No thanks to my dermatologist, for the last couple years I have been treating my DSAP with a combination of two pharmaceutical medications, Tazarotene and Effudux.
I wouldn’t have even know about this treatment if someone else with DSAP hadn’t told me. So, I went to my dermatologist who knew very little about DSAP and asked him for the prescription. Since he didn’t know of any other options, he happily gave it to me. I have tried other lotions and potions with no results (I’ll go over those in another post) and while this creamy cocktail certainly doesn’t cure the disease, it is the only thing I’ve done that has made any impact at all.
The treatment takes anywhere from 14-28 days and is best done in the winter (after New Year’s) so you have lots of time for your lesions to heal before bathing suit season starts. I don’t suggest doing it before the holidays in case you want to wear something a little more revealing on New Year’s Eve.
Also, I got the best results on my arms and thighs. I did not get very good results on the backs of my calves. Also in the last few years I have started to get them on my hands, which really sucks. This treatment seems to make them smoother, but doesn’t eliminate them unfortunately. But, each person has different results.
DISCLAIMER: Since this is ‘experimental’ and not an official cure, everyone will have different results. I am sharing my results and experience.
Here is what my arm looks like on about day 10. It looks worse than it feels.
Here is a photo after the treatment, when it was healing up, looks pretty nasty, but the DSAP spots were really bad in that one spot, several grouped together.
And voila, here is what the same arm looks like 6 months later with no concealers on (it has looked this good for at least 3 months)
In a nutshell here’s how it works.
1. First, decide what area of your body you want to tackle first. I suggest you do one area at a time. I tried doing my arms and legs last year and almost went mad! At about day 10 or so the affected areas become hot and itchy. Doing one limb at a time is much more sane. Your family will thank you!
2. For 14 days you apply the Tazorac (Tazorac is the brand name for tazarotene) to areas that have lesions. If you don’t have very many lesions, you can use it as a spot treatment onto the specific lesions. If you’re like me and have them all over, I just apply it all over my arms or legs.
Tazarotene is typically used to help skin renew itself more quickly. It’s typically used to treat acne, wrinkles and plaque psoriasis.
3. Starting around day 10 ish you will start to see a change in your spots. They may become bright red, peel-y and some of them will scab over. At first i thought nothing was happening because it took so long to see a change but it does, don’t you worry! Most of my spots just turn red while just a few scab. The temptation, which I usually succumb to, is to scratch the scabs. I’m sure this isn’t a good idea!
4. Then starting at day 15 you can start applying the Fluorouracil (brand name is Effudux). I personally don’t see any further change after using this cream but that’s probably because it’s working to maintain the work the Taz has done. In the simplest terms fluorouracil is used to treat skin conditions where there is a rapid multiplication of cells (Like skin cancer). This drug inhibits cell growth and with continued treatment, the remaining cells may also die. In other words, the Taz makes the cells look strange enough for the Fluoroucacil to attack it.
5. Some people recommend using the two drugs simultaneously to get the same results. You would use the Taz in the morning and the Fluorourail in the evening. I haven’t tried this method but I will use it next time. I like the idea of cutting the treatment time by half.
Please leave your experience in the comment section if you have tried this treatment on your disseminated superficial actinic porokeratosis
Good luck!
I have done the taz/eff routine both ways- used them at the same time for 14 days and then tried one for 14 days and the other for 14 days. The results were the same so now I do it simultaneously as it reduces the time to 14 days
I will definitely try the 14 day method next time as well. Thanks for your comment Alex.
I have done the Taz/eff routine successfully on my calves of both legs. I did it the old way with Taz for 14 days and then Eff for 14 days. I had great success and treated approximately 50 on the left leg and over 60 on the right leg. On the downside it is like having lots of mosquito bites and was very uncomfortable for the second 14 days (antihistamine tablets helped). The other downside was the time it took for the “scars” to heal and disappear. For me it was almost 2 years until I had normal looking skin. I do have a few new DSAP spots on my calves but they are small and not noticeable so my legs actually look “normal” now!
Jo (UK)
Hi Jo.
Just wondering if you treated your spots individually or did you rub the cream all over. Well done or your legs looking normal. Thats fantastic!
Angie
Hi Angie,
just chiming in here, I’ve done the taz/eff routine 4-5 times now and I rub the cream all over. I have too many spots to dab each one individually. The skin that doesn’t have spots is unaffected while the spots turn red. I’m actually in the middle of it right now. Have you ever done it? If not I’ll post some pics for you to see.
Please can you tell me the strength of the taz – 0.5 or 1 percent ?
Jo Please can you tell me if this treatment is more effective on the calves of your legs than the home freezing wart kits ? My dermatologist says she won’t freeze on the calves of my legs due to the danger of ulceration – what is your view on this ? I know you say that your legs took 2 years before they looked normal again, but how long did it take after you had finished the taz/eff treatment for the scars to start to fade ?? Also, have you done the taz/eff on your arms ??
When I did my arms 2 years ago. I rub the cream all over my lower arms. My whole lower arms looked like I had been burned. It was very painful. But it worked. Going to do my legs and hands this winter.
Hi LIsa,
i had some bad spots on my arms and since they were so close together, the taz/eff routine also made my arms look like I was burned. But i used Manuka Oil and so it healed pretty quickly, in less than a week it was back it normal skin color! https://www.dsapinstitute.org/manuka-oil-reduces-redness-dsap-lesions/
Hi
I was just diagnosed with DSAP 2 months ago even though I have had “spots” since my late 20s (44 yrs old now). I am doing the Taz/Carac simultaneous treatment right now – on day 9. I guess that I am being aggressive (or torturous) because I am doing my arms and legs at the same time. So far my spots are getting really red and a little peely so I have hope that this treatment is working. My dermatologist wants me to continue this treatment for at least 6 weeks but if I start getting majorly uncomfortable she wants me to stop for a few days but start back up again. She told me that it takes a long time to really know if the treatment is working. Not sure what she expects to see after 6 weeks. Has anyone ever been told to do this treatment for that long? Also how do you know if this treatment works and how long after you stop treatment do you know that it worked? If it worked do the rings around my spots become smooth (or disappear) even though the “spots” may be discolored for a period of time?
Hi Jenn,
that does seem like a long time. Most people do the taz for 14 days the effudux or flour for 14 days. Although this last time i did them both at the same time for 14 days and that seemed to work better. 6 weeks does seem like a long time. I posted a picture in an above post– you can see how red and raw it looked in a couple of spots where i had lots of lesions clustered together. I can’t imagine six weeks. I did both my arms and legs together ONE TIME and it was miserable! From a time perspective it makes sense but it was insanity!
You know the treatment is working if the spots peel, flake or scab over. Not all of them do. My skin is now much smoother than it was, no rings around them, but the spots are still red, but it’s been less than a month since i stopped the treatment. I will put together a little photo collage so you can see progress.
Thank you so much for the reply. I would love to see the collage just so I can judge if the treatment is working for me. For the spots that don’t peel, flake or scab over, I assume that they still remain and you would have to take a different route to clear those???
Hello, I am so thankful to find these postings. I am 43 and have had dsap for 15 years on my arms and legs. I feel like it makes me look like a freak. I have tried Efudex (alone) with no help, Aldara, freezing (which helps but I have to many), chemical peels, and now have been doing PDT with Levulan. How is this combo better do you think? The PDT works some with at least getting smooth and removing some.
I have used maybelline coverstick concealer and sunless tanning for years. It help but sometimes gets stuck in the rings,
Any help or suggestions would be appreciated. This controls my life and is so depressing
Shelley
Hi Shelley,
you asked “how is this combo better” I am assuming you mean the combo of both the tazorac and /efudux? (Efudux is a cream that contains the active ingredient Fluorouracil)
When I first tried flourouracil years ago, my doctor gave it to me to use by itself and it did ABSOLUTELY nothing. So I didn’t bother with it. It wasn’t until years later that I tried the tazorac first. It is the tazorac that basically nukes the lesions so they can heal.
Since you likely don’t have cancer, the flourouracil doesn’t see the skin cells as cancerous and therefore doesn’t have an effect. However, when we “nuke” them first with Tazorac, we trick the flourouracil to thinking there is something weird going on with our cells so it can do it’s job of incorporating into the cells’ genetic material, DNA and RNA. Both DNA and RNA are needed for cells to grow, repair themselves and multiply. Fluorouracil causes problems with the production of DNA and RNA in the “cancerous” cells and this causes them to grow in an unbalanced way, resulting in the death of the cells.
So, using the Tazorac concurrently with the Flourouracil is mandatory if you want to get any results at all.
Has anyone tried coconut oil to ease the condition? It seems to reduce the redness when ued as a moisterisor
Thanks so much for your quick response. Efudex didn’t do anything for me either so I will have to try the tazorac with it. Has anyone tried PDT with success or does anyone feel the Efudex/Taz way works.
I use coconut oil under my eyes and it works great. Haven’t used it yet on arms but will start trying it. I also ordered the Manuka Oil so hopefully that will ease some of the redness…
Praying for a cure someday…..
I read about this treatment on this website. The dermatologist I saw asked me to try Taz for 4 weeks on one leg and Efudex for 4 weeks on the other then swap over. After 4 weeks both legs were very red and blistered and so sore that I could hardly put my foot to the ground. There was no way I could swap creams. When healed the Taz leg had very good results, the Efudex leg was only a little better. I then tried the backs of my legs for a month using only Taz. Although improved I still have some lesions so I thought I would try the 2 week Tax, 2 week Efudex. I am now on day three of the 3rd week. Having only used Efudex for 3 days, again I am feeling such a lot of pain that I can hardly put my foot to the ground. As I hate this condition so much I will persevere as long as possible. Has this happened to anyone else? I noticed that someone had tried 2 creams at a time and someone else responded by saying I will try that next time. Do you have to repeat this treatment, and if so how often.
Thank you for all of the reasearch that you have done and all of the info you have shared. I am on day 15 of Tazorac am/Effudex pm. My spots are red, itchy and some are scabbing. How do you know when to stop using the combo so that it can heal?
Does any one have a good concealer that does not make your skin look worse? I tried the Dermablend, but I hate it.
Rose L.
I am on day 5 of EFF after 14 days of Taz on both arms and the Taz did most of the work so far. I’m on day 3 of Taz on my legs so maybe I will go to am/pm routine there; may be a better way to compare? I will get the Manuka oil for sure. Thanks
I showed my dermatologist this site when i adked for taz/eff prescription. He was surprised such a group exists. This is the most hope i have ever had. I am on day 14 using the combo. The redness and peeling has just started… whoohoo! No time frame was given, so its a bit of a guess. Im thinking anout 28 days. I live in the tropics and wet season has just started. I am so keen and not wanting to wait for winter.
II was diagnosed with dsap app 3 yrs ago I have tried everything nothing has worked, it covers all my legs and lower arms is very itchy and is almost unbearable I cannot go out and three times daily I need to ice my legs for comfort. I am desperate to find something that will ease my discomfort and allow me to spend some quality time with family example just yesterday had to cancel my trip with my family to see our daughter in Boston ,I live in Florida and I am a 69 yr male
I have been to dermatologist over the years as well and most didn’t know what my skin disorder was. I was so thrilled when one did know what it was . DSAP has kept me from feeling comfortable to expose my skin so I resort to wearing long sleeves. He prescribed the efudex morning and night for 2 months as well but only on the spots. I had so many spots and the meds did nothing after two weeks I didn’t think it was working and he said I needed to keep doing it. I am so happy to hear about the success you have had with the tazarak. I know have hope that I will one day be able to expose my arms again without embarrasment. It is getting warm around my area and it is hard to stayed covered in the warmer months. I want to try the tazorak and the Efudex together. Is it one in the morning and the other at night? I am the happiest person right now after having this condition for 18 years only not as bad as now. Thank you for this site!!!
Hi, I would like to share with everyone that when I was 43 years old, I discovered a few spots on my arms and a few on my left lower leg. I went to a Dermatologist and he treated me from that time until now. I have had just about every treatment possible for this condition. I do believe that all these various treatments have caused more spots to come out. Now I’m 53 years old and I have an abundance of spots on both legs–the left leg worse then right–spots starting on both my upper legs. Both of my arms from forearm to upper arms are full of spots. I am in the process of trying this combo treatment. This is day 10 with the Taz. and most of my spots are scabbing over and some peeling. I’m so thrilled to see a change in these spots. The Dermatologist had stated, “my condition of DSAP was one of the worse he has seen”. So after 10 years of treatment–almost giving of hope–I’m excited about this and hoping it works for me. I’m to the point I don’t want to wear capris because my spots are so bad on my lower legs. I do have one question: How many times can I do this combo and do I need to wait a period in between for repeating treatment? Thank you so much for giving me hope again. I can not wait to see the results after the second 14 days–Fluorouracil.
I was diagnosed with DSAP when I was 43 years old, now I am 53. I’ve had various treatments and instead of my spots getting better, they have multiplied 10 fold. I have them on both arms and both lower legs(left worse then right and now they are appearing on my upper legs). I’m on day 10 of this treatment plan(Taz.) and can see changes with my spots. They are scabbed over, many lighter in color, several peeling. I’m treating both of my lower legs first to see the end results before tackling both arms. My Dermatologist had stated, my case of DSAP, is the worse he has seen. I was to a point of stopping treatment all together and just living with these awful, ugly spots, until I came upon this article. You have giving me some hope again. My spots are so bad and I have so many, that I’m to the point of not wanting to wear capris outside my home. I do have a question: How often can you do this combo treatment and is there a time period between treatments that you need to give your skin a rest? Thank you for sharing your experience.
Hi Sherri. I would be interested to see / hear whether this treatment is a success for you and how long your skin takes to heal after the treatment . Did you do arms and legs at once ?
Thanks for sharing . Pictures of ‘after ‘ the treatment wold be useful ! Thanks and good luck with getting rid of this horrible disease . I live in the uk and my dermatologist won’t prescribe taz/eff but if I can show success stories she might be more open to it .
Carolyn
Carolyn, I used the Taz. for 14 days and the Efudex for approx. 5 days, I wanted to go the full 14 days but my legs(which I only treated both my lower legs) where getting extremely red and irritated to where it was very uncomfortable(almost painful) to have my pants rubbing against them while walking. I’m on my feet all day at work, my legs(especially my left lower leg and ankle would swell bad). So I had decided to let my leg heal for a couple months(which it has only been a couple weeks since I stopped treatment) and my legs(since I had to treat my entire lower legs with both creams–too many spots),are patchy, reddish brown color–almost like a burn(plus my spots are red, some turning a lighter color(not as red as some). I believe that it will take a good couple months for me to see the true results of this treatment. If at that time I feel I need to start the treatment over, I will try the Taz. in morning on those spots that haven’t improved much and the Efudex in the evening, instead of the Taz. the first 14 days and the Efudex the second 14 days. In the information stated above, apparently it doesn’t matter which way you treat your spots. I will let you know in a couple months if I’ve seen improvement with this treatment option.
What is there’s single not prescribing them? Are there some known side effects to be wary of?
Oh drats!!!! Typo! * Waht is their reason??
I don’t know really why they won’t prescribe them but I’m going to show them this site next time and the fact that other people have had some success with this method.
Carolyn, I had tried this combination and after years of dealing with the ugly red spots on my legs(especially my left), they have lightened up. They are more of a light brown, which makes it easier, for me, to deal with. I hope this helped.
Hi SherrI Good luck with it and I hope it heals well and you are pleased with the result . Do you have before and after photos ? I am hoping to try this in the autumn but just trying to work out whether to do it the old way of 14 days then 14 days or both together . Do you think you will get any scarring from this treatment or is the new skin growing through ? I know that obviously we will always continue to get new spots as that’s the nature of the disease but if we successfully eliminate some of the old ones that would be so great ! I am really hoping you get some success . Keep us posted ! Carolyn
Carolyn, I tried the combination of these topical meds. and it helped a lot. About 98% of the red spots are now lighter brown, I only have a couple spots that I could treat again(I’m thinking they are new ones).
Good luck!
Sherri I am so pleased for you and hope that the spots stay away ! Can you just tell me how long from the start of the treatment until it had fully healed ? Carolyn
I am on my 25 day stopped flouracil at 24 days and I am in the scabbing stage. I have 2 questions if anyone could answer. One of my spots on my cheek is not scabbing over and is still fresh looking and doesn’t seem to be scabbing like the other spots. I am concerned that cream is not working and could be a squamous cell rather than basal cell. I have a daughter getting married in a month and am concerned if 4 weeks is enough to heal. Also think I should stop treatment on spot which is not healing and try the Taz after the wedding on that one spot. Please any similar experience or advice would be so appreciated! This website is the best I have found!
Hi all, My name is Cindy. I have just received a diagnosis of DSAP after 6 years of these horrible lesions. My dermatologist suggested Efudex, but did not mention Tazorac. Is Efudex ever used without Tazorac? Thanks, Cindy
I was diagnosed 2 months ago by a photo my NP sent to the derm dept. They suggested a steroid cream for a week, which did nothing. I saw the derm about a month ago and he looked and said since the steroid did not work it definitely was DSAP. He ordered just efudex for 21 days and see him again. I am reading a lot about this alone not working but causing a lot of irritation. I have recently started an aquatic exercise program, which I really need for other issues. Derm says I can still do treatment and aquatic together.
1- I don’t feel that he really knows about treating this, I don’t want to go thru 3 weeks of treatment that doesn’t work
2- I am very concerned about the chlorine water and the red legs
3- How would I find a dr who knows DSAP in central Ohio?
4- So far I only have them on my lower (ankle) legs.
Knowing how toxic effudex is, I would not under any circumstance suggest you expose yourself to chlorine while being treated. That’s only my suggestion not a dr.
My dr gave me just the effudex cream. What does the combination do. And do any of you have small children. I’m scared to use the effudex being around them. My youngest is 3 and has Down syndrome. He needs mommy a lot. Don’t want to expose him. 🙁 And I don’t want to live with this ugly condition forever.
Using effudux alone will not do anything. I remember the first time i was diagnosed and my doctor did the same thing and nothing happened. It’s the Tazorac that is make the spots blow up and scab over.
I was diagnosed with DSAP. My doctor prescribed Tolak. I tried Tolak 2 years ago and it helped very little, plus I went through 3 tubes of it for 1 treatment period. Is Taz & Eff still prescribed and in use? How did the TCH Peel work?