How to Reverse Skin Aging

About a year ago, I was diagnosed with early/pre-SCC on my forehead, which was surgically removed. At the same time, another lesion was removed that the histology report identified as part seborrheic keratosis and part actinic keratosis.

A few months ago, a new lesion appeared in the same area. My dermatologist says it needs to be removed and has recommended preventive treatment for my whole face with Imiquimod. She also mentioned I could try Imiquimod on this spot (it’s just a few millimeters) before surgery, but due to my “cancer” history, she prefers surgical removal. Surgery is scheduled for next Friday.

What should I do? Go for surgery or try Imiquimod first? Has anyone used Imiquimod before?

I also came across this study which makes Imiquimod also a possible skin anti-aging medicine? What do you think?

019110704.pdf (476.6 KB)

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I would try the ointment first. It will probably leave a big scar if they operate on the same spot. Good luck with that.

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I don’t know about your specific situation, but I’ve used efudex on a spot that reappeared after I had blue light. My spot was AK.

To be proactive for future AK, my derm had me get blue light on my entire face instead of efudex because she said a large majority of the people can’t tough out the entire treatment of efudex. (If you don’t have much to target, it hurts less). I do see that the cream your doc is recommending seems to be better tolerated.

It makes sense that Imiquimod might leave behind nicer skin, because people say the same about efudex, and bluelight.

I would also use the cream first if the result is a smaller target for the surgery. (These creams on a smaller spot are more tolerable than the entire face…I didn’t love it but it was also no big deal).

As LaraPo said, it can scar. It can depend on how cosmetically skilled your surgeon is. My friend had surgery on her forehead done by the derm, and literally drove from that surgery to a plastic surgeon’s surgical center to have the PS stitch her up. She has no scar.

One friend used the cream on little portions of her face at a time to make it more tolerable. With this other cream, perhaps you can use it all over without much trouble.

The blue light (and efudex- and apparently imiquimod, too) is supposed to improve skin appearance. It turns out the blue light did nothing cosmetically for me because I didn’t have anything else to target on my face. It turns out efudex probably wouldn’t have either for the same reason. It sounds like with your multiple past issues, you might have more to tackle and therefore might get some clearer skin afterwards?

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Thanks for the advice. I was worried about scarring too, but this lesion is close to my hairline, and the surgery will be performed by a plastic surgeon, not my dermatologist. My previous scar healed really well—it’s invisible to the naked eye—but this new lesion is very close to that scar tissue. At the time of my last surgery, I was taking rapamycin, which might have helped minimize scarring, as I usually scar quite badly otherwise.

I’m really unsure about what to do. My skin isn’t overly problematic—yes, I have a fair complexion and am more prone to sun damage, and I do have a few rough spots on my nose. However, most of this damage is likely from a severe burn I got early in life that resulted in second-degree burns on my nose and forehead.

I’ve been using tretinoin for at least a decade, and pycnogenol has also helped keep my complexion in good shape. That said, maybe I could benefit from full-face Imiquimod treatment. The tube has been sitting on my bathroom shelf for weeks, but seeing pictures of others during treatment looks pretty intense.

My dermatologist insists that Imiquimod only causes a reaction on skin with AK, SK, precancerous, or cancerous cells, and otherwise, the skin tolerates it well, possibly with just a reddish hue. I want to believe that, but those photos make me nervous.

Unknown

@Beth how was your face after blue light? This was one of my dermatologist proposal as well but I would need to cover it out of pocket as my insurance would cover it only if I have more than 3 AK lesions already removed.

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I"ve had multiple BCCs removed (from a lot of outdoor time as a younger adult). For the AKs, my derm. will burn them off with liquid N2 and/or I will use 5-fluorouracil (an anti-metabolite cream that targets rapidly dividing cells like AKs). It works well.
I would think that with a plastic surgeon doing the surgery, you should be fine, esp up near your hairline. If you have a BCC in a more visible spot (like your nose), they will do Moh’s microsurgery to try and minimize the amount of healthy tissue removed.

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My face was 100% fine after blue light, but that is because I didn’t have anything to go after. My derm sent me to UCSF dermatology to have it done, and normally they have you come for a few sessions, but the guy said I only needed one because he could tell there was nothing on my face that needed more zapping. If I recall, I would have had some scabbing pimple-like things if I had some things brewing under the surface. Not sure how I didn’t after going to school in FL!? The impression I had was that blue light is not for serious cases. You might want to research that more because I really don’t know.

It was out of pocket for me, too, and it was very expensive, so yes, it was a bummer there was not a little beautifying effect afterwards. The good news is I don’t have skin cancer, so there’s that :slight_smile:

And yes, what your doc said about it only affecting the spots on your face if you have something there is exactly what I’ve heard. To put it in perspective, when I used efudex on my forehead, I only used it on a qtip sized spot, but even in that little area, it looked NOTHING like the photo you shared. It hurt but it was just a little spot of puffy and pink irritation. It never scabbed or turned red. The nice thing is if you do put the cream all over your face and there is a lot there, it will start to hurt etc, and then you can just choose to stop if it becomes too much (which means you would still need to find another way to treat it). So, it’s not like you put the cream on once and then you become that girl in the photo… that is if you keep going.

I talked to friends after my derm said most of her big tough guy patients can’t finish the treatment, and the guys said, it’s not bad a the begining, but when you have to put the chemo cream on your already irritated face, it’s life altering painful :slight_smile: I know a few guys who did tough it out but they said it was brutal. Keep in mind, once again, I’m talking about efudex and not the cream your derm is recommending. I knew one guy during his treatment and he had a LOT of things to go after, and therefore, he had baby skin afterwards… and he also said there is no way you can do this!

I’d say just pick a random spot and use it there… having one painful square inch is very different than having a painful face! So, on your forehead, do it on that spot, but maybe make the area bigger than it needs to be. And if that isn’t too terrible, then you know you can handle it on your entire face later… or just bits at a time (that would be my plan!). And yeah, on the skin that doesn’t have anything, it won’t be so bad.

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My sons have both used Imquimod cream on their feet to try and treat warts. It worked great on one son but not the other. There were no side effects of any kind. You can purchase some and try a little on an out of the way spot to see what happens if you are worried. However it is quite expensive. I ordered some from India.

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As I’ve already stated, this thread prompted me to start taking care of my skin. One of the major detrimental factors seems to be photoaging. I’ve heard people suggesting a protection factor even with a cloudy sky, or in New York city in the winter, which made me almost laugh, I thought, some guys are really exaggerated by nature.
However, I’m realizing now that I was thinking the UV radiation only in terms of the UVB wavelength. I totally ignored about the UVA wavelength, which seems to be way creepier since does not burn but according to the recent literature does cause most of the damage in terms of photoaging.

This article is good to rethink the matter, I’m going to study it thoroughly. I’d like to understand the riskiest conditions as far as UVA radiation goes since it’s all so different from UVB irradiance, that I knew pretty well, especially so since my skin is a sensor of UVB rays (does not tolerate them much) but apparently does not sense UVAs.

https://onlinelibrary.wiley.com/doi/full/10.1111/exd.12388

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Even if I don’t leave the house, I wear spf because some UVA is coming through the windows. Even though we have a little sun protection on our glass, we have huge windows, so I’ve wondered how much damage is occurring even when I put off applying it for several hours.

I could see not doing that in a NYC apartment, but even then, I imagine something is coming through the windows, but I don’t know how much. I personally wear spf 50 when I’m walking around NYC, even on a grey January day.

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That would have made me laugh uproariously up to a short time ago. It still seems impossible to my rational mind that the pale light in a grey January day in NYC can be so damaging. But it seems it is, unless the research is wrong. Mysteries of life…
After pasting the below excerpt, I realized that on a grey January day in NYC UVA radiation is still less than in the other seasons, especially so if early morning or late afternoon. This may be useful to adjust the SPF, if leaving to commute in winter it may be lowish, if staying out at midday in winter medium strength, if in summer, especially around midday, top strength.

Solar UV irradiance depends on many geo-orbital and environmental parameters including latitude, time of the year (season), hour of the day, meteorological conditions and the thickness of ozone layer. UVA radiation is less affected by those parameters and varied to a lesser extent than UVB radiation. For example UVA irradiance is less affected by seasons, and decreases to a lesser extent in winter 2. The time of the day plays an important role too. Indeed UVA and UVB radiations both raise from the beginning of the day, peak at noon and decrease at the end of the day but UVA radiation is present for most part of the day as it follows the variation of visible light whereas UVB rays are at the highest between 10 a.m. and 4 p.m., especially around midday. Another interesting characteristic of UVA radiation is that it comes through glass, whereas UVB rays are almost entirely absorbed. Thus, high UVA doses may be received even in indoor conditions while erythemal UVB radiation is filtered out.

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After reading that, I have to return to my long lost diligence of putting on spf before I go to the living room in the morning. (Sigh)

I know it seems crazy, and I was shocked too, but I discovered that if I was on the porch just a little past sunrise while having my coffee, I’d come back in to see a red face! That’s when I started to put spf on my face when I woke up! I then just got lazy and skipped the porch aspect so I didn’t have to bother. (My porch is in a sunny location with elevation)

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Unreliable company. All scientific evidence suggests that the Klotho protein can’t be effectively absorbed through topical application. Their own science with small scale trials of 10 respondents claiming some improvements after months combined with in vitro claims are not reliable. Don’t waste your money.

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In the video “The Only Skincare You Need (No Sponsors)”

, Dr. Abs said that blood tests from his patients show that testosterone propionate 1% cream applied topically has only local effects and not systemic. This is in addition to the results in the paper he discussed - the effects, including hair growth, appeared only in the area where the cream was applied, and not elsewhere on the subject’s body.
The results in the source paper were remarkable.
Anyone know a compounding pharmacy that will make testosterone propionate 1% cream?

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In the video of Dr. Abs (cited in a post in 2024,

), he stated that in the study he discussed, which was conducted some decades ago, hand skin of elderly subjects was treated with testosterone propionate 1% cream. After treatment (may have been for 3 years), hand skin sprang back after being stretched. He stated that this shows that elastin was produced. (I can neither confirm nor deny, just reporting what he said.)

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I would believe it if a biopsies were done and confirmed histologically. Otherwise, too much margin for subjective influence.

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That gives me an idea for the SUPER CREAM - WRINKLE ANNIHILATOR 3000
Ingredients:
Testosterone propionate 1% cream
Estriol 0.3%
Rapamycin 0.01%
Vitamin C 1%
Tretinoin 0.05%
Niacinamide 4%
Hyaluronic Acid 0.5%

That would restore my face back to the Acne ridden teenager :rofl:

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I’ve just completed a treatment for keratosis using a combination Efudix and prescription Vit D cream.

Applied the combo cream to my face, neck and décolletage for 5 days, twice daily. Day 7 -10 showed an intense response (very red). By day 15, it was pretty much well healed.

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The source paper says “Biopsy samples obtained since the onset of the work amount to more than 1500 individual specimens.”
The source paper (written in 1966) is downloadable for free here:

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Is 2 mm shallow enough to avoid the facial arteries?

2 mm may cause very light bleeding from capillaries.

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