Skip to main content

Has anyone in this group used picato yet, and if so what were the resuts, and how much does it cost?

13 Answers

stevehofer 16 March 2018

Two days ago, my dermatologist told me about Picato and gave me a prescription for it. I was excited to possibly treat my face and scalp with this new RX. First of all, the clerk at CVS pharmacy said that it was not covered by my insurance. When she looked it up, she said it would cost me $1,159! You have got to be kidding me! Can that be true? I would love to give this RX a try! Will see if my doc has any coupons to give me to help.

Votes: +0
Pharmaquestions 7 Sep 2018

You can not trust local pharmacies. It’s absolutely not true. Currently the “not covered” cost is $50. I would ask your doctor to send it to a specialty pharmacy. There’s always a solution. Don’t let pharmacies impact your medical care.

Jasmin_t 26 June 2017

Research before using!!! I've just gone back to my doctor as I have second degree burns on half of my chest from using Picato gel!!! He said "Oh sorry about that, that's a really bad reaction, I probably won't be prescribing this anymore.." So glad I could be the guinea pig! :( I am so emotional. He told me it would scar less than having the (tiny) solar ketosis frozen off but now half of my chest is burned down two layers!! This is going to take weeks, if not months to heal and I could be permanently scarred. Research this gel and other options EXTENSIVELY before using it as prescribed as I did. If I could post a picture, I would. Nobody would ever use it if you saw my chest right now. F*** my life!! :(

Votes: +0
Pharmaquestions 7 Sep 2018

How does your chest look now?

ckneier 24 May 2017

I used picato on my arm, had redness and flaking skin for a few days, nothing more. I used on my chest and it became extremely red and burning. it got worse after 2nd applications. multiple open lesions, crusting, open blisters, and very painful pustules. I am 7 days out and hope this will get better with time. I have been putting aquaphor on lesions which does relive pain. not painful enough to take any analgesic, but I have high pain tolerance. I have had multiple cryotherapy to area in the past. I did have drug card from the company, and the copay was $40. insurance was billed $700.

Votes: +0
Pharmaquestions 7 Sep 2018

Well that’s why you have insurance! Even generics in Dermatology are expensive now.
Your reaction are expected to be different in different areas. It’s all related to sun damage, past sunburns, and years in the sun.

Kboo 8 Feb 2017

I started using Picato on Sunday night. The first day was ok, some blistering. The second day was lots worse! Swelling, blistering, itching. But today, my eyes are swollen so badly that's it's difficult to see. I'm extremely dry and itchy. So glad I'm finished with the gel treatment! Question, can I use Aquaphor now that I'm finished with the treatment or will that burn? I definitely don't want anymore burning sensations!! I've done Effudex and I will most certainly say this treatment is far worse than that! The only good thing is that you only have to apply it for 3 nights!
So, Aquaphor?

Votes: +0
Momma675 18 March 2017

I'm on day 5 of Picato treatment. Finished the 3 day application and had horrible pain, blisters, itching. Starting in the evening of day 3 had eyelids starting to swell. Day 4 one eye almost swollen shut. Today the swelling has moved down to my inner eye area and under eyes. Did you experience this and how long to subside?

Kboo 18 March 2017

Oh yeah. The swelling was all around my eyes. But that actually went away the next couple of days after finishing. Good luck. I know how difficult this is!!

Kboo 19 March 2017

By the way, I highly recommend using the Aquaphor. It helped tremendously with the itching!!

Momma675 19 March 2017

I called the Picato help line and they said nothing on skin for 2 weeks! I can't imagine not putting something on. My skin feels like sandpaper and is sooo dry and tight and itchy!!

Kboo 19 March 2017

I can't imagine that either! But Aquaphor is so thick that it really relieves the itching. Maybe because it's still in the healing stage? I don't know, but I was going insane with the itching!

Inactive 21 Oct 2016

I have recently used it on my cheeks nose and forehead. Normally I have my solar keratosis removed with liquid nitrogen but my dermatologist no longer does this on the face.
You apply it three days in a row and thats it.
After the first day but especially on the second day any mutated cells start to blister and go red and bumpy. Its quite ugly for a while. However it clears up really quickly. I would start on a Friday night and try work from home or not do much the following week if its on your face,
The results were very good for me, the scaly skin went and there are no scar or discolouration marks on my face.
The prices in the US for this cream is insane. It costs £65 in the UK for the three tube treatment. That's less than $100! Someone is ripping you guys off.
I hope my description helped.

Votes: +0
jlnnm 6 Jan 2017

I am a redhead. I used Picato all over my face due to the varying thickness of my issue with actinic keratosis. My Dermatologist also gave me the discount card and my copay was $25. I am really happy about my results. In only a week and a day and I have seen vast improvement. I agree with the person who said the first day was the hardest. Maybe we just acclimate to the pain by the second and third day... but I thought it was fairly easy for the great result. I did this during a break from work and didn't go out much, but when I did I didn't see it bothering anyone. My face was very deep red and swollen.

Sbreshin 5 Feb 2017

Went to walgreens in palm beach gardens, FL yesterday and they quoted me $3000 w/o the coupon, and $2100 with the coupon. Needless to say, I will not be purchasing this medication.

missjane13 15 Oct 2016

Hello, I used Picato about 7 weeks ago for actinic keratosis just above my lip and there does not seem to be any visible change to the area.


Votes: +0
margo62145 4 Aug 2016

Well, prices have gone up, as I got cash quotes of $1000 from Walgreens and $975 from CVS. Fortunately my insurance covered and I paid $7 copay. So -- doc didn't tell me there were these weird side effects everybody's talking about. I finished my 2nd night of using it on both my legs. I have NO redness, NO itching, NO pain -- just went on here to find out when my spots would be gone and now I'm freaking out that within a week I'll look like a leper!!! Oh well, too late now, LOL Gotta say the way they package this stuff isn't so hot -- finally had to cut those little tubes to get the rest of it out -- for that price I'm not wasting ANY of it!!!

Votes: +0
MareKT 12 March 2015

I just did the 3 nights of Picato. This was the 2nd year in a row I did this. I have a history of BCC. It cost me $25 with coupon and my prescription insurance. Night 1, I knew to take 2 advil before I applied the gel. Mild burning. Nights 2 and 3, took Advil again and had mild burning. I am on day 5 (2 days after last dose) and the itching is unbearable! I tried coconut oil and Aquaphor and it helps but does not eliminate. Face is blotchy. Under eye swelling was noticable on day 3, almost half as much on day 5. My face is scaly and rough like sandpaper and is peeling pretty significantly, but I have had no blistering or weeping. My first go-round last year was not nearly as bad a reaction. As of today, I would say the itching is the worst side effect. I am 52 and live in Texas but born and raised in the northeast. A sun-worshiper and tanning bed person for many years. Guess I deserved the BCC. They had to remove half of my nose and required a plastics closure so I am careful now. Hope the info helps. I found these sites helpful.

Votes: +0
Chris Cohen 26 Dec 2012

My physician prescribed Picato for face. Checked with local pharmacy and was quoted $700 for one script. Called my insurance to check on my coverage and was told that through Medco, I could get 3 boxes for $70. Also, Picato provides a discount card. Be sure to ask about it. Could cost as low as $25 with card. Doctor told me to put on at night 2 hours before bed. Leave on at least 6-8 hours. First day was like a sun/windburn. 2nd day, lots of swelling and blisters. Didn't want to put 3rd dose on at all. Opted to put it on at 6:30 p.m. and shower it off at 12:30. The second day was the worst because I dreaded putting on next dose! Made me very emotional. The 3rd application was brutal and itched like crazy. Took Benadryl/Tylenol/Motrin to sleep. Put Neosporin w/pain killer on face. Really helped with pain and itching. I suggest putting on Picato in the afternoon for 8 hours and then shower off before bed.


Then apply Aquofor/Neosporin and take lots of Benadryl. Can't sleep otherwise due to burning, itching and anxiety from the ordeal. It's not fun but I survived it.

Votes: +0
chatter555 31 Dec 2012

My doctor prescribed in the summer for me to use in the winter. I decided to start the three day regimen yesterday, but, of course, the doctor's office is closed for the holiday, so I can't contact him. This is my question: Can I use anything on my face between the times that Picato is on my face? Or is it best to wait until the entire treatment is finished.

lavelle2000 22 June 2014

This response was ironically EXACTLY like my experience. I had a lot of swelling and little puss type of blisters on my face and did not even want to do the 3rd dose. I, too, put on the final dose at 6:30 PM and then got up at 12:30 to rinse it off! I just came online to search out whether it is OK to put on Neosporin after treatment. Thanks for the good info! Just FYI, I did Picato on one area on the side of my face a few years ago. It has been all clear right there since. The treatment this time was for several other areas around my face and on my nose. I purchased it for $25 through the Picato coupon offer. I also got the other kind for one spot on my leg - also for the $25 offer.

bruno123 1 Dec 2014

I just finished my 3 day treatment of Picato and WOW it really does burn. If it works half as well as it burns I'll be happy. Hopefully, I will have good results. I will post the results in 2 weeks.

My cost was $40.00 as my insurance paid the remaining balance which I am unsure of.

lsparkuhl 5 July 2012

I just started my first treatment. My face feels hot, but seems okay, just red. It looks and feels like I got a sunburn. The cost is only $25. Ask your dermatologist for a co-pay card. My pharmacist said it would have cost me $700. Since the drug was just recently approved in the US, they are trying to promote it, so the co-pay cards are readily available, and can be used for up to 3 refills.

Votes: +0
aggie24 14 June 2012

My dermatologist prescribed Picato for a small pre-cancerous lesion on the left side of my nose. I previously had Mohs surgery for a larger basal cell carcinoma on the right side of my nose. The dermatologist gave me a coupon card good for three separate purchases. My co-pay was $25 for three tubes, which were to be used for three days--each tube discarded after one use. Without the card, my insurance co-pay would have been $50. The pharmacist said without insurance the cost would have been $600.


I completed the first treatment last night (2 hours before bedtime). My dermatologist instructed me to coat my entire nose with the gel, not just the small lesion. Almost immediately I began to feel a burning sensation and experienced mild redness. When I woke up this morning, My nose looked like it had severe sunburn and it was throbbing. It was slightly swollen. Because I have a job that requires me to be in public, my dermatologist told me it would be OK to cover the area with makeup, so I did. I used Lycogel, which is suggested for use after cosmetic procedures. The Lycogel did a reasonable job of covering the area. I also used Dermablend loose setting powder. I did have a sensation that a small amount of pus was oozing from the area, but once I removed the makeup, the oozing seemed to stop. My dermatologist did not say anything about using moisturizing cream, so I did use Roc after I washed my face this morning. Probably a mistake. I used a mild Clinique moisturizer after washing my face this afternoon, and that felt really good.

I didn't expect such an immediate reaction on the first day. After reading other comments, I am nervous about continuing the treatment. I had hoped to time the treatments so that the worst part of the reaction would be during the weekend. However, I'm expecting tomorrow morning to be pretty bad. I appreciate Valorsmom's comments. I hope my the reaction tonight and tomorrow will not be a severe as the first night.

Votes: +0
aggie24 6 July 2012

Wanted to update this post. It's been about a month since my first treatment and the skin looks great. My nose peeled for about a week after the third and final treatment. The pain stopped almost immediately after the last treatment. I have a followup exam in two weeks, so I'll know then whether this actually worked. I still can feel a small rough spot on my nose where the AK lesion was, but it definitely feels smaller.

deb055 1 Aug 2016

I used picato for lesions above my lip and for a lesion between my eyebrows. The lip are healed well but after 20 weeks the spot between my eyebrows has not healed. I have used hydrocortisone for 3 weeks and the spot has gotten smaller but still there. Does anyone have any suggestions to help this with healing?

mews 16 May 2012

I used picato on my lip. My doctor gave me a coupon, so I only paid $25 although I was told the cost was $550.00. The first day after applying it, my lip was slightly burned. After the second application, my lip was swollen and blistered. When I put the gel on the third evening, my lip was burning and throbbing. I was extremely uncomfortable that night. My lips remained swollen and painful for 3 more days. After that, they were substantially better. I was told that day 7 would be the worst, but, luckily, I did not experience discomfort for that long.

Votes: +0
valorsmom 18 May 2012

I was told day 7 would be the worst too, but I found the first night to be the worst. It has been a week and I am peeling big time, just like I would after a sunburn. I am also itchy now that my skin appears to be healing. The cream helps both those things. I am still slightly red but not as bad as I was the first three days. It is definitely getting better!

khf 6 June 2012

I've researched Picato. It is not to be used on the lips. There is a strength for the face and scalp (not lips) and there is a strength for the trunk and extremeties. The face and scalp skin reactions will start on day one and peak within the first week. Most reactions are mild to moderate and should be back to baseline by day 15. The trunk and extremeties skin reactions will start on day one and peak at about a week and are mostly mild to moderate as well. Whats exciting about Picato is that we only have to apply for 2 or 3 days and then by 2 weeks our face will be back to baseline, and our trunk will be back to baseline by 4 weeks. As the doctor said above there are no contraindications, and I also read there is no systemic absorbtion.


I looked into the price as well and asked my doctor about co-pay cards. The co-pay cards cover up to $200 dollars off, but we pay a minimum of $25. I only had to pay $25 both times I used it. My expereice was fast and furious and I loved it. I will use it again. My doctor actually told me this is her favorite AK topical treatment and said she is surprised that most insurance covers it.

valorsmom 12 June 2012

Yes, your research results were correct. It has been over a month now (6 weeks) and my face is doing great! I am pleased with the results. The first night was definitely a little more then moderately painful although I think it depends on your own personal pain toleration. Also, I have very sensitive skin and it may be that my reaction was more severe then it would have been on someone with less sensitivity. I used the face strength Picato and my reaction was immediate. I am happy that others are adding to this group discussion so that there will be good solid information out there for others to see! My skin did not take that long to heal up and the results are good.

Pharmaquestions 7 Sep 2018

Its not indicated for the lips. I’m not sure why you were told day 7 would be the worst, it peeks writhing the first week.

Inactive 30 April 2012

within a couple days of starting treatment my patients are starting to see some redness and irritation that escalates for about a week. By the end of the 2nd week they have started to see the redness decrease by the 4th week complete clearance. I have had one patient with much slower result on the body but the face seems to be more routine with that period.

The drug is not covered by most insurance companies at this time and depending on which course can be anywhere from $700-900 for the treatment for a cash pay patient.

Votes: +0
VickiB130 30 April 2012

Thanks for this information. I have 2 more questions: How are the side effects in severity compared to Effudex or Carac? How do you feel the results are thus far, compared to fluorourcil cream? Thank you very much in advance! Vicki

Inactive 30 April 2012

the reaction is similiar, we are tending to use it for patients on coumadin as there is no contraindication with picato and coumadin as there is with Efudex/Carac and coumadin. There are quite a few patients that are not completely resolving with the Picato and are either going to need to have cryotherapy or another course of Picato.The benefit to Efudex/Carac is that a patient gets a 40 gram tube and can use it for more than one course with that tube for $170-$190 cash pay price.

john691 13 May 2012

The cost of Picato gel was $51 with my insurance. I was told it was $600 without my insurance. I have three spots that were determined to be AK via biopsy. I treated one AK on my eyebrow for three days and there was almost no reaction. I treated the second AK on the bridge of my nose for four days (today is day four) and there is currently a mild reaction. I have not yet treated the third AK. The instructions called for only three days of treatment and I am hoping that an extra day of treatment will trigger a better reaction. It might just be my skin as I have already done efudex, aldara, PDT, and MOHS. I am interested to hear about your experience with Picato.

valorsmom 14 May 2012

I just went through the 3 days of applying Picato to my face. The first night I put it on and within minutes I felt a slight stinging sensation. It progressively got more intense but I was extremely tired so was able to sleep through it. I woke earlier then normal the next morning. My face was bright red and felt like it was burning. I couldn't wait to wash it off. Even after I washed my face, twice, with soap and water, my face continued to have the burning sensation for a couple of hours afterward. I called my doctor because I wasn't sure if I was having an adverse skin reaction however I was assured that this was normal and to continue treatment.


The second night was not as bad as the first, although I did feel like my skin was irritated. Again, I woke with my face bright red and feeling like it was burning. The third night was very much like the second night, a milder stinging burning sensation, but I was able to sleep through it. The only thing similar in feeling that I can describe it as is when you are cutting up a hot pepper without wearing gloves and you get the burning sensation from the hot seeds touching your skin. This is what it feels like with the first night being worse then the following two nights. It was tough but not impossible.

I now have very rough feeling, very dry skin. I will post back in the next few days with updates on my progress just in case anyone is interested. I did a search on the internet before I started treatment but found very very little due to Picato being so newly approved by the FDA and only on the market a very short time. So I thought my experience might be of interest to those who have not yet tried it. My doctor did tell me to buy over the counter 1% Hydrocortizone cream to help with the pain. The pharmacist told me to use it sparingly. I did use it a couple of times to help ease the burning sensation, but only after I washed off the Picato gel in the morning but it did help.

VickiB130 14 May 2012

Valorsmom-This is a very helpful answer and thanks! I'm still waiting to start because it's possible I can get into a "results" trial at my dermatologists and get the Picato for free, which would be very helpful since we have no prescription coverage. And you're correct: because it just became available April 1, there is very little information out there. It does sound as though you had a reaction and hopefully that means it is doing it's job. Please do a few followup comments with further details and results. Thanks again!

valorsmom 15 May 2012

Glad I could be helpful to those who are thinking of using Picato. I did call my doctor today and was told that I could use a moisturizer now that the treatment is complete. They recommended CeraVe, Cetaphil or even plain Vaseline. The greasier the better they said. When I asked why, they said non-greasy type moisturizers can sting... but greasy moisturizer doesn't. So I ran out and purchased CeraVe cream. It didn't hurt when I put it on and it felt so good!!! My face is still very red and rough to the touch and feels stiff and dry so it helps a little. So far I don't look as bad as I thought I would look though.


As far as the cost, it is extremely expensive. This medication is made in Australia and there is no generic available. So the cost is high - about $700 for a small tube. However, my doctor gave me 3 tiny tubes that were samples. I used one tube per day to cover the area of my face. So it didn't cost me anything! Ask your doctor for these samples if you can't afford the cash payment and don't have insurance. The down side of all this is that in clinical trials results were only about 46% complete clearance of pre-cancerous lesions. So it is recommended that this treatment be used in addition to regular freezing and lasering and of course frequent doctor examinations.

If I had it to do over again, I would do it. It isn't pleasant but hopefully results will be worth it!

khf 5 July 2012

Actually, Picato has great commercial insurance coverage with a co-pay coupon that makes Picato $25. Cash price is an average of $620.00. This branded product is less then some generic topicals indicated for AK's.

khf 5 July 2012

Another thing, the complete clearance of Carac and other topicals are all similar. The great thing about Picato is that it's a faster process.

Hisson0712 14 Jan 2014

The drug is to expensive. They put out coupons which are no goo00d. I ordered the medication and presented ad coupon stating the medication was $458.27 and when I wanted to pick up the medication I was informed it was $684.00. The coupons are no good. free discount card

Related topics


Further information

Similar questions

Search for questions

Still looking for answers? Try searching for what you seek or ask your own question.