‘Why are you swearing?’: After decades in the sun, my Anglo skin faces payback time

As usual, my dermatologist hums tunelessly as he works. He turns my arms … hiimm, hoomm, heemm … looking for nasties hiding on the underside. He leans in to check out a flaky spot on a calf … heemdee, hoomm, hiimm … zaps it with liquid nitrogen, then freezes several more on a shin and a couple on the other calf before shifting focus to my face. Hmmm, hoomm, deehiimm … He blasts the lobe of an ear, followed by a sustained attack on something horribly sensitive in a fold of the nose.

The treatment is painful, ugly and debilitating … it’s like a technicolour billboard promoting your own serial stupidity.Credit: Getty Images

The secondary pain then sweeps in– a wave of stinging protests from everywhere he’s been, led by a deep, eye-watering burn from the outraged nose. Doodee, dumdum, dee …

“What about my forehead?” I say irritably.

The humming stops.

The sun-damaged area below my hairline has been periodically inflamed and scaly for some time, the skin so thin and worn it feels like ancient parchment. In the past, the humming dermatologist used to touch down all over my brow like a bee in a flower garden. Then, a couple of biannual visits ago, he stopped going there. Why?

“I think, for that area,” the doctor says gravely, “it might be Efudix time.”

Mishearing, I laugh at his audacity. “So I’m f…ed?”

“No, no: Ef-u-dix. It’s a topical ointment [chemotherapy] drug treatment that takes some weeks. Temporarily, the side effects can be quite painful and unsightly. But it usually works.”

Two weeks later. The mirror doesn’t lie: I have turned into The Singing Detective. (Dennis Potter’s classic 1986 TV series was about a writer disfigured by acute psoriasis, a skin and joint autoimmune disease that leaves him looking like a freshly tenderised sirloin.) After a fortnight of applying the prescribed cream to my forehead twice daily, the whole area is a scarlet, blotchy, itchy, burning mess – like a “baboon’s arse” in the words of another sun-damage victim who recorded her Efudix experience online.

Every night, the weepy, precancerous lesions being “burned” out of my skin stain the pillow; each day, when we walk the dog, I wear a loose cap pulled low to block sunlight and hide my appearance. If I sweat under the cap the stinging is acute, and I have to stop at a tap and wash the area in case traces of the toxic cream leach into my eyes. But the worst moments come at dawn when the discomfort drives me from bed and I confront the ever-worsening burn zone in the bathroom mirror. “Why are you swearing?” mumbles my partner from the bedroom. I shut the door. It’ll be over soon, I remind myself, just close your eyes and think of Noosa.

The endless bummer: in 1968, we roll down the hill at Noosa Heads for the first time in our old Ford Zephyr. The waves are perfect and we surf all day as the sun arcs across a cloudless sky. Tomorrow, like my mates, I will be semi-crippled by acute sunburn. But today all I feel is a warm, invigorating, healthful glow. At 17, I’m lean, fit and completely innocent of the fact that my largest organ – almost two square metres of once-pale, Anglo-Saxon skin – is already accumulating the UV-induced free radicals that can lead to molecular damage and cancerous growths.

Even in later years, when the notion of “healthy” tans has been scientifically debunked and UV blocking creams gain wide acceptance, I remain a high-risk skin abuser: brown as a Bunnings’ snag from year-round UV exposure with minimal use of those annoyingly sticky, sand-gathering blockout lotions.

The basal and squamous cell skin cancers begin appearing during my mid-30s. Over the next 25 years I have scores of them cut, curetted and burnt from almost every part of my body. The process itself becomes as familiar as the ritualistic humming of my veteran dermatologist, and the shared expression of stoic regret on the weather-beaten faces in his waiting room.

So far, unlike many other Australians, I’ve been spared the most dangerous skin cancer, melanoma, whose origins (although associated with sun damage) remain unknown. Yet, for some reason, reaching the “Efudix stage” – as it’s characterised by users – troubles me more than all the cutting, scraping and burning that came before. It isn’t life-threatening, and its active ingredient – fluorouracil – works wonders by eliminating precancerous and cancerous cells with little long-term effect on normal cells.

But the treatment, drawn out over six to eight weeks, is painful, ugly and psychologically debilitating. Not just because it makes you look like a monkey’s arse, but because – in revealing the full extent of the cumulative damage hidden within the skin’s layers – it’s like a technicolour billboard promoting your own serial stupidity.

As per the instructions, I stop applying the cream after three weeks. Now, a week into the “healing” phase, the darker, sun-damaged cells revealed within the skin are peeling off in white, curly flakes.

Undamaged areas have already lost their angry hue, and the stinging has eased, but it’ll be another month or so before healing is complete. After that, depending on the dictates of the humming dermatologist, it’s possible that me and f---ing Efudix may have to burrow yet again into my long and reckless association with free radicals.

To read more from Good Weekend magazine, visit our page at The Sydney Morning Herald, The Age and Brisbane Times.

The best of Good Weekend delivered to your inbox every Saturday morning. Sign up here.