I just discovered something important for anyone dealing with actinic keratosis especially if like me the lockdown has left you to deal with this scary condition without medical supervision or help. So, here’s my whole story. First, it might be important that when I was 13 I had a rare allergic reaction to something ( they never figured out what caused it but the reaction was called Stevens-Johnson syndrome and if you have had it once there’s a higher chance you will again. Further, a history of SJS might be a key in making the interaction I am going to describe work because diclofenic is notorious for causing SJS. Anyway,, what I experienced as a teen was on the very mild end of SJS and a 7 day high dose prednisone taper saw me home from the hospital very quickly for SJS.
Fast forward from there 15 or so years. I got a few very tiny, very itchy spots on my skin that were nearly impossible to see visually but felt like sand paper to touch. Scratching the top off of them would temporarily stop the burning from hell itching but I found that instead of healing like a normal cut, the tops would just grow back and the itching would restart in earnest. I eventually went to the dermatologist who told me that the name for the spots is actinic keratosis . She prescribed diclofenic gel and in light of my history of SJS, prednisone to keep on hand “ just in case “. If anything resembling SJS occurred or even a mild rash I was to Immediately discontinued the gel and start prednisone and seek emergency care.
The gel worked well with few side effects.
It’s 8 years later and the AKs are back in much larger numbers. I tried to get a referral to a dermatologist appointment but with the lockdown and being exclusively on state insurance, nothing has come of my repeated requests. They say that they are working on it. Yeah at the speed they are going I could have stage 4 cancer before they do anything with the referral request. My dad’s a pharmacist in England and he told me that diclofenic gel is available over the counter for arthritis there and might be in California as well. So, I did some research and low and behold as of last year, diclofenic 1% is OTC. As a prepper, I now keep prednisone around most of the time anyway so I thought trying this lower dose version could not hurt much. I didn’t think I could lose anything by trying it.
At first, it seemed to work well but then smaller AKs started popping up as the big ones disappeared and these pinhole AKs seemed resistant to the gel. However, today by accident I discovered that applying diclofenic gel and then 3% hydrogen peroxide ( I went to clean on of the AK after my bandaid came off in the sand table... babysitting and playing with a kid).
the reaction seemed like that reaction that teachers show in 3rd grade for making volcanoes.... vinegar and baking sodai if memory services. It bubbled and burned like hell and as I went to wipe it off the whole AK came off leaving a completely flat AK-free hole. The gel worked before but not in one application. Ir took around a month for the 5 on my left arm to slowly peel off.
It should be noted that all my AKS are already slightly open because the itching drives me crazy and I scratch the tops off the best I can sometimes even in my sleep. So I don’t know if the reaction requires the catalyst that normally makes hydrogen peroxide bubble on an open sore or if it would work on closed AKS. However, I tried it on 3 more AKS with similar effects. It should be noted that afterwards I had the beginning of a pink hot rash on my legs. So I took a shower and washed off the gel and took 30 mgs of prednisone. I plan to do this on one or 2 of the most annoying of the AKS a week while taking prednisone and vitamin K ( to prevent bleeding from mixing an NSAID with prednisone until the AKs are gone or my referral comes through so I can request a safer treatment option.
The best I can figure is that my first experience with diclofenic didn’t trigger SJS because I was using it on one very small area of one arm. This time be contrast the AKS are all over and I didn’t think to take it one patch at a time. Even if all the AKS go away, I still plan to get in to a dermatologist ASAP to be checked out because cancer or pre-cancer isn’t something to mess around with. It’s only the California lockdown plus the speed at which Medi-cal does nothing that forced me to medical maverick this. Just thought I would post something about this experience in case anyone else is having similar issues
