon, I too would be concerned about using it on your healing wound. I would steer clear of it, personally! But ask your Dr for sure. I got quite blistered and I’m not scarred at all. It did take some time to get back to feeling/looking presentable but I’ve got nothing left on my face that gives any indication of the treatment although my skin feels REALLY soft! : ) Best of luck to you!

  • Sharon Alexander
    Posted at 05:06h, 20 July Reply

    Hi Tracey, thankyou for responding to my email and thankyou for sending luck my way. I did pay my Dr a visit yesterday. He said to continue using the Strataderm cream on my healing scar and to just work around it. So today I was courageous and applied my first dose of Picato. To my surprise ‘day 1’ has been reasonably comfortable. I have had slight burning in my upper lip area and some tightening over the day. I have also experienced some tingling sensations as well as some itching. I took your advice and applied some Paw Paw gel to my lips first. Like you I have also taken photos. I started at 9.30 am this morning. My skin is feeling warm and a little tender this evening (9.30pm).

    I am so happy to hear that you did not have any scarring and that you have recovered well from the treatment and have been given the all clear.

    Can I ask how long it took for you to feel good and look presentable?

  • Sharon Alexander
    Posted at 20:19h, 20 July Reply

    Hi Tracey, ‘day 2’, is itching a common reaction to the Picato treatment?

  • Sharon Alexander
    Posted at 18:25h, 21 July Reply

    Hi Tracey, ‘day 3’ today. I woke up with slightly swollen face. I have applied my last dose of Picato. Feeling some burning and still have tingling and itching, otherwise bearable. I am looking forward to rinsing this off this afternoon, then I will apply some Q.V. Ceam to ease the tightness and to moisturise.

    Unlike yourself, I had to apply the Picato across my forehead also. I noticed some slight blistering and weeping across my cheeks.

    Well on the home run now. Taking the next week away from work to heal and begin to feel normal again.

  • Sharon Alexander
    Posted at 23:30h, 21 July Reply

    Hi Tracey,
    Thankyou for sharing your experience with those of us having to go through this process. It can be very daunting for many individuals as was the case for myself.
    Feeling very sensitive this afternoon. I’m looking forward to applying some Paw Paw cream tonight.
    Thanks again. You’re areal Angel.

    • Sharon Alexander
      Posted at 21:14h, 28 July Reply

      Hi Tracey, day 10 today. I have a lovely pink complexion. Still it prickles and feels itchy on and off. How long before you can use SPF sunblock?

      I am contemplating taking a few more days away from work until the sensitivity eases. Any suggestions?

      • Tracey
        Posted at 16:02h, 03 August Reply

        Sharon, I have used sunblock everyday since my treatment! : ) Sounds like you’re good to go!

  • Jen Gray
    Posted at 13:31h, 23 July Reply

    I was prescribed Picato and they are delivering it to me Wednesday. Ugh. I was totally fine with it until I went online. I don’t know that I want to do it. Does it remove brown spots? If not, I’m tempted to forego it and just keep doing my pre-cancer spot treatment. This looks horrible. Embarrassing/gross/super painful torture. My husband might even be scared. 🙁 If this is simply to prevent me from having to continually get those spots removed I think I would rather just get them removed here and there.

    • Tracey
      Posted at 16:05h, 03 August Reply

      Jen, I’m so sorry you’re in such a tough spot. It was really hard and seemed so extreme at the time. So much so that I still haven’t done my chest (like I’m supposed to). I didn’t really have brown spots where I applied it so I don’t know if it removes them. Basically it burns everything to heck and you’re left with brand new baby skin. I’ll be eager to hear what you decided to do.

  • kerri stella
    Posted at 23:33h, 30 July Reply

    Hello Tracey, I have just come back from my appointment with the skin specialist. I’m totally freaking out. Had a sample tested and now having to wait for results on whether its a nasty melanoma, but I was also prescribed Efudex and Picato gel for my face (i still need to discuss with my hubby which one I will use due to the difference in price) but I cannot remember if the Efudex was a shorter treatment or the Picato gel was shorter?

    • Tracey
      Posted at 16:09h, 03 August Reply

      Oh wow, Kerri, I hope you get good news on your test!! I’m so sorry you have to go through this stress. ugh. My picato gel was a shorter treatment and my Efudex was much longer. I never did the Efudex for my chest. Since my last visit I went back and my dr. gave me picato variety for my chest that wouldn’t take as long. I still haven’t done it! Wishing you all the best, Kerri!!

  • Jonathan
    Posted at 09:13h, 01 August Reply

    Hi Tracey, thanks so much for this information page. I’ve just finished a 4-week course of Efudix (forehead only) and have been contemplating how I am going to manage doing my face (since being male I have the extra problem of shaving and if I do not shave, after a few days it wouldn’t be possible to get any cream to penetrate). So this Picato seems to be a practical solution for men who would otherwise have had no other alternative to Efudix, provided of course the doctor is OK with it. I am just curious if you do not mind me asking. What was the reason for being prescribed Efudix for your chest versus Picato? I would have thought the huge benefits of Picato are getting back to normality very quickly and I am struggling to understand any disadvantages, other than the higher cost. Afterall, Efudix hurts like heck as well – and for longer!!

    • Tracey
      Posted at 16:14h, 03 August Reply

      Jonathan, thank you for your comment. I NEVER would have thought about the shaving. Ouch! That’s a tough predicament. I’ll really be eager to hear how you deal with that. Maybe your Dr. has some advice? I honestly have no idea why I got the Efudix for my chest but after what I went through with only 3 days of Picato, I DIDN’T want to do it! When I had my follow up Dr. appt. I admitted I didn’t do my chest (with Efudix) and so I was prescribed a Picato treatment for my chest. My Dr. has acted like it was a new option which I thought was weird. Regardless, I have the prescription for both my check and my forehead and haven’t done either. Gah! I’ll be eager to hear how it goes with your treatment and facial hair!

      • Bernadette Perchard
        Posted at 14:20h, 06 May Reply

        Hi Tracey, I have been reading your posts and have noticed you are very nervous about using Efudex on your chest. I have been doing mine for 3 weeks now and can honestly say it is it painful (like your face experience). My entire area has a dark red rash it gets itchy and at times I can’t lay on my side to sleep as it feels like the skin will crack. Going to my doctor to enquire about the cream you used,,, very very nervous about it but don’t have enough down time to use Efudex on face, neck you can hide

  • Sylvia Webb
    Posted at 07:20h, 04 August Reply

    Hi Tracy, today is my last day of my Picato treatment on my nose.I am already peeling. Can you tell me if tomorrow I can go back to wearing my normal Simple moisturiser and foundation cream,as I would like to try to hide the redness. Also is it safe to use sun cream. The instructions in the package does not refer to these queries. Thank you, Sylvia

    • Tracey
      Posted at 09:47h, 04 August Reply

      Hi Sylvia, I’m glad to hear you’re on your last day. As for moisturizer or sunscreen, I would use it whenever you feel like your skin is ready. You can always rinse it off if it hurts or burns. With makeup, I waited for a number of days before I used any. I was too afraid it would hurt if I applied anything to the skin that wasn’t yet healed.

  • Rhonda Starcher
    Posted at 08:35h, 10 August Reply

    I was prescribed Picato for a “VERY SMALL” spot on my nose, this spot is only about half the diameter of a pencil eraser, very small. Should I worry about my eyes swelling? I only have one good eye, I have a cataract in the right one and if my left one swells, I won’t be able to see at all…

    • Tracey
      Posted at 09:40h, 06 October Reply

      Hi Rhonda, I’m hoping your treatment is behind you now! Hoping you didn’t suffer any swelling. Would love to hear how it went!

  • Lesley
    Posted at 14:14h, 13 September Reply

    Hi Tracey,

    Just found your blog and loved it. I too have been prescribed Picato for face, chest, arms, and hands. This is a fabulous drug that works. Yeah, a few ugly days but the results are incredible. The unfortunate part of AK’s is they do re-appear. This is the Third time I have used Picato on my face, chest, arms, and hands. First treatment was the worst, each treatment that followed got easier and easier as the AK’s were being decreased.

    I know this treatment works the problem of having to reapply is only because I am a fair skinned, green eyed, blonde that loved the sun and failed to wear protection.

    Do your chest WOMAN! You will be glad you did. I find starting treatments on Thursday early evening works well as I have the weekend to hide thru the worst of the wanting to hide routine.

    All the best to you and I know others have and will benefit from reading your blog.


    • Tracey
      Posted at 09:43h, 06 October Reply

      Lesley! Thank you for the nudge. : ) I still haven’t done my chest. GAH! But, hearing that it has gotten easier for you with each treament is enlightening and gives me hope. I had yet to hear from anyone who has done treatment more than once so I thank you for sharing that!

  • susie
    Posted at 08:37h, 26 September Reply

    I too am starting the Picato. About 18 hours into it! Definitely have been feeling the burning sensation, like my face is on fire and am so thankful for your tips. I already know I will be using them (probably all of them) throughout the process.

    • Tracey
      Posted at 09:45h, 06 October Reply

      Susie, I’m sure you’re feeling much better now – I’m hoping it didn’t get too bad and that the tips helped minimize your discomfort!

  • Susie
    Posted at 08:42h, 26 September Reply

    Quick question, when did you feel normal again? Was it day 10 that you could wear makeup and by makeup I mean foundation?

    • Tracey
      Posted at 09:49h, 06 October Reply

      Susie, I didn’t put make up for almost 2 weeks but you’ll be able to judge for yourself as the days pass…you’re probably right at about 10 days out now so I’m curious as to how you’re feeling.

  • Vonda Roberts
    Posted at 15:39h, 27 September Reply

    Thank you!! I just got blindsided by diagnosis today . . . A whole new world for me, but you make it seem manageable. And you’re so cute, If you’re down for it, than I can be too. Thank you for sharing your advice with all of us.

    • Tracey
      Posted at 09:50h, 06 October Reply

      So glad you’re up for the challenge, Vonda! You got this! : )

  • Sharon Stewart
    Posted at 00:49h, 28 September Reply

    Everyone who has made comments will be helping someone! Me included!
    It sure is scary when you read all out this gel. I am about to do my last day (Day 3) and it sounds like I am fairly “lucky”. Just a two small patches on forehead. I decided to do one at a time (The first patch is hidden by hair – JUST!) Will tackle the second patch when i see how this goes first!! Call me a coward!!!
    Lets hope we can ALL look back on this with some amusement with repaired glowing skin in a few moonths time!! Keep sharing!

    • Tracey
      Posted at 09:51h, 06 October Reply

      Love your attitude, Sharon! Here’s to happy healthy skin for all of us! : )

  • Lorraine Berends
    Posted at 16:24h, 01 October Reply

    Hi everyone.

    I finished my Picato treatment a week ago and I couldn’t be happier. My experience was a mix of everything I’ve just read, though I think I got off quite lightly in terms of any pain. I applied it primarily to my forehead and nose, and also my temple areas. I started in the early evening on a Thursday and I agree with Lesley that this timing is good to get over the worse of the reaction over the weekend. I definitely got the eye swelling, it looked like I had conjunctivitis, so it could be right that this is related to applying in the evening.

    My pictures are much like Tracey’s, but no weeping blisters. I basically went from having lizard like skin one day to pealing the next.

    The Picato I used was quite thin and very easy to apply, sounds different to the heavy cream that someone described? The cost was $135.

    I am just thrilled with the result, like Tracey my skin is baby soft, still a bit red but not too bad. Everyone says I look amazing which was the last thing I expected. I’ve been using moisturiser since day 4 (Dermatologica) and sunscreen since day 6 (Olay).

    I would highly recommend Picato, far preferable to the countless “zapping” of sunspots that I’ve always had when I visit my dermatologist.

    Good luck to those about to start, Lorraine

    • Tracey
      Posted at 09:54h, 06 October Reply

      Lorraine, it’s always helpful to hear success stories so thank you so much for sharing your experience. I’m so glad you love your skin. That’s the goal!

  • Anne Norton (Australia)
    Posted at 16:12h, 07 October Reply

    Thanks for the Lansinoh tip— it’s been a lifesaver on the 4th day.However it relieves the stinging but not so much the itching. I guess that’s just part of the peeling process. Very reassuring to read all these comments. I also found the Picato easy to apply. Thanks everyone and especially Tracey.

    • Tracey
      Posted at 10:11h, 01 November Reply

      Anne, thank you so much for your comment and sharing your experience with us!

  • Dan
    Posted at 12:52h, 13 October Reply

    Thanks for this blog, Tracey. I just finished my second treatment with Picato and wanted to share some thoughts.
    There are a lot of scary posts about terrible reactions to the drug, akin to exposure to nuclear waste. Know that everyone does not react that way. I’m as fair skinned as it gets. My experience both times was controllable minor-moderate pain and redness of course. Advil alleviated it significantly. Now on the day after treatment I’m still red, tight skinned and starting to peel. Some scabs have formed. Really not bad at all, though not pretty. I get the feeling that some of the really adverse reactions are actually allergic ones.

    After my first treatment a lot of the redness was gone within a couple of weeks, but if you dig deep on the Leo webpage it notes that full recovery takes 8 weeks. I was presentable long before that.

    A couple of further suggestions:

    The first time you are treated with this drug do NOT try to cover large areas of your face. See how it goes. If it’s not so bad then next time do as much as possible. The doctor will probably try to get you to do as much as possible the first time. If you’re one of the people who has a stronger reaction you will not be happy. That’s what I did and I’m glad. That said, do discuss with your doctor. If time is of the essence that’s another matter. As far as medical procedures I’ve had in my life this one rates pretty low on the pain scale. Hope the same for you! -Dan

    • Tracey
      Posted at 10:12h, 01 November Reply

      Dan, your insights are greatly appreciated! Thanks so much for sharing with us.

  • Susan ANDERSON
    Posted at 07:51h, 18 October Reply

    Hi,Tracey. I started this treatment last night and it was awful. I am sooooo burned and so uncomfortable. Is this really worth it? I cannot imagine putting it on my face again tonight! I also made the mistake of doing both my chest and face…..very stupid. My chest is so burned and swollen. I will not continue both of them tonight. I just texted my derm to see if I can do just 2 days on my face. I am a nurse who works with children and simply cannot take time off to do this process. Gosh darn this Irish skin!!!! LOL~ Susan

    • Tracey
      Posted at 10:14h, 01 November Reply

      Susan, I’m sorry to hear of your suffering. I can relate! Face & chest together…not fun. BUT, I’m sure now you’re so releived that it’s all behind you. If you want to share an update, I’m sure everyone would be happy to hear from you.

  • Kelly Blackwood
    Posted at 08:39h, 28 October Reply

    Hi Tracey, your blog has been a great help, although totally freaked out before applying Picato, and put it off for about a month. However, have just applied the third day treatment to my face, and other than redness, not pain, no itching, and so far no blisters. Am anxious to see what happens now. thank you again, Your sharing really helped me along with the journey

    • Tracey
      Posted at 10:17h, 01 November Reply

      Kelly, I’m sorry to have freaked you out (lol!) but I’m thrilled to know you did it and you didn’t have such a terrible experience. What a relief!

  • ulrike Ischler
    Posted at 02:21h, 29 October Reply

    Hi Tracey, thank you so much for your help with great photos and detailed description. I started yesterday evening with Picato and had a lousy night.I’ll what will come….. kind greetings from Vienna, Ulrike

    • Tracey
      Posted at 10:19h, 01 November Reply

      Ulrike, hang in there! It’s not a pleasant experience at all BUT, at least you’ve gotten the application it behind you. Now, onto the healing! Good luck to you.

  • Lisa
    Posted at 05:53h, 05 November Reply

    Tracey – your blog was so helpful in understanding what the process is. Thank you for sharing. I am on day 4; so all done treating my upper lip. It looks pretty bad. Fortunately I can work from home most days. I’m shocked that my DR did not go into more detail of what the process would be. Very glad to have your posts to help with the situation.

    • Tracey
      Posted at 12:46h, 05 November Reply

      Lisa, so glad to hear the worst is behind you. Hoping your lip heals up quickly. I appreciate you commenting here. : )

  • Lori Theodore
    Posted at 12:40h, 19 November Reply

    I am doing this today and am so petrified!! I am only doing my forehead because I don’t think I can do my whole face in one period. Will I look horrible on Thanksgiving? I can’t wait to wash my face in an hour– its been burning all day but manageable– assuming tomorrow will be worse.

    • Tracey
      Posted at 12:26h, 30 January Reply

      I’m sure you’re all healed up and looking awesome, Lori. Aren’t you glad to have that out of the way? Phew!

  • Susan B
    Posted at 18:05h, 27 November Reply

    Hi Tracey, thank you for your blog. I wish I would have seen it before I started! I’m on Day 6, and it’s amazing how quickly my face is getting better, even though I had a lot of reactions. Although I started my treatments in the morning, and rinsed in the afternoon, I had eye swelling days 2-5. It didn’t affect my eyesight, it just looked ugly. I had treated along the end of one eyebrow, between my eyebrows, nose, and cheeks. There was quite a bit of swelling, and burning, similar to a bad sunburn. I didn’t have any pus blisters that I could see. The worst part for me was where my glasses sat on my nose, pressing on the swollen area. I’m very nearsighted so going without glasses wasn’t an option. At times I put a little piece of tissue under my glasses but the evening of day 5 when I pulled it off it took some skin with it and I have a few scabs. Day 4 I was uncomfortable but didn’t know what I could or couldn’t put on my skin. I ended up cutting open a couple of Vitamin E capsules and smearing that over the inflamed areas.
    Day 5 was the worst of the itching, I smeared Benadryl gel over my face (hmm, now I’m wondering if it wasn’t dry when I put the tissue under the nosepiece of my glasses, duh). But the Benadryl gel did help a lot with the itching. Today, day 6, there is a lot of flaking and only a little itching, Yes, the treatment was uncomfortable, and somewhat painful at times. But really, it was about the same as a severe sunburn. I’d do the treatment again, rather than do the liquid nitrogen. Only this time I’ll have that fan ready!

    • Tracey
      Posted at 12:26h, 30 January Reply

      I also had the same issue with where my glasses sat on my nose. OUCH!! I’m so glad you got your treatment done and behind you! Thanks for sharing your experience.

  • Michelle Lynn
    Posted at 19:05h, 28 November Reply

    Thanks for sharing your experience. I’m on day 2 of treating my chest…. It’s so uncomfortable to sleep. I’m normally a side sleeper but that’s impossible. I have to prop myself up with pillows to feel comfortable and help me to not roll. I made that mistake once! The first day my chest was just super red and began to blister. Today, day 2 I have a very large blister that is probably 1.5 inches in diameter and other smaller blisters that are seeping. It’s disgusting. I previously had Levulan photo therapy and the side effects are very similar so I had an idea of what I was in for…. but I need to treat my forehead, cheeks and upper lip… dreading it. There’s no convenient time to ever do this. What I wasn’t expecting was how small the tube was…. there’s no way that one tube would fully cover the chest area… I would say that I honestly need about 4 tubes to fully cover the area that I was hoping to treat… so, for now I just chose the small 2×2 area that looked the worst to me… but sort of bummed that I can’t treat the whole area and just knock it out.

    • Tracey
      Posted at 12:24h, 30 January Reply

      I’m sure you’re dreading your next treatment after such a horrible chest treatment. I STILL haven’t done my chest treatment. : (

      • jessica bieber
        Posted at 15:10h, 14 July Reply

        I took the first treatment last night to a small quarter sized area on my chest. I have blisters all in surrounding areas way beyond the application site. When I called the nurse, she said that the blisters are where the pre cancer cells are and its killing them…this statement scared me bc I thought I was dealing with a small area and now I have blisters all over my chest so these pre cancerous are everywhere? do I have cancer all over my chest? Is that what these blisters mean?

  • Sandy Blanchard
    Posted at 09:56h, 01 December Reply

    Tracey, thanks for your post. I kept the picato in the refrigerator for a year and finally got the nerve to do it over my Thanksgiving break. I was searching for ways to minimize the pain, etc. and your blog really helped me out. I am so glad I did it. My skin feels and looks great now. Had my dermatologist shared this type of information with me, I probably wouldn’t have waited a year. Thanks again!

    • Tracey
      Posted at 12:23h, 30 January Reply

      That’s such great news, Sanday! I’m so glad you did it. YAY YOU!

  • Kim
    Posted at 09:20h, 26 December Reply

    I started Picato on my upper chest this morning, 7 hrs ago now and have virtually no mark or burning sensation. I’m going for a shower soon and will apply my soothing cream. Just hoping that the following two days won’t jump up and bite me. Will keep you posted.

    • Tracey
      Posted at 12:21h, 30 January Reply

      I hope you got through it with little pain or discomfort, Kim!

  • John Harrop
    Posted at 22:09h, 03 January Reply

    Hi Tracey,

    Thanks for such an informative blog! I started with Picato on my face two days ago = but the doctor accidentally prescribed the heavy 0.05% dose instead of the o.o1%. The stronger dose is not intended for the face. After one dose the pain was almost unbearable the next day, especially as I left it on for a full 24 hours before washing it off. I contacted the doctor who told me not to use a second dose and I’ve been using paracetamol and cold ice cloths for the last 24 hours. My face blistered after just a few hours and I can’t use lotion until the skin heals. I thought I would share this so that people check they have the right dosage. I think the doctor is sorry for the mistake – but I realize that she can’t apologize because of insurance and liability issues. I should have checked more carefully and asked the pharmacist. Sadly, mistakes can happen.

    • Tracey
      Posted at 12:20h, 30 January Reply

      JOhn, I am SO SORRY you had to suffer so much due to improper dosage. OUCH!!! Thank you for sharing this with us…hopefully it will help prevent it from happening from anyone else. I would never think to double check the dosage. I hope you’re on the mend now!

  • terri tippette
    Posted at 06:49h, 12 January Reply

    Hi Tracey!The information you shared has been most helpful.I’m on Day 2.My question?I have a few big blisters.Should I just leave them alone or try softly to break into them.Thanks for any advice.My face looks very similar to yours.Have a great day.

    • Audrey
      Posted at 18:42h, 13 January Reply

      thank you for your generosity in taking the time to support fellow sufferers. I completed my 1st day post treatment…applied the picato to one eyelid and the area above my lip, my nose and the remainder all over my face…as per Dr instruction. Areas that I had previously treated with a longer term product were not as impacted. Other areas were swollen and red in the a.m of the 1st day like a bad sunburn. . Left treatment on til morning as I slept through the night. Burned pretty badly and swollen then until I took 3 ibuprophen and an acetaminophen. The 2nd night I was able to sleep on and off and felt a mild burning, but definitely got up after 6 hours for a welcome cold water rinse. I had small bubbly blisters all over my face which ultimately turned into large blisters and broke and peeled…probably from the thick lanolin I was smearing all over my face and then trying to remove to apply the next dose……(the Vaseline recommended by my Dr wasn’t cutting it)
      So, yes the 3rd day was literally “hell”…The burning started immediately since my skin was so exposed and sensitive by then. I counted the minutes until I could rinse it off fantasizing about that ice cold water rinse. Ice packs on my face saved me, a fan on night stand helped but got irritating after awhile. Definitely the combo of Ibuprophen and acetaminophen helped with swelling and pain before during and after treatment those first 3 days. Now just uncomfortable and raw with thin layers of peeling skin from the blisters, I’m now keeping face moist with bacitracin….waiting for the itch of the healing process. Afraid to use lotion (ptsd from the burning), but unsure if blisters will heal if I don’t let them dry out so they can scab? Thank you again for your blog. Have referred to it numerous times during my process. You were so much more helpful than my Dr. What a wonderful support to know what to expect and having access to tips on how to deal.
      AUDREY E

      • Tracey
        Posted at 12:18h, 30 January Reply

        Sounds like a painful experience Audrey. Day 3 was the worst for me too! I think the pain meds really help! I’m sure you’re healing up well by now. : )

    • Tracey
      Posted at 12:18h, 30 January Reply

      Terri, I emailed you directly about not popping the blisters. I hope all is well now as it’s been a few weeks. Glad it’s behind you!

  • Teresa
    Posted at 14:43h, 15 January Reply

    Thank you so much for your post. I have applied 1 tube and will apply the second tonight. I will definitely take the tylenol and have a fan ready. I really appreciate the pictures and letting me know what to expect.


    • Tracey
      Posted at 12:15h, 30 January Reply

      You’re welcome, Teresa! Glad you got your treatment done! YAY YOU!

  • Laura W
    Posted at 10:15h, 16 January Reply

    Thank you so much for giving such helpful information Tracey! A few months ago, I found your info as I prepared for my first time using picato on my forehead. I was prepared for the worst, and it was rough, but I didn’t have a reaction as strong as you had. Today though, I find myself back here trying to reassure myself that my new treatment on my cheeks, (started last night) is normal. I might be even redder than you were! Ouch. Your info is definitely the most helpful I ‘ve found! Thanks again!

    • Tracey
      Posted at 12:15h, 30 January Reply

      Laura, one thing I’ve learned from all the comments here is how unique each application can be. Maybe it’s the type of skin that’s treated or perhaps the dose of the medicine. I’m glad you have gotten your cheek treatment done now! Phew.

  • Ham Sadler
    Posted at 17:35h, 17 January Reply

    This was a very helpful resource to me this morning when my face was burning after just one application of Picato. I was told to put it on before bed. Unfortunately I failed to read the instructions that say not to wash your face right before…so I believe my face wash w/Vitamin C and the Picato mingled and gave me a burning sensation all night long. I really thought I wouldn’t be able to do it again tonight. However, after reading all of you helpful people’s experiences, I went and washed my face with a gently cleanser, took some ibuprofen, applied a fresh aloe leaf from the yard and then applied BOOM moisturizer. After about 30 minutes it all started to settle down. I almost feel like I diminished its efficacy…I don’t know if that is possible. So I would highly recommend the Boom product in helping put moisture back in your skin while enduring this treatment. I will be putting it on again tonight and we shall see how I fair this time, without washing my face right before. Thank you again all of you.

    • Ham
      Posted at 10:45h, 18 January Reply

      Ok, so I did last nights round and suffering the same burning sensation and redness this morning. Hoping it will settle down a bit midday. Using a hand fan helps too. Thanks all

      • Tracey
        Posted at 12:12h, 30 January Reply

        Indeed, Ham! The fanning really helps.

    • Tracey
      Posted at 12:13h, 30 January Reply

      I’m sure the Vitamin C might have made things worse. I know I have had some slight irritation with the C from time to time. Glad you got the process behind you!

  • Liam Vachaud
    Posted at 03:35h, 20 January Reply

    I have used Picato as a treatment for Solar Keratosis on my face,hands and chest on numerous occasions over the last few years so knew fully what to expect.
    I have always applied it early in the evening before going to bed and have never had any problem with swelling in the past. However, this time not so lucky!
    Yesterday evening I applied the third and last tube to a 4 x 4 cm area on my forehead and to two lesions on my temples.
    This morning I woke with both eyes and the bridge of my nose very swollen.
    I’ve never had this reaction before so turned to your blog to see if anyone had been prescribed anti inflammatories for the swelling. It’s a Sunday here and impossible to get in contact with a doctor.
    I did read that someone applied cold packs to their eyes. I will try that.
    Thanks for creating this forum!

    • Tracey
      Posted at 12:11h, 30 January Reply

      Liam, I’m sorry to hear you had such swelling this time. I’m sure you’re feeling much better now! At least you got it out of the way. Phew.

  • Joan Townsend
    Posted at 06:27h, 30 January Reply

    I’m suppose to start using picato for 3 days on my nose. I must say I’m not looking forward to it. I have a question, my doctor indicated I needed to stay inside for a couple of weeks, next to impossible since I live alone and my mailbox is a few feet from my front door. Is it imperative to stay inside during use?

    • Tracey
      Posted at 12:10h, 30 January Reply

      Joan, I’m sure the doctor only meant to stay out of direct sun for extended periods of time and/or because it can look so bad and be so painful. Running in and out I’m sure is fine. Best of luck to you! Thankfully, it’s only for a few days. You can use some of these methods listed (in my blog and in the comments) for some releif. : )

  • SAscha Gibson
    Posted at 02:44h, 09 February Reply

    Has anybody done multiple areas at the same time i.e. Face,chest, hands … or is this not recommended

    • elliot davis
      Posted at 13:47h, 24 February Reply

      ive done areas greater than 2×2 inches. i will collect like 9 of them and do the the equivalent of like 7×7 inches. its a bigger shock to the system but i did it. i don’t know why they only use the 3 small tubes. maybe to protect people from just over medicating on the smaller area

      • Tracey
        Posted at 17:50h, 11 March Reply

        Great response, Elliot. Thanks!

    • Tracey
      Posted at 17:48h, 11 March Reply

      Sascha, I think you’re allowed to multiple areas at once but check with your Dr. But it can be so traumatic, I’m not sure how much I’d do at one time!

  • ellioty davis
    Posted at 13:43h, 24 February Reply

    hello all,
    i have used picato twice on my scalp. it has done the job. BIAFINE is hands down the best moisturizing, healing creme. it is not heavy like aquaphjor. it is light, all natural ingredients and very soothing. works immediately. it is a well known French healing cream.. buy the 186g size on the internet. costs between $25 and $35 on the internet and shipping is free
    all in all, takes me two weeks to heal. during the process, i always get freaked out looking at my skin, wondering if it will ever look normal again, somehow it does

    • Tracey
      Posted at 17:50h, 11 March Reply

      Elliot, Thanks for the tip about BIAFINE! It is amazing how well it heals considering how horrible it can look for a while. Thanks for your comment!

  • Ruthie Klomp
    Posted at 12:14h, 01 March Reply

    Hi, so thankful for your initial story about Picato and the questions and your answers. It made me brave enough to use Picato on my face. Started on Tuesday. Each day was worse, with today (day 4) the worst, Cool water helps, neosporin stings. I got out my Jan Marini Bioshield from a previous laser treatment and it seems to soothe.
    If Picato does take care of the pre-cancer on my face, then the pain is worth it. By the way, my treatment area ‘roved’ into 3x the size of the initial spot to be treated, The Picato does SPREAD! Just an fyi for future users. Apply ONLY at the treatment spot, not around it.

    • Tracey
      Posted at 17:53h, 11 March Reply

      Thank you for your response Ruthie. You are right about it spreading, that’s why it’s so important not to get to close to the eyes. I appreciate your input.

  • Craig Fowler
    Posted at 10:20h, 05 March Reply

    My dermatologist recently prescribed Picato for my face and back to treat AK. He was vague as to its application, so your blog has been very informative. And as someone pointed out earlier, it is important to use the correct strength for the face (0.015%) and not the strength intended for back, chest, arms, etc.(0.05%).My question: is it intended to be applied only to the visible AK patches rather than broader areas? I’m still a little chicken to use it, but feel it will be worth it.

    • Tracey
      Posted at 17:57h, 11 March Reply

      Craig, I was told to use it all over sun damaged areas. My Dr. traced a line (with her finger) around where she wanted me to use it on my face so i knew where to apply it. The area was sun damaged for sure but I wouldn’t say they were AK patches. I think you can apply to broader areas but keep in mind it’s thin and it does spread after application. Good luck! You can do it!

    Posted at 05:38h, 07 March Reply

    Thanks for your blog post which I have referred to several times during the past week. I am now on day four after applying Picato for past three days and am now waiting healing to take place. I looked at your pics and thought my reaction would not be as bad. It was worse. Have used Imiquimod and solaraze previously. Picato really burns in comparison.

    • Tracey
      Posted at 18:01h, 11 March Reply

      Andy, I’m sorry you had such a bad reaction. Thank goodness the worst is behind you now! It’ll be better with each passing day.

  • Stevie Nelson
    Posted at 05:51h, 12 March Reply

    Hi Tracey,

    I hope this sight is still active just to vent my frustration even.
    I am on day 2, and am searching for aftercare already, as there is no aftercare in the leaflet.
    I live in the UK and don’t know which medicines are comparable to the ones you were using.
    This is a seriously awful experience, thanks for putting it out there for us.
    Your new skin? Please say it’s obviously better than before?
    There has to be something good at the end of this to look forward to.
    Like you, Ive had to put it across my nose and cheeks, but forehead and chin too. So basically my whole face!
    I am in a new relationship,and feel like I never want him to see me again, I hope it is healed enough by 8 days!

    Get it on your chest Tracey, its better than the alternative! I will have neck and chest next….god help us:)

    • Tracey
      Posted at 17:23h, 12 March Reply

      That was my frustration too, Stevie. No help with aftercare. My Dr didn’t say anything and neither did the leaflet. That’s why I decided to share my experience and the things that worked for me. I just tried the most gentle of moisturizers and tried them out before I loaded them on. Lot’s of cool water and patting dry! And YES…your skin WILL look better than before. Once you’re healed, it’s the softest, newest skin you’ve ever felt. Once the application days are done, you’ll get better with each passing day. And yes, I DO need to do my chest!

  • Chris Sloan
    Posted at 10:20h, 13 March Reply

    I am on day 4 treatment and want to
    post that I have experienced red burning areas like a bad sunburn but no blisters so far. I have not needed any pain medication. I have carried on in my activities with heavy foundation. Not one person has noticed. Today I am still red. I am fair with blue eyes and 50 plus years abusing my skin without protection. This has to be better then the longer treatments

    • Tracey
      Posted at 14:08h, 19 May Reply

      Chris, it’s always encouraging to hear of mild experiences like this. I’m so glad it’s been a fairly pain free reaction. That’s awesome!

  • Suzanne
    Posted at 13:55h, 16 March Reply

    Hi Tracey,
    My last application was a week ago. My overall reaction was tolerable. It felt like a bad sunburn with areas that were dark red and painful. Then the itching drove me crazy. That said, I healed very fast and the new skin feels great. I thought I was completely healed yesterday. Then today, I woke up with bright red, puffy, extremely painful, almost swollen shut eyes. Has anyone experienced this? I am assuming it Is reaction to picato, but it has been a week of healing.

    • Tracey
      Posted at 14:07h, 19 May Reply

      Wow, it’s interesting you had a delayed reaction. I’m eager to hear what the Dr said about that. I think you’re the only one who has reported that kind of swelling after the fact!

  • Carolina
    Posted at 13:55h, 19 March Reply

    I think I’m quitting! I did Day 1 and nearly passed out from the pain. I don’t have the luxury of time to be able to go through the 2 days plus then the recovery, healing process. It just seems so long and I have to travel for work in a week.
    Thank you for your post. It’s really an informative and relevant blog post.

    • Tracey
      Posted at 14:05h, 19 May Reply

      Oh Carolina, that sound excruciating! What a horrible experience. I think yours sounds like the most dramatic reaction by far. Maybe you have an allergy to the medication. I’m so sorry you went through that and I’m hoping you can come up with an alternative with your Dr.

  • Tiffany Sanborn
    Posted at 07:00h, 26 March Reply

    I currently finished day 2, I was curious about what is “Lansinoh” that you were speaking about. I woke up this morning and part of the skin on my nose where I previously had a blister had broken off. Do you recommend putting Neosporin or Vaseline on this broken area?

    • Tracey
      Posted at 14:03h, 19 May Reply

      I would try it on an edge of the open wound to test the pain (if any). That’s how I figured out what worked for me…just little tests before I went all in. And if something burned, i just splashed it with cool water. Hope your skin is looking better than ever!

  • Cathy
    Posted at 10:20h, 27 March Reply

    Hi Tracey,
    Thank you for all of the excellent information on Picato. I appreciated your daily account and truly appreciated all of the photos. I finished my last application last night and have ALL of the same symptoms you shared. I have raw, burned skin with a few small yellowish crusted things. I was looking for information to heal my skin and LOVED all the suggestions! I have never heard of Lansinoh and will be purchasing it today! I have some 99% Aloe gel and was wondering do you think that is also beneficial? Great to know the skin will heal quicker if it is moisturized!! Loved reading about Benadryl too! Thanks so much for all of the excellent ideas!

    • Tracey
      Posted at 13:54h, 19 May Reply

      I’m glad the post and comments helped. I’m sure aloe would be great, as long as it doesn’t burn. Hoping you’re skin is better than ever now!

  • Dee Morgenthaler
    Posted at 23:43h, 30 March Reply

    Hi Everyone – So grateful for this blog. It is a scary and intense process and it is nice to hear from others that have gone through it.

    I am spot treating a basal cell carcinoma above my lip with Fluororacil 5 and opted to treat the rest of my face with Picato concurrently in order to hopefully catch any of the pre-cancers that might be lurking.

    I just finished my third treatment of Picato and had all of the symptoms listed – my biggest surprise was how swollen my cheeks and eyes became and how badly it burned.

    Holy mama.

    I had blistering on my forehead and near my eyes day 2 and 3 – small blisters that didn’t weep. My skin became very, very rough as it swelled.

    For symptom management I started my dose at 3 pm so I could (gently) wash it off with Cetaphyl cleanser and cold, cold water at 9 pm and go to bed. I covered an ice pack with a soft cloth to get through the really hot moments. I took a mega dose of ibuprofen to help with pain and swelling.

    I appreciate the Benadryl tip – I am going to go take some Benadryl now because I’m starting to itch!

    Best of luck to everyone!

    • Tracey
      Posted at 13:53h, 19 May Reply

      Holy mama, is right! It can be QUITE the experience! Sounds like you had a rough go of it. Hoping you’re all healed up now!

  • Patrick McShane
    Posted at 21:26h, 05 April Reply

    Day 2, redness and minor blistering, I hope this works

    • Tracey
      Posted at 14:01h, 19 May Reply

      I’m sure your Dr. confirmed that it was a good idea to have done the treatment! Hoping your experience wasn’t too bad. Wishing you all the best, Patrick.

  • Mike Goodnight
    Posted at 10:07h, 06 April Reply

    Is there an approximate time of duration when the swollen area around the eyes subsides? It started on the night of the 4th day and now into the 5th day is very swollen. Thanks

    • Tracey
      Posted at 14:00h, 19 May Reply

      I feel like everyone has a difference duration for the side effects. I hope your swelling didn’t last too long and you’re back to better than before!

  • Amy May
    Posted at 06:49h, 16 April Reply

    Thanks for all the informative posts. I am on day 2 and have covered up my redness with make up. I applied on Sunday night and went to work yesterday and today. I took 3 ibuprofen before I applied the picato gel. I found being at work kept me distracted from the slight burning sensation. I told everyone at work to expect the worse and they are pleasantly surprised. I think that the less you focus on the pain, etc. the better you will be.
    Keep in mind it is temporary and you will be healthier afterwards, not to mention a fresh looking complexion.

    • Tracey
      Posted at 13:51h, 19 May Reply

      Amy, I’m glad you didn’t have a very bad reaction! What a relief!

  • Kaci
    Posted at 16:59h, 21 April Reply

    Hello! On day 4 here and OUCH! I was wondering if it left any scarring? Thanks for all of the helpful tips!

    • Tracey
      Posted at 13:51h, 19 May Reply

      Hi Kaci, no scarring, just some pinkness for awhile (it’s just the new skin). Hoping you’re all healed up!

  • Julie Reid
    Posted at 00:00h, 04 May Reply

    Thanks to everyone for their great advice. I am waiting to apply but gathering all the tips I can. I was going to apply this weekend but didn’t realise the ‘down time’ so I’m waiting for 2 weeks so I can take some time off work. I’m off to purchase as many of the lotions and potions that have been recommended! I’m in the UK and I had researched what I needed (Picato) went to the DR’s who gave me a prescription- cost -£9 ish. I got no information whatsoever on application or pre/post care. I am so glad I found this ‘place’ and all the fabulous advice!

    • Tracey
      Posted at 13:29h, 19 May Reply

      Such a good idea to wait until you had the time to let it heal. Wishing you all the best with your treatment!

  • Gail Korner
    Posted at 08:29h, 04 May Reply

    These posts have been VERY helpful! I began my treatment on a Friday evening and had NO idea of the reactions I was about to have. No warning from my DR or any aftercare instructions. I applied to most of my face so it was a large area and extremely painful. I made it through the 3 treatments with a very high reaction. My face turned extremely red with blistering and weeping and scabs. Long story short..I happened to have an appointment with my dermatologist that Monday for something else and she took one look at my face and agreed I had a high reaction and it was actually showing signs of infection. She prescribed an antibiotic (mupirocin) and I believe a steroid ointment (desonide). She told me my reaction was indeed because I had lots of pre cancerous areas so this was a good thing and good thing I did the treatment. On the positive she said my skin will look beautiful as a result (almost like having a chemical peel!) So good luck to you all doing this procedure and if you think your reaction is not normal…you may need some extra aftercare. Everything is fine for me now and probably another few days I can even wear makeup again!

    • Tracey
      Posted at 13:29h, 19 May Reply

      Wow, Gail! That sounds horribly painful and very extreme!! I’m glad you got the input and help from a Dr. Thank you for sharing your experience!

  • Marta
    Posted at 06:42h, 06 May Reply

    Hello! I was reading all of these tips and they are super helpful. I am about to start Picato for a spot treatment on my cheek- has anyone had experience using this just as a spot treatment versus full face/large areas? if so, how was your experience? hoping it will be less extreme than what I’ve read but haven’t been able to find many accounts of spot treating with this. Did it leave any discoloration once healed? Thank you!

    • Tracey
      Posted at 13:27h, 19 May Reply

      Hi Marta, I’m sure you’ll have a much easier go of it since you’re doing a small spot(s). Would love to hear how it went! My cheeks still get redder than usual after hot showers but no discoloration that lasts longer than being flushed after a shower.

  • Julie Reid
    Posted at 03:36h, 07 May Reply

    Having researched further it would appear pre skin condition ie. washing and products used on the days leading up to application do have ame measured affect on the sensitivity on the skin. No vitamin C creams, no scubs, no glycolic creams, no peels, for at least 2 days prior to application. Wash with basic cleanser and Pat dry at least 2 hours before applying. It makes perfect sense to think about what you have been using prior to starting.

    • Tracey
      Posted at 13:25h, 19 May Reply

      This is incredibly helpful, Julie! You’re right, it does make sense (although I didn’t think of it at the time). I appreciate you sharing this with everyone!

  • Gillie
    Posted at 08:34h, 07 May Reply

    I’m about to start this treatment on my nose. Can anyone tell me from the UK what to put on afterwards , I’m not familiar with any of these lotions. Thanks in advance

    • Tracey
      Posted at 13:25h, 19 May Reply

      I hope you found the list from Julie helpful. Hoping your treatment is behind you now and went well.

  • Julie Reid
    Posted at 09:12h, 08 May Reply

    UK products: all bought from large Boots: Lansinoh- find in the baby section, Savlon advanced healing gel- find in first aid section, La Roche-Posay- 3 products effaclar H ,derma soothing hydrating cleansing cream, Lipikar Baume- anti itching balm, Toleriane Ultra- intense soothing care.
    I’ve been using the cleanser and soothing care for 3 days now to ‘prepare’ my skin before starting the treatment and I’m very impressed.
    Best of luck!

    • Tracey
      Posted at 13:24h, 19 May Reply

      Thanks for this list, Julie. Wishing you all the best on your treatment!

  • Mrs. Margaret Tierney
    Posted at 00:19h, 15 May Reply

    Through my three day treatment I found relief useing a cold pack on my face as the fan made me hotter.

    • Tracey
      Posted at 13:23h, 19 May Reply

      Great tip! Glad it helped!

  • Brenda Rowlandson
    Posted at 16:15h, 21 May Reply

    Thank you SO much Tracey. So glad I found your site. I’m about to start the two week skin preparation on hand and forearm with a glycolic/salicylic cream that softens the AK’s first, BEFORE the Picato. My skin specialist scared the hell out of me when he described the symptoms post-application—used words like “paint stripper’ and ‘sniper fire and other incendiary terms! I had a tearful, angry conversation with him about it and told him I needed him to have a MEDICAL conversation with me instead of scaring the life out of me! They want me to do both arms and hands at the same time (two applications over two days, by nurses, in his office. $220 EACH time!!). I am insisting they do only one arm now, and the other at a time to be discussed.. It’s MY body and I know it better than anyone else and how I respond to these things. I’m a psychotherapist, and to have to sit with people in their own pain, while I’m coping with burning, itching, blistering and pain in BOTH arms, just seemed unbearable. So one arm at a time for me. I am so thankful my face is okay for now. But, I should have listened to my mother about going out in the sun, with my red hair and fair skin, and I defied her every caution. So now I pay for it.
    This is my punishment for not listening to my mother!! Haha! .

    Your tips are very, very useful and welcome, and BTW, I have multiple tubes of Lansinoh around the house! Can’t live without. One tip about using it on faces would be to melt it (put tube in hot water for a while, or microwave for one second at a time (not in the tube!). It turns to liquid and would be easier to apply. Wish me luck for my treatment at end of May. Brenda (Australia)

  • Julie Reid
    Posted at 01:23h, 24 May Reply

    Tracey, this site has been my go to place to get tips on everything, thank you so much for taking the time to put it together.
    I started the treatment yesterday! One full tube on face- it started burning immediately and itching, I left it for 7 hours, rinsed it off and applied the cream I had kept in the fridge – desperately needed! I did feel though that the cream was aiding the burning so I rinsed off and put some medicated gel on which was much better, I applied this a few times before bed. This morning I look like I have severe sunburn with blisters in places, my face is swollen and eyes are ‘gooey’ although I avoided them and pre treatment circled them with the nipple ointment. Perhaps the night cream managed to ‘seep’ in. My face was burning like hell yesterday and painful but I forgot the tip on taking painkillers! I won’t forget today! I’m just about to apply the second day treatment and I’m going to try to avoid the blisters- I’ll keep you posted 🙂

  • Bryony Spencer
    Posted at 09:32h, 24 May Reply

    Thanks so much. I think Picato should give you a meddle. I only desided to try it after reading all these comments. I v just started the treatment today. I m 63 and also can hear my Mums warnings….

  • Jennifer
    Posted at 01:01h, 26 May Reply

    Hi I am an Aussie and proud to say this is an Australian invention much needed as we have some of worst Amon cancer rates in the world. I’m on day 3 of the picato burn, thanks for this blog and all comments as reminds me I’m not alone going through picato hell ha ha. I have been doing this annually for several years and it does get better, be aware you need to keep it up. I have a specialist akin cancer doctor.. good news.. he advised it’s like taking 5 years of sun damage off your face etc. I try to remember how amazing my skin looks after about day 7.. and the cancer cells being killed. Stay strong.. even now my face was on fire day 1.. had to talk to a date on phone that night and explain as I was icepacking desperately before call ha ha.. it’s worth it all hang in there.

  • Katrina
    Posted at 18:43h, 27 May Reply

    Oh my god. I would never do this to myself again. Side effects started almost straight away. Today is day 4 and my eyes are almost swollen shut, I have terrible headaches and nausea. I saw my dr this morning and he said this is a moderate reaction…. What!
    Anyway your blog really helped me know what to expect.
    I am in australia. We pay $145 for the 3 tubes.

  • Kathleen
    Posted at 20:13h, 31 May Reply

    Thanks for your post Tracy, I just put it on for day three and today not feeling so good. The whole weeping thing threw me for a loop. Mine didn’t weep until I took a shower the next morning, then it just went ooze crazy. The reason I was trying to find other experience (female) is that my poor nose has swelled up to be a bit bulbous like Rudolf the red nose reindeer and was concerned it would not go back to normal. Seeing your pictures gives me some assurance. I have some Neosporin but wasn’t sure I could use it, so tomorrow I will definitely put some on.

  • Rob
    Posted at 11:10h, 02 June Reply

    This is my third round with Picato. First two were on my forehead and bald scalp. Not too bad, and the results were great. My rough uneven old looking skin suddenly looked 10 years younger. This time we added my nose. It hurts like heck, but I am hoping for the same good result. I did the third treatment last night, and I look like a cartoon drunk with a bright red nose.

    Anyone hesitating, be reassured. It works. It is worth it. I was getting embarrassed at how my scalp looked, and now it looks great. I have hopefully avoided a more painful cancer removal process. Certainly discuss this with a doctor, but if Picato is recommended, try it.

  • Lisa Hecht
    Posted at 02:11h, 08 June Reply


    Thanks for this thread . I too used Picato back in April 2019 . I only used it for 2 days on my face . I could live with the burning but the sinus pain was something awful . Now 2 months later if I go in the sun even with sunscreen, a hat etc my face feels like it’s burning and I get bad sinus pain . I find it’s left me very sensitive to heat and the sun . Like a deeper chemical burn , I don’t know just me . I’m a real red head and skin sensitive and have been through many bad burns in my life . Sunblock wasn’t invented when I was young so being a red head, you just burned . I like you took pictures as well documenting my face and looked like yours . Aquaphor really help me though . I can say to add , my burn pain only lasted 6 hours then gone and as my doctor said, the sun damaged areas that you apply to actually came to the top of my skin or really showed themselves and 3 areas above my lip turned into sores just like when you get them freezed off . Above my eyebrows too, sores formed but by day 5 peeling and almost gone . I still get the redness with heat and any sun. That’s a leftover side effect in me . I never layed out to tan and never used tanning beds . Skin cancers run in my family . Thanks for your posts and these comments were helpful .


  • Diana
    Posted at 21:43h, 09 June Reply

    AS so MANY have already said….thank you for taking the time and effort to post this blog regarding Picato. My initial research in April landed me on your site and I too said WHOA!!!! this is crazy to do.
    I went back to my derm and discussed my concerns. I was especially alarmed at all the “eye” irritation issues as I am a contact lens wearer. I eventually agreed to follow thru with it. I did three facial applications – cheeks and above my upper lip, but did not do my nose. Plenty of burning stinging itching red etc. Swollen face, especially under the eyes and upper lip. I am at day 4 now with tight skin, itching, red and a variety of blisters, with most of the major pain from the three application days gone. I also had an odd runny nose, and kept wondering what I would do if I needed to sneeze! Odd thought. All of these were listed on the medical instruction info. They are listed as “side effects”, but with so many users experiencing most of these or more they should be expected vs just “side effects”.
    I did my app’s in the late afternoon til pm, took reg tylenol and then later took a tylenol pm before bed. Slept thru each night.
    I did call Leo Pharm to ask about what they might suggest to apply for burning, itching etc and aftercare. I did get a call back and was informed that during the clinical trials for this product none of the individuals in the trial applied anything during or after the process….so at this point…Leo Pharm has NO credible information to include in the info sheet and directions….thus most likely the reason Dr.’s make no mention of it either. Personally, that is a big oversight in my opinion. My Dr follow up is in another week and the Leo Pharm person also asked if she could follow up with me. We’ll see what happens. If you look up the main ingredient for this medical application it is actually derived from MILKWEED. I believe a poison or often classified as such and very capable of burning your skin etc.
    Will be curious to see my outcome over the next few weeks. I have also photographed as you did each day, just to see if changes are dramatic or subtle as I think everyone will have a somewhat different time frame to work with. I may try a little of my regular natural face cream to see how it goes. thanks again for YOUR information.

  • Tom Trevelyan
    Posted at 05:40h, 11 June Reply

    Hi Tracey, I just finished my 3 day treatment and I am starting day 4. Your blog and all the comments from others was a godsend! However I have something that others about to undertake this might consider. My wife bought me some Aveeno baby wash to use to wash off each days treatment and it worked great She also bought me some Johnson’s shea/cocoa oil gel which I used to combat the drying and tightness. It went on like liquid silk and worked great. I used each day after I washed off the picato with the Aveeno baby wash gel. My face this morning is blisterd/dry and crusty. I just applied the Johnson’s again. It went on very comfortably and my face feels more pliant already.I will continue using this until I am completely healed. Hope this helps someone. Thank you and all others for the excellent insight.

  • Jamie Ryan
    Posted at 14:50h, 18 June Reply

    Hi Tracey,

    Just started Picato today. Small area (pea sized) on my nose.

    Day 2 tomorrow, I’m working outside. Can I apply suncream? No mention of it on the instructions.

    Thinking I might do the day with suncream, then apply my Day 2 Picato when home in the evening.


  • Julie Williams
    Posted at 06:47h, 22 June Reply

    Hi, I just finished my day 3 of Picato for Basal Cell on the ala on my nose.. My dermatologist told me to use only 2 vials and save the 3rd for possible treatment a month from now. Since its a small area. My whole side of my nose and half my cheek is red and swollen all the way up to my eye. I did not apply past my nose. Is it normal to spread like that? Weirdly my right cheek is red and I applied my Picato on the corner of my left nose. Can the medication spread through skin? I haven’t put anything on my site yet. Waiting to wash off the 3rd dose in hour or two. Then I am going to get some Vaseline or something else to start healing. I actually work for a group of dermatologists, I work Monday its Saturday. I don’t think I should wear makeup. How long did you wait for makeup? As far as price goes (for others who asked) I searched GoodRX for prices in my area some ranged from 1000-1500 US . But, don’t pay that . Picato has coupons for $25.00 and there are other specialty pharmacies, like Benzer and Pharmacy Toi who can get you that drug for $30. Just ask doctor. I was blessed my doctor gave me free sample pack.

  • Narelle Macpherson
    Posted at 15:18h, 30 June Reply

    Day 3 for me and still no redness or pain.
    Perhaps my pain is still to come.
    Feeling anxious.

  • Linda Craig
    Posted at 10:38h, 01 July Reply

    I’m on day 2 and while I am quite red & swollen, it’s not dreadful – like a bad sunburn. I’ve been sleeping in it and thought the first night was more uncomfortable than the second. My dermatologist recommended Cicalfate cream by Avene for daytime and it seems to help. I’m not sure but I think that the more damage to your skin is in the more war of the medication is doing, the worse you look and feel. I was told to expect to look the worst on day five but it could be six or seven We will see but I think we’ll worth doing! My husband had 20 stitches recently where the dermatologist removed a basal cell carcinoma from his Foreign. Prevention is much better! As to price, my Costco pharmacist told me this little 3 pack is over $1000 retail, I paid $100 with insurance.

  • Ray Goins
    Posted at 07:17h, 12 July Reply

    Thanks Tracey and all the commenters, very helpful, especially hints on pain management. I can only make it through 2 days, but I also will be getting my every six month (for years) blue light special (Kmart shoppers!) or photodynamic therapy in a while which I think has helped me on my face. 2nd day today, Lots of redness and eye swelling and I’m still planning on performing at my piano bar gig tonight. Let the people gasp, They should know what I go through for beauty! It’s worth it to try to keep the cancer away.

  • michelle sharkey
    Posted at 00:17h, 18 July Reply

    Hi Tracey, thank goodness for your blog. I am on day 3 of treatment with Picato gel. I thought on the first day I was going to need to stop as the pain was unbearable and I got a severe headache. It felt like my nose was burning off. The second and third days were not as painful but still feels like someone has taken a blowtorch to my nose. It is really helpful to see how your skin healed and how many days it took. I’m supposed to be back at work Monday but I may take a couple of days off so I don’t look quite so bad. I’ve nicknamed myself the elephant man. 🙂 Hopefully with some creams to ease the burn and rehydrate the skin it will feel better. One quick question did your skin get really scaly before it peeled?

  • Jesamine Mello
    Posted at 00:22h, 12 August Reply

    Thank you so much for this post.   I too am in my 50s and having to pay the price for not taking better care of my skin.  At least now I feel a sense of orientation as I enter into the next few days.

    I applied my first dose last night before bed because I had not yet found your site. Yowza! indeed.  indeed.   Needless to say, I did not sleep well at all.  It feels – and looks – like someone punched me in the nose and then put a blowtorch to it.    I do not look like myself at all.

  • cheryl dahl
    Posted at 09:38h, 24 September Reply

    this is my 3rd time applying Picato and he prescribed the strongest dose and it has wiped me out. This is day 5 and i am feeling better, but still am having the burning. If this does not work we are going to do the blue light therapy gel and not sure how that works.

    Posted at 08:16h, 25 September Reply

    I am on my day 3 swollen eyes burning red raw nose I keep hopeing the next day will be better I would like to put fresh aloe on but Dr. told me aquaphor

  • myglamm
    Posted at 03:52h, 30 September Reply

    It’s very hard to use

  • Mel
    Posted at 08:37h, 02 October Reply

    This is my 2nd time using Picato on my entire face. In between I did just my forehead. My reactions were similar, very red, burning, and Itchy. Days 4 & 5 seemed to be the worst. The first time I was prescribed Picato, it was by a female dermatologist. She gave me some great advice and prepared me for the worst. After washing off each application I smeared my face with Aquaphor. It’s not easy to do with the blisters, but it definitely kept my face soft. I washed it off with Cerave hydrating cleanser each time. I would wash with warm water at least twice to get the Aquaphor off completely. I used a soft brand of paper-towels to pat my face dry.
    I found it easier to put the application on during the day and washing it off before bed. I changed my pillowcase after each application. I wonder if some of the eye swelling is from sleeping with the Picato on and then it transferring from the pillow case to the eyes when sleeping.
    Before each application I washed my face and then waited at least and hour before applying the gel. I put carmex on my lips, around my eyes, and around my nostrils to act as a barrier so the gel wouldn’t touch them I also washed my face over the sink so the shower wouldn’t beat on my face. It is not easy, but it definitely helps with the AKs. I found that by day 7, I could go out and do my normal routine. I was fortunate to be able to take a week off from work.
    I wish everyone the best!

  • lisa
    Posted at 00:00h, 17 October Reply

    what is the use of this Picato ?

  • joe
    Posted at 11:21h, 24 October Reply

    I’m surprised yours was that painfull because I used on one spot on ear and one spot on forehead and it wasn’t bad (scabbed over more then yours), but mine eventually came back months down the road in same spot so he gave me something different to use on it

  • nicky jewett
    Posted at 21:10h, 27 October Reply

    OMG thank you, Tracey, for this blog! It is priceless! I got so much information out of it – there is NOTHING useful on the internet other than your blog – I’ve spent hours looking!
    *** I’ve scoured the net for info and called my dr office numerous times & CANNOT seem to get an answer on 1 very important question. Don’t know if anyone can weigh in:
    I am done with treatment. Day 5. I didn’t have much pain or itching so I don’t NEED to use Aquaphor or another moisturizer, but I’m wondering if I SHOULD use it. If I do use it, does it diminish Picato’s effectiveness? If I DON’T use it, will my skin scar? All my dr office would tell me is that I MAY use it, but won’t tell me if I SHOULD use it or if I should try my best to tough it out & let all the skin peel & stuff naturally. Any advice would be appreciated!

  • nicole jewett
    Posted at 21:15h, 27 October Reply

    Ooops, also… SHOULD I wash my face daily or twice a day or not at all AFTER the 3 days of treatment is done? Do I risk infection if I don’t wash? Do I wash once a day or twice a day?

  • Debra Toshack
    Posted at 16:22h, 29 October Reply

    Oh my goodness, thankyou Trace for this site. It has been my saviour. I am on day 7 now of treatment. I mentally wasnt prperaed for such a traumatic event. I feel like my face has fallen off several times and had the pink new skin but now if feeling quite rough and it’s still flaking off. How long does this last for? I have been using 100% organic hemp oil during from day4 onwards. This has been soothing and relieving to a degree. But today I am needing a heavier moisturiser and am using avene skin recovery cream…This seems to be ok so far.
    Thanks again, everyone’s comments and your blog has been useful and reassuring through each day of this hectic treatment.

  • Leigh Hazelgrove
    Posted at 05:41h, 17 November Reply

    I have used both Efudex and Picato in the past. When my doctor recommended the Picato, it was appealing because of the shorter application period. I used it for a few spots on my face with great success. Recently, my doctor prescribed Picato for my entire face and chest. The application for the face is a weaker strength than the chest, but the chest application last only 2 days. You are done before you know it. I just finished my second day for face and chest. It is so nice to know that I don’t have to do another application on my chest! I’m dreading the last application to my face.
    I have now used both Efudex and Picato, and I prefer the Picato! To me, it’s a no brainer! Go with the shorter treatment! Either way, you are going to need time to heal, but the healing starts much sooner with the Picato!

  • Dianne
    Posted at 05:58h, 21 November Reply

    I just finished my 3 days of picato on my face. It wasnt to bad at all. But on the 4th day i used polysporin on it and it burned so bad i had to wash it off. It was fine after that. I asked a question a couple weeks ago that no one answered. So i tried anyway. I used picato on a spot on my leg the same that i used on my face. I did not work. So i guess i have to get stronger dosage for leg. Good luck to all with picato i think it works great 3rd time ive used it with no issues

  • Beverly
    Posted at 15:33h, 03 December Reply

    I’m on day two, Thank you for your testimonial, pictures.

  • Jane Gabbert
    Posted at 08:31h, 21 December Reply

    Cannot thk u enough for this blog. Extremely helpful. Started treatment as of last night on my nose. Very scary starting this regime but all your comments gave me the confidence to continue! Thanks so much. Mild itch & burning so far. Will report as I travel thru this. JG

  • Jane Gabbert
    Posted at 08:31h, 21 December Reply

    Cannot thk u enough for this blog. Extremely helpful. Started treatment as of last night on my nose. Very scary starting this regime but all your comments gave me the confidence to continue! Thanks so much. Mild itch & burning so far. Will report as I travel thru this. JG

  • Harold F
    Posted at 22:49h, 29 December Reply

    Thank you so much for this blog – I got a lot more out of it than I did from the directions on Picato or from my derm. I wanted to share a few more thoughts from the perspective of a bald gentleman. I was treating my forehead and my exposed scalp after a endless period of freezing off PK’s. I have been lucky that my discoloration and discomfort were not as great as yours. I can’t say it was any fun,and I’ve definitely had burning, itching, and some blistering, but I wasn’t totally incapacitated. I even managed to go to an NBA basketball game with my family on night 2 (thought that had some challenging moments). I do think hunkering down in omfortable clothes with something good on TV is a great tip.

    There were a few additional challenges being bald. First, I did this in winter. I usually wear sweatshirts with hoods or a beanie around the house or out in the world, especially at night because, well, bald guys get cold in winter. This presented quite a challenge. I ended up using my softest hoodie, but there was no way avoiding it rubbing on my irritated head. If I could do this over again, I would do it in somewhat warmer weather there this would not be an issue. Another challenge is that it is really hard to find a way to sleep. I followed your example and did the applications in the morning instead of at night (I have no idea how I would have slept between discomfort and concern about getting it in my eyes), but no matter how I slept some part of my irritated scalp was on the pillow. What I ended up doing was seeping with the very soft hoodie, hood up, on my side, which minimized friction against my irritated skin. The final additional challenge as a bald man is that one tends to touch one’s head with some frequency for various reasons, which meant touching the application areas – both uncomfortable and made me uncomfortable in the first hour or two about getting Picato on my hands. In any event, I just wanted to share these observations for other bald men who may be going through the process. I don’t have all the answers, but it is good to know the challenges up front!

  • Sheila K
    Posted at 18:53h, 02 January Reply

    This was so helpful and actually kept me going with the Picato. Thank you so much. I was pretty much like you in terms of days and your pictures. I used aloe and Pawpaw cream mainly on day 4 for healing. On day 8 and most the flaking or scabs have come off and the pink is starting to fade. Thank you again, I may have quit had I not stumbled across your blog.

    • Lori powers
      Posted at 18:46h, 07 January Reply

      Totally agree that her information kept me going also. I feel like she shared more of what to expect and how to soothe it better than my doctor or the literature did.

  • Lori Powers
    Posted at 18:04h, 03 January Reply

    Thank you so much for all your helpful information. I read through everything and put off using the gel as prescribed until I could take this week off of work. I have referred back to your info many times the last few days. I actually went to my scheduled follow up appointment not having done the treatment as instructed a couple months ago and had my dermatologist go through my other options because I was scared to do it after reading your blog but it still was the best option for my problem.
    I’ve just finished my 3rd application on my face today. I’m afraid I messed up and had a brain fart yesterday with the 2nd application because I put the lansinoh over the Picato gel and left it there during the whole treatment. It didn’t occur to me until today I probably shouldn’t have done that and hope it didn’t keep the Picato from doing its thing. I’m treating the area between my mouth and nose and a corner of my bottom lip with the Picato. Anyway, feeling a bit delirious on my last day here but wanted to let you know what a great help you’ve been.Happy New Year! Lori

  • Tonya Pilichowski
    Posted at 13:48h, 07 January Reply

    Thanks to everyone who has shared and the suggestions for relief.

    I was diagnosed with basil cell skin cancer on the side of my nose six months ago. I had Mohs surgery shortly thereafter to remove it. Success! My Dermatologist prescribed Picato gel (low dose) for my chest to use while I recovered from the Mohs surgery. I used it for the 3 days and overall not a terrible experience. Some redness and scabbing, but not much. Went in for my three month check up and were going to discuss Picato for my face. Unfortunately, they found another basil cell skin cancer on the bridge of my nose. With another Mohs surgery, we decided to wait on the Picato for my face a few months later.

    I decided it was time to do the face, minus the nose and surgery areas. Since I did not have a bad reaction on my chest, I had the expectation that my face would be the same. Wrong! I put 1 tube on last night, watched some tv and went to bed. Woke to a very red face, like a very bad sunburn. Needless to say, I went back through and read the literature from the manufacturer and started reading online and left a message for my Dermatologist as to what I should do or if I should continue. I have since taken 4 Advils thus far today and placed a cool wet cloth on my face for a bit. Both have helped. I definitely am more sensitive on my face than on my chest. Since I have started it, I am going to suck it up and continue with the other 2 days and be done with it. I would assume the next few days is going to be rough…

  • Charlotte E Irwin
    Posted at 11:13h, 25 January Reply

    I’m on day 4 so over the worst. Don’t think my pain was as bad as yours on day 3, managed with combination of Paracetamol and Ibrobrufen. Haven’t put anything else on my skin yet. The think that surprised me was how tired it made me feel and just generally unwell with a constant headache. Also had 2 nights of very vivid dreams which has happened before with sunburn. But the tiredness was a surprise. Once I’d rinsed after 6 hours and taken pain relief I enjoyed an afternoon sleep!

  • Deb M
    Posted at 11:54h, 21 February Reply

    I have put off using the Picato since November. I have the tubes in my ‘frig— just SO don’t want to start it. It has helped to read your stories and see pics…BUT still so scared! I am suppose to put this on my lower lip, even though the instructions say no lips! I called the nurse and she said it would be fine. Did anyone else have to put it on their lips?

  • Deb M.
    Posted at 10:57h, 22 February Reply

    Tracey, thank you for responding to my question. NOW I have another important question. I have been reading about Picato and the UK has issued a warning that it can increase the chances of getting skin tumors, especially if you’ve had skin cancer. Here’s the link:

    Now I really don’t know whether or not to use it. Have you , or anyone else, seen this new report?

    • Cj Lycett
      Posted at 15:35h, 21 March Reply

      Hi Deb, I read your comments and I too noticed the recall. I had to make a decision about this and called my dermo and they prescribed imiquimod which does the same thing but the topical treatment is for a period of 1 month! and then it keeps working and who knows how long for the final healing. So I took a leap and did Picato anyway, and so far things are fine and just as Tracey has outlined. I felt that there were risks no matter what I was going to choose but I definitely wanted something aggressive and a fast process which picato is. I am on day 5 right now… you can see my comments I posted March 21st. I was scared too but you aren’t alone.

  • Karine Wright
    Posted at 01:48h, 27 February Reply

    I was prescribed picato recently for my face but having read your blog decided to do some research before using it.
    The European Medicine Agency EMA has suspended the use of picato pending results of their investigations as there seems to be a link between the use of picato and skin cancer.
    The Danish manufacturer has withdrawn picato from the European Union market but continues to market it elsewhere.
    So glad I read your blog. I have now been prescribed Solaraze by my doctor instead.

  • Cj Lycett
    Posted at 15:18h, 21 March Reply

    Hi Tracey, thank you very much for sharing your experience. I am a 50 year old male who has spent a lot of time in the sun and finally needed to do a few large spot areas on my face(cheeks, temples and upper nose area. I was quite intimidated by the process but just took the leap of faith and just did it. I knew it would be a quick and aggressive treatment which is what I wanted so it wouldn’t drag on…I definitely look like I got run over by a bus and dragged a few feet in the process haha. But I knew what was coming and its required to get rid of the pre cancer skin. Its day 4 and I have redness and peeling going on. It definitely stings but no pain that cant be handled and without pain relievers too. The effects of Picato were just like yours. I started using Aquaphor today on the areas that had crusted over. I am hopeful and confident my skin will turn out great. I am documenting mine and want to share when its all over. Thanks Again!

    Posted at 07:47h, 06 April Reply

    I popped 2 benedryl and 2 advil at night and slept just fine. Also, spread fresh aloe vera on to soothe. Day 1 and 2 were the worst with Day 3 now, lots of little blisters and itching but no pain.

  • Beth
    Posted at 05:14h, 07 April Reply

    Not sure starting during a pandemic is the best idea, but the dr said to start when I had some down time so here I go. I did the first treatment yesterday and holy wow it burned. I do not know how I will voluntarily put on that second treatment today, but so thankful for your account so I know what to expect. I could feel it on my tongue…I can’t explain the sensation, but almost like it was swollen. Anyone else have this? I will definitely be taking Tylenol before today’s treatment. I’m doing it at 4:30pm everyday and taking it off at 10:30. I’m going to have dread all day until 4:30. Everyone stay safe and well during this time!

  • Tom Seaman
    Posted at 11:57h, 15 April Reply

    Thank you for sharing this. I’m sorry the experience was so painful. I completed day 3 a couple days ago and was wondering what you suggest using now on it to keep it moisturized? My pharmacist said to not use anything this early to speed up the healing process, but I am at a loss as to what to use on it now. No pain, Just very red and dry. Thanks very much!

  • Molly Mueller
    Posted at 18:49h, 13 May Reply

    I am currently on day 3 after treatment. My doctor gave me a 2-tube prescription, so I used it for 2 days. Until I read the comments here, I didn’t realize there were 2 different prescription types. I used the .05% on my chest AND my face. I’m kind of freaking out at this point also, because I just read that in January 2020, they discontinued the use of Picato in Europe due to increased incidence of skin cancer in people who used it!
    My tips for facial comfort: Buy some really good, as pure as possible aloe vera gel and some cold pressed organic coconut oil. Start with the aloe vera on the night of day one. The next day, use aloe vera again at night after your second treatment. The third day, start alternating coconut oil and aloe vera every few hours.
    Do NOT get this stuff anywhere near your eyes. I put some near my eyebrow by my nose, and my eyes swelled up like I had been punched. The skin is all rough and patchy and gross. And it’s so sensitive that it hurts to touch my eyes at all.
    But other than that, everything is great! LOL

    • Deborah Graham-Schroeder
      Posted at 13:56h, 11 October Reply

      Hi Molly, Did you talk to your doctor about the recall in Europe? Thank you for the tips. I am to start soon and I have had basal cell cancer twice in the last two years, so I am scared..

  • Debbie Riddick
    Posted at 15:02h, 02 June Reply

    Did you see this new research on Picato? A liitle scary! Glad mine is still in refrigerator!

  • Rres ended
    Posted at 19:28h, 15 June Reply

    Day 1 for me: applied at 9:00 this morning, by 10:40 I was on phone with derma office as the reaction was so profound and fast. I expected pink/red burning, but more towards day 3, not within an hour of day 1. They told me the reaction was to be expected. By 1:30, I called again to ask about washing it off. They said to leave it in until day 2 morning, wash it off, and apply 2nd dose. By 6 PM, I COULD NOT leave it. Very gently rinsed it with cool water. It is now 10:30 PM, my nose where I applied it is red, blistered, burning, swollen, and the red spreads about 3/4 inch beyond where it was applied. Much worse Reaction than I expected.

  • Yocheved Turner
    Posted at 23:35h, 24 June Reply

    Hi Tracy,
    This post is just amazing. Thank you for sharing your personal experience with the medicine and sun damaged skin. The pics says it all.. great effort in the article. Enjoyed reading it.

  • Joan Towne
    Posted at 08:38h, 05 July Reply

    I just finished day 2 of 2 on my chest. I thought I was going to loose my mind I was so itchy! It is very painful but from a clinical perspective does its job. If you’ve been prescribed to do it, I would suggest get it done. You look freakish for a short time and do suffer but it passes and your skin looks and feels good. This is the second time I’ve done this, the first time it was my forehand and that was awful!! I hope I’m finally done with this medicine, and am staying out of the sun as much as possible.

  • Virginia Quade
    Posted at 07:23h, 07 July Reply

    I’m on day 5. I did all three treatments and my face is so swollen! Yesterday was the worst day for me, although still very painful today. I have been using Vaseline and aquaphor, but just ordered the Biafine through Amazon. Thank you so much for the pictures and tips! Very helpful. I also experienced nausea and chills. I worked the first three days since I have to wear a mask right now anyway. So glad I took two days off after that! Lymph nodes are extremely swollen and painful and have had constant headache. I can tell the moment the Tylenol wears off! I don’t think I’ll put myself through this again!

  • Deni
    Posted at 19:56h, 14 July Reply

    Thank you a million times… I followed your post daily, which kept me going as I though for sure I was having a worse than normal reaction. Thank you for the photos also. I put it all over my face, as per dr orders and it was painful as hell. But now I’m on the fifth day and I see improvement . My skin is peeling off and so soft underneath. It was too painful to put anything on my face for the first three days, so I couldn’t even put sunscreen on. Basically I stayed out of the sun. Thank you again for your detailed post…

  • Trish Spence
    Posted at 13:59h, 17 July Reply

    I haven’t read all of the comments but when I woke up with my face on fire in the middle of the night, (think rubbing a jalapeno all over your face) I dipped a washcloth in cold milk and placed it on my face. It was the only thing that soothed the burning enough to allow me to go back to sleep!

    My experience was similar to yours except I did my chest first. Didn’t seem to burn as bad but ITCHED like crazy! I am happy with the results of both treatments, but hope to not have to repeat it on my face!

  • Kay Lienhop Patterson
    Posted at 21:00h, 14 August Reply

    I must be doing something wrong. I’m on my second day, and my skin is barely a little red; no pain at all. ???

  • Genevieve Sullivan-Cornell
    Posted at 08:32h, 26 August Reply

    Tracey, To day is day 4 for me I have a small spot on the left side of my face fairly close to my nose . Because it is so dry, itchy and scaley. I applied some vitamin E oil on it today and plan on continuing to do that daily. I feel like the Vitamin E helped that same area after a small biopsy sample was taken for evaluation. Do you think the Vitamin E is ok to apply and NOT just leave the area alone? I am nervous to have marking or discoloration

  • Suzanne Thompson
    Posted at 07:25h, 05 October Reply

    My Doctor asked me to put it around my nose so I did three days of this it was very very painful and very red but the fourth day The pain subsided then I went back and he asked me to put it on the rest of my face so I did this but (after it sat in the Refrigerator for a year I finally did it )this time the box said apply at bedtime so I tried this and it seem to work much better when I would put the gel on right before going to bed and taking two Benadryl.

  • Dean Bagley
    Posted at 18:56h, 06 October Reply

    Tracey, your experience and advice has been invaluable. Thank you so much! I’m starting my procedure this week and I’m sure it will be easier using your suggestions. One thing I wasn’t clear about, did you use Lansinoh balm in the jar or Lansinoh cream in the tube? Thanks again for your insights and sharing your experience!

  • Simon Spencer
    Posted at 22:58h, 14 October Reply

    I am on day 3 of the Picato course (my entire nose) and its hurting alright. The skin is red and blistered and looking in the mirror is not fun at all. I can feel the blistering hardening into scabs and tightening the skin underneath which is adding to the discomfort. My doctor also prescribed me a steroid cream called Advantan Fatty Ointment which he said I can start using from day 4 onward to reduce the inflammation and discomfort. Looking forward to day 4 tomorrow.
    Hoping very much that the reviews I’ve read about bad experiences with Picato don’t affect me the same way, especially those who have complained of having darker skin in the treatment area even 9 months after the treatment.
    I’ve also now read that Picato has been banned in the EU as research has found that the risk it poses to actually cause skin cancer is too high. Not sure I would’ve started this course if I had read that before it.

  • Terry
    Posted at 10:29h, 19 October Reply

    Not sure how old this post is but I will relate what my doctor told me to do. It says CLEARLY on the directions several times to not get this near your eyes. That is one of the places I was told to put it. On my lower eye brow next to the corner of my eye! After I read all of the instructions I thought she was crazy. Her reaction after I expressed concern was ” just don’t get it in your eye!” As it was June when I got the medication I decided to wait a while before starting the treatment. I work out doors and didn’t want to take a chance on sweat washing it in my eye. Well I have waited as long as I can as it is now mid Oct. and the medication expires in November. I started the first treatment today. I had blisters all over within the first three hours. { can hardly wait for day two and three.

  • Joseph Belcher
    Posted at 07:22h, 24 October Reply

    Just started day one last night. I must say, I am NOT looking forward to the next two applications. I feel like I dipped my nose in lava! Has anyone used a steroid for the inflammation and healing after all applications? Just curious if anyone used a steroid post applications to help speed up the healing process. Also, to help with the inflammation.I used the whole tube for the first application. Seemed like I used way too much. I assume your to use the whole tube for each application.

    • Joseph Belcher
      Posted at 07:01h, 25 October Reply

      Day two was not bad. Hoping day 3 will be the same!

  • Lee
    Posted at 04:08h, 11 November Reply

    Tracy, Effudex (5-FU) will NOT be as extensive a reaction, because it works by a single mechanism to “kill” the abnormal cells, whereas Picato attacks the cells AND has an immunostimulatory effect as well–why there are all the marked inflammatory symptoms.

    Effective one-two punch, but boy oh boy, can you see and feel it working, hmm?

    Joseph, you do NOT want to use a steroid, because that would be suppressing the immune reaction.

    So helpful for you to document this, so people won’t panic.

  • Dallas Neeley
    Posted at 12:53h, 16 November Reply

    Thanks for the info. I am starting a 0.05% dose on my left arm (driver’s side) Wednesday. I was told to just do one day. Your info and photos helped me to figure out what to expect.

  • Christine Adams
    Posted at 20:03h, 08 December Reply

    About to start 2nd round of Picota on my chest after yrs. I’ve had treatment consistently since 2010. My sister n law did effudex on her face and traumatized me. I refused both Picota & effudex on my face and opted for PDT, photodynamic light,therapy, aka blue light therapy; FDA approved for AKs. It’s tough but for a far shorter time. I “marinate” for 2 hrs with Louvalon kerastix solution then 17min under the light. It’s very painful but only 17 minutes. It feels like a million needles pricking you with excruciating heat, A fan is absolutely necessary. It’s intolerable without a fan. I have earbuds, play very loud music & I sing for distraction. For 48 hrs you avoid sun & fluorescent lights. Then you peel. Treatment is about 10 days total and of course aquaphor & polysporin.. Polysporin because there less risk of scars. Its painful but well worth it and I won’t do anything else on my face.

  • Christine Adams
    Posted at 20:11h, 08 December Reply

    In addition, the 1st 48 hours can be tough. It depends on the amount of reaction which it only r eww acts to damaged skin. I’ve run the gamut from not so bad to ice water clothes and fan for almost 48hrs.. That time was my fault cause I ran neccesary errands after treatment. I paid the price. Light keeps the solution active as you don’t wash your face for 24hrs. Of course there can be inflammation, headache etc. Just thought I’d share.

  • Christine Adams
    Posted at 20:15h, 08 December Reply

    I do have PSA pictures on FB.

  • Jacqueline Sieling
    Posted at 08:31h, 08 January Reply

    My experience was almost the exact same as your. Thank you so much for posting this, so I had an idea of what to expect and also didn’t get alarmed that something was wrong. I bought a small fan which plugs into my computer and had that on face while I worked. It was hard and I’m glad its over. Thanks.

  • Frances Browne
    Posted at 12:54h, 19 June Reply

    I’ve put off using Picato on my forehead for almost a year now and I’ve just gotta do it! Thanks for your writeup. Very helpful to learn exactly what to expect. Do you use topical Benedryl or pills?

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