It turned out I had another lesson to learn when it comes to removing these nasty lesions. Over the pass two (2) years there were times I thought the AKs were all removed and I was finally finished using the fluorouracil cream but there were several times I was wrong!

You may not know the difference between smile and laugh lines. Smile lines point down and go from the nose to the corners of the month, laugh lines point up and start on one cheek and go down under the chin and up the side of the other cheek. I had several problems of cracking skin in these places along with the bridge of my nose and any other place that wrinkle or fold when I make a SMILE or LAUGH!

The following series of three (3) pictures were taken within 15 minutes of each other. In the last stages of lesion removal I used aloe vera gel to dissolve the dead lesion and obtain lesion release without damaging the surrounding healthy skin.

The first picture was taken two (2) hours after the fluorouracil cream was applied, the dead lesion becomes white and crusty and looks like a scab. The second picture was taken after I rubbed aloe vera gel on the area, the dead lesion dissolves into the clear aloe vera gel and the clear aloe vera gel turns into a white opaque aloe gel. The third picture was taken after I wiped the aloe gel, fluorouracil cream and dead lesion mixture off with a white tissue.

As you can see the lesion came off very easily and left a smooth surface on the fresh skin beneath after releasing. I removed AK lesions several different ways during the past two (2) years and I feel this was the best way to remove the actual lesion.

Lesions on smile and laugh lines are different, they are what I call SCARED LESIONS! When we make a smile or other facial expression, these scared lesions are created on the smile lines and laugh lines. After years of bending the skin along with excess sun exposure, these lesions get thicker and harder to remove than normal lesions.

Right side smile line lesion finally comes out

This is how scared lesions come off; after about a week using the fluorouracil cream, the lesion starts to come to the surface. The skin cells of a lesion are harder than normal skin cells. After the lesion comes to the surface, the surface becomes harder and brittle in a way.

The areas of the face that bend start to crack, causing the cracked skin to bleed. But this is not your normal bleeding, it only bleeds from the base of crack in the hardened lesion. I was never alarmed when the skin cracked because it was only the lesion cracking, not the fresh skin beneath the lesion. I realized the deeper the crack, the deeper the lesion and when the lesion was gone, the crack would be gone!

It is very important NOT to apply the fluorouracil cream to any skin that is bleeding! You must first let the area heal by washing the skin and applying aloe vera gel and Neosporin antibiotic ointment continually, until the crack heals and the bleeding stops.

It only takes about 24 hours for the base of the crack to heal and seal enough to allow application of the next fluorouracil cream dosage. I knew I could start applying the fluorouracil cream again if after I washed my face, I could pat dry the area with white tissue and NO BLOOD absorbed onto the tissue.