An Intense Facial Treatment

Hi friend,

Why are we exhausted? Well, for one, we’re not sleeping that well. (There was a whole book about this released not too long ago, matter of fact.) But maybe we’re also sapped by all the things we need to stay on top of these days.

Consider an issue like microplastics. Every article we read on the topic includes tips about how we can avoid consuming them. Or extreme weather events, and how we should prepare for them. These pieces are well-intentioned, but the takeaway is one of extreme individualism, even in the face of enormous global crises. Should our health and safety be directly tied to our own vigilance, awareness, and research?

What we are experiencing is a crisis of expertise, which — as philosopher Dan Williams points out — seeks to widely reject anyone with deep knowledge of, or credentials on, a certain topic, such as scientists, doctors, college professors, and journalists. “The populist rejection of expertise is not merely an intellectual disagreement over truth or evidence, even if it is typically presented that way,” he writes. “It is, in part, a proud refusal to accept epistemic charity from those who present themselves as social superiors.”

Williams argues that, “Gut instincts, intuition, and ‘common sense’ are fundamentally unreliable ways of producing knowledge…the valorisation of such methods means returning to a pre-scientific, medieval worldview dominated by baseless conspiracy theories, snake oil medicine, economic illiteracy, and know-nothing punditry.”

What he doesn’t say, but we feel (maybe this is just our gut instinct) is that the fewer experts we can rely upon, the more we are expected to fill the void left by them. And who has time, or energy, for that?

This week, in Gloria: What it’s actually like treating your face with topical chemo (ouch), plus a few recommendations for your weekend.

Bye,
Your friends at Gloria

After a delicate surgery to remove basal cell carcinoma from my face, my dermatologist suggested I do a round of fluorouracil. Known by the brand name Efudex, this topical chemotherapy may lower the chance of getting skin cancer. To prepare, I read as much as I could about how it works, its efficacy, and what to expect during treatment. 

Efudex, or as I call it, the eff YOU cream, is prescribed to adults who have a high risk of melanoma on parts of the body where it's difficult to simply cut it out, like the face and hands. The cream sinks into your skin, finds precancerous cells, and kills them. At least, that's how I understand it. I'm not a doctor and no part of this essay is medical advice.

Testimonials online showed people who looked like burn victims, their faces blotchy and red. They complained that their skin dried out. Some had trouble sleeping. Very few had acute pain, but everyone looked uncomfortable. Surely these are extreme cases, I thought. Only the most shocking content goes to the top of search results. Plus, there's always the disclaimer "your results may vary."

My results did vary in part because the worst effects happened after the point when most videos and blogs ended. Expectations are everything.

Although I was scared, I decided to do Efudex because I didn't want to have Mohs surgery ever again. It had been more traumatic than I anticipated — not the surgery itself, which my doctor explained so thoroughly that I could picture exactly what was happening as she worked, but the final step of sewing me up. She told me in advance, "I won't know exactly how I'll do the sutures until I get to them." Fine. When the time came, she needed to free up some skin to get enough slack to pull everything together. This she did with scissors. I laid on the operating table hearing every snip about an inch from my ear. It sounded like crunching snow. I was suddenly very aware that a team of people were slicing open the good part of my face, the part that didn't even have carcinoma, and my job was to trust them. All my muscles tensed. "Just. Hold. Still," I told myself. The last thing I wanted to do was twitch.

After that nightmare, giving myself a chemically induced sunburn to prevent future operations sounded like a good deal.

For two weeks, I snapped on a surgical glove and applied a thin layer of Efudex and a vitamin D derivative called Calcipotriene all over my face and chest, once in the morning and once before bed. Mixing the two together was meant to speed up the effects and keep my treatment time short. Once I "had the reaction," as one nurse put it, I could stop, even if I hadn't hit the two-week mark. She added, "If it gets to be too much, you can stop." I was determined to make it to the end, believing it would give me the full benefits of the treatment (remember: I'm not a doctor). The nurses, doctors, and pharmacist all hammered at me to avoid sunlight since fluorouracil makes skin extremely photosensitive. Here are some highlights of what happened.

Day 1. The first day of treatment, I was terrified. Efudex is a thick white cream. Calcipotriene is semi-translucent and extremely viscous. Neither has a smell. I worried they'd sting as I put them on, but they were as mild as Vaseline.

I traced my gooped-up finger around my lips and eyes, being careful to not get too close to them, and spread a thin layer everywhere else. Could I feel it? How about now? Did my skin look red yet?

Nothing happened.

Days 2, 3, 4. In fact, for four days, nothing happened. The tip of my nose felt dry and rough, but that was all. I wore a hat, face mask, and sunscreen (always!) outside.

Days 5 and 6. The first hints of red appeared on Day 5, but to the outside eye, I didn't look much different. My chin, the areas on either side of my mouth, and the divots next to my nostrils turned pink. At night, they were inflamed, dry, and tight, but not painful.

To this point, I hadn't had other side effects, like headaches or nausea, but I was thirsty! So thirsty! I chugged several glasses of water a day.

Day 7. The halfway mark! All the pink areas were now darker. It looked like I yanked a starfish off my face. If you saw me, you might think I had a rash or an allergic reaction.

I work remotely and have for years, but if I had an in-person job, I would have stayed home starting around Day 7 or 8.

Days 8 and 9. "Efudex feels like a sunburn." Everyone says this, but I noticed quite a few differences. Sunburns are painful for me, and they come on in a matter of hours. With Efudex, the effect came on so slowly that it was pain-free, at least to this point.

Maybe it's more like boiling a frog than a sunburn, I thought, so gradual that you adapt as it happens, but before you know it, you're past your breaking point. I wasn't there yet. My skin tingled, but it didn't burn. Sometimes my face felt hot, though.

Sleeping became an issue. Finding a position where I was comfortable but not rubbing the Efudex onto my pillowcase was tough. Since my skin was clammy with ointment, every speck of lint in the air gravitated toward it and stuck to it. The irritation kept me awake. I felt like a loaf of Spam that had fallen on a dirty floor.

Day 10. Job interviews have a way of popping up when you least expect them. I had been hoping to get an invitation to a video call within the month, but I didn't expect it on Day 10 of Efudex treatment.

We just found a new source for extremely cute, easy-wearing essentials that are priced really well. Kut from the Kloth has all the basics — in particular, jeans and linen shirts — to mix and match with fun pieces like these perfect-length shorts or these pretty pants. There are so many pieces on our wishlist now, including this extremely cute dress.

You can shop it all here. #partner

TO WATCH People of a certain age remember Lamb Chop, the sock puppet voiced by ventriloquist Shari Lewis that appeared on the kids’ show Lamb Chop's Play-Along!. Now a new documentary, Shari & Lamb Chop, takes a look at the truly unique Lewis, one of the colorful characters from an era where adults were attempting to make smart content for kids.

TO TRY We had been settling for whatever coffee was on sale each week until we discovered Trade, a specialty coffee marketplace featuring over 450 handpicked roasts from passionate small-batch roasters worldwide. Freshly roasted and delivered within 48 hours, Trade has transformed our mornings. We’re excited to share that Gloria readers enjoy an exclusive 50 percent off your first month when you subscribe today. The perfect roast is just a quiz away. #partner

TO LISTEN Who better to explain what’s going on with the Jeffrey Epstein story than Julie K. Brown, the Miami Herald reporter who originally broke the news of his crimes? Her convo with journalist David Sirota is a good overview of what’s known about the case, and what still remains a mystery.

TO STREAM Set in 1950s Rome, the film Finally Dawn (now on Apple TV+) follows a normal Italian girl who, after auditioning as an extra, is pulled into the glam world of showbiz. It debuted to mixed reviews at the Venice Film Festival, but it still looks worth a try. There’s also the new Netflix thriller Untamed, where Eric Bana plays a special agent for the National Park Service trying to solve a murder in the wilds of Yosemite.

A 40-second mood lifter. • Having a preteen when you’re in your late 40s is not for the weak. • A fascinating story about how American’s newfound love for whey protein is keeping our dairy industry afloat. • The magic of the 40th-birthday girls’ trip. • “Nobody wants to hang out on TV anymore.”

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