PDT vs. Efudex - I used Efudex 5 years ago and would highly recommend it. I am onboard[mostly] with with what Dr. M stated that Efudex is the gold standard.
In my experience, I should have gone 5 weeks and not 4. Now 5 years later some of the more stubborn AK will get a dose of PDT. I want Efudex again but my current derm has an unexplained preference for PDT (without doubt it’s for the cash). Carac (sp) is another form of Efudex. I would like to do it on specific spots. The Efudex 5 years ago carpet bombed 90+ % of the AK off my face, neck and upper chest.
Brave your way thru 5 weeks, twice a day. One real drawback is that you lose pigment. Reports state you may lose pigment but truth is you will loose pigment. The first week you spend getting red and then after that the fun begins. Just bite the bullet, hold your head high and brave your way thru 5 weeks. After you will spend 3 to 4 weeks healing. Then after that everyone you know will say you have the most awesome skin. Efudex, though it is a bit hellish, is the best. And remember to wear SPF 30 for the rest of your days.