Actinic Keratosis – Part I

Actinic keratosis  (AK)  is a precancerous skin growth that happens on sun-damaged areas of the skin.

Gene is a farmer and has basically spent his life outdoors working and playing softball. He always wears a hat and most of his farm work is done from the cab of his tractor. But that has not protected him enough from the sun’s rays and through the years has caused red blotching on the side of his face (see the picture below).  It had gotten worse and he had developed some slightly crusty areas. Finally the family doctor recommended that he see a dermatologist.


  Years of sunlight (UV) exposure damages skin and causes it to grow abnormally. Patches on skin pale or redden causing a mottled appearance. Then rough, scaly, or crusted areas develop. These areas are usually pink, but can be gray. Sometimes a small horn of fingernail-like material grows.   This is often due occupational sun exposure or sun-bathing.

The lesions are benign (noncancerous) but they can occasionally convert to squamous cell skin cancer.  If this happens it must be surgically removed. Patients that  have many lesions have a higher chance of skin cancer.

AK may remain unchanged, spontaneously resolve, or progress to skin cancer. The fate of any one AK is impossible to predict.    People with sun-damaged skin should see a doctor at regular intervals.

This information was taken from

Fortunately for Gene, they are not seeing any cancer but they decided he needed to do preventive treatment to his face with Fluorouracil Cream which is a chemo drug.  The dermatologist also “froze” some spots on his ears and face. We knew several people who have taken this treatment and heard their stories about how “bad” their faces looked. Now he has his own story.

Gene is allowing me to photograph and write about his experience so that it can help or educate others.  He has found other people’s personal blogs and utube posts to be very helpful. The doctors give you medical expertise but people tell you personal experiences.

Two weeks ago he started the Fluorouracil Cream treatment. Twice a day he had to put the cream on his face and ears.  This was a bigger ordeal than it first sounds.  He would take a shower and shave. Then he had to wait half an hour before putting the cream on. He feels like it is taking him a long time to “primp”, especially in the mornings. It took about a week before the skin reaction started showing.  Each day his face has become more blotchy and red.

Day 11: I decided I should take a picture….



His face is starting to hurt.  The skin feels tight and tingly. He said it feels like there are needles pushing into his skin.  He can not stand for the pillow to touch his face. He didn’t go to church on Sunday as it looks bad enough you don’t want to be in a group of people-you try to avoid people!

Day 14: Two weeks and each day it is getting worse and worse.  It is really bothering him and hurting. The corners of his mouth hurt and feel sore. The skin feels tight and hot.  He is having headaches and trouble sleeping.  He had a two-week appointment with the dermatologist today and he was anxious to go.  She gave him some options going forward but decided to stop the cream treatment and see how it looks in six months when she will reevaluate. He may have to do it again or take the “blue light” treatment. Going forward he is suppose to wear sunblock lotion every day-even cloudy days as there are still ultraviolet rays coming through the clouds and wear a wide brim hat.  He asked her on a scale of 1-10 how bad he looked.  She said a 6.  She showed him a picture of a guy who looked a lot worse.



Day 15:   Gene is plain miserable. He felt terrible last night and had trouble sleeping.  He finally got up and dug around in the medicine cabinet during the night and found some pain pills. He also put some Neosporin on which gave him some relief.  Now in addition to being deep red he looks like a greased pig!  His face hurts.  The skin is tight,  slightly swollen, deep, fiery red and painful.  He says he looks like he has been lost on the ocean on a raft for two weeks with no shade protection!  I went to the pharmacy today and got him some A & D first aid ointment and Caldyphen Clear Lotion for pain relief.  The Caldyphen Lotion did not help as it set his face on fire.




These pictures soften how bad it really looks in “real life”!  Needless to say he doesn’t like to be out in public any more than he has too!

Two of the men from church came by today to see him. They could sympathize as they have had to do the same treatment.  Both were rather shocked at how bad he looked. They thought they had looked bad but both said they were not this bad!!  At this point you cling to the promise that there is hope at the end of this ordeal. He will have a new face and everyone says his face will be good-looking again with nice skin-better than what he had.  He is blessed. He does not have cancer and he does not have to have areas surgically repaired.

Actinic Keratosis-Part II  (Day 16-18) and Part III (Day 21-24)




  1. Windows Live Hotmail Team Said:

    Dear Pat and Gene, My brother Danny had the same treatment and he, too, looked like he had been in a bad fire and it took a while for it to go away but when it did he had “baby” skin. We will keep you in our prayers, Gene, and trust Him for your care and comfort. He is able and wants you well. So sorry you have to go through this difficult time. Love and prayers, Dwight and Linda Date: Sat, 8 Mar 2014 01:50:42 +0000 To:

  2. Bud Skillman Said:

    Still my buddy Gene. Speedy recovery

  3. Ruth Hochstetler Said:

    I have used the same treatment for my sun damaged skin. After having precancerous spots removed annually for many years, we decided to go with the same cream treatment that Gene used. It was miserable, but I will admit that it was not as bad as Genes. It healed nicely. I changed doctors, (so that I wouldn’t have to drive the almost 2 hours to Richmond), and when I had my annual visit several months ago, I took the cream along and we discussed going through the treatment again. He recommended doing it again, which I have done, but I had very little reaction this time. I hope Gene will soon be healed, and will be feeling fine again.

  4. Donna Wyatt Said:

    Looks very painful! So sorry for you and you are in my prayers.

  5. so awful to know Gene has this but Gene is going to be ok Pat ,causeGod is good,I will pray for you and Gene,I know it was hard to see this but it helps cause I went thru a ordel so painful with my hands like that three years,used gloves and everything to soothe my skin,I couldhave cryed.!it was terriable,you know Gene i s going to be ok.I am so thankful to know you all thru these blogs.God will watch overGene this really i sa keeper for folks to see praise your Gene.thanks Joann

  6. Pete Sisti Said:

    Gene, after seeing you today, gotta think you looked better than these photos – you’re obviously on the mend! And it was good to see (or hear, I guess) you haven’t lost any of your convictions during this process – still as feisty as ever 🙂 Here’s to a speedy recovery, bud

  7. […] read… Actinic Keratosis – Part 1  (Days 1-15 of […]

  8. […] read….. Actinic Keratosis Part I (Days 1-15) and Part II. (Days […]

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