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Ask Dr. S. Attili Your Own Question
Dr. S. Attili
Dr. S. Attili, Dermatologist & Dermatopathologist
Category: Dermatology
Satisfied Customers: 5175
Experience:  MRCP (Dermatology), Int. Board Certification in Dermatopathology
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I am on a Fluorouracil Cream treatment on my face and have

Customer Question

I am on a Fluorouracil Cream treatment on my face and have been for 2 weeks, with 2 to go. Of course, things are red, sting, etc, but having a specific issue that seems abnormal. Around my nose, and cheeks, it appears to be burnt (different from other areas). My cheeks and specifically around the crease in my nose/nostril is on fire. Pain level reaching 7-8, where other areas, 2-3. This is a proactive treatment from my Dermatologist, but I have had a history of some basil cell carcinoma's in past. Am I suppose to be putting this cream on that area of my face. It seems excessive in terms of pain and with 2 weeks left and that fact it appears to look like a severe sunburn, seems abnormal to me. I did NOT put it on that area of my face this morning.
Submitted: 7 months ago.
Category: Dermatology
Expert:  Dr. S. Attili replied 7 months ago.

Hello. I am Dr. Venkat Attili, Dermatologist and Dermatopathologist with over 10 years of experience in this field. I am here to assist you and will answer your questions to your complete satisfaction. Can you please upload a picture at your convenience?

Customer: replied 7 months ago.
I have added two pictures below. Note the difference on skin reaction between the rest of my face and the cheek area through my nose. The crease in my nose is the part that is extremely irritated. I surmise it may because the product accumulates there and maybe cause an overdose in that specific area. I have stopped putting more on there. I continue to put on the reast of my face, but not that region. Last dose there was Sunday.
Expert:  Dr. S. Attili replied 7 months ago.

Thank you. This is an expected reaction from using 5-FU. PLease read the info in this webpage

Often subclinical areas of sun-damage also start reacting with the cream, even if you have not directly applied the cream on the area. This is expected and actually is a good thing. Please apply lots of moisturising cream (petroleum jelly would do) and if itchy, cortisone cream twice a day for 2-3 days on the affected area. Please stop using the 5-FU cream until the burning settles and then restart the cream. However if you have been applying the cream 5 days a week, I would suggest cutting it down to three days/ week and that should make it more tolerable.

Hope this helps. Do keep me posted & get back if you have any further questions or feel that I have missed out anything. I will be here to provide ongoing advice as necessary. Please do not hesitate to ask. Best wishes.

Customer: replied 7 months ago.
You mention 5 days per week or possibly reducing to 3. I have been applying every day for 2 weeks. Should I have only been doing 5? Is 7 excessive? If I cut to 3 days per week, is the treatment less effective and how long should I use it for at this point? The instructions say 4 weeks. Is that still the case if using only 3 days? I assume I should stop using on the crease in my nose?
Customer: replied 7 months ago.
Thank you by the way. Very helpful
Expert:  Dr. S. Attili replied 7 months ago.

Yes 7 days per week is a bit excessive. I normally suggest 3-5 days per week at the most. It is as effective as daily use, the only difference being that the side effects are more tolerable. If no redness at all, you can use the cream 5 days per week. I would usually continue treatment for 6 weeks. Yes, please stop using it on the crease of the nose. It is unnecessary to apply it there.

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