Imiquimod cream (Aldara)

Imiquimod cream is an immunotherapy. Open a glossary item

It is a treatment for:

  • basal cell skin cancer Open a glossary item that is small and in the top layer of the skin

  • a skin condition called actinic (solar) keratosis Open a glossary item 

  • some non cancerous conditions such as warts around the genitals and anus

How does imiquimod cream work?

Imiquimod cream uses your body’s own immune system Open a glossary item to help kill the skin cancer cells. It works by releasing a number of chemicals called cytokines Open a glossary item. One of these cytokines is called interferon.

Imiquimod cream helps your body´s own immune system to produce natural substances which help fight your basal cell carcinoma, actinic keratosis or the virus that has caused your warts.

When do you use imiquimod cream?

Imiquimod cream comes in a tube or individual sachets. You use it before going to bed. You wash your hands and the cancer area with mild soap and water. After you have dried your hands and the cancer thoroughly you put on the cream.

You use enough cream to cover the cancer and 1cm (about a half inch) around it. Rub the area until the cream disappears. Leave the cream on for 8 hours. Do not shower or bathe during this time.

When using it for basal cell carcinoma you leave the cream on for 8 hours and then wash it off.

You might not use all the cream if you are using the sachets. Do not keep the remaining cream you must use a new sachet each time.

How often do you use imiquimod cream?

How you have imiquimod cream depends on your individual situation.

Basal cell carcinoma

You usually put imiquimod cream on to the affected area once a day, 5 days a week for 6 weeks.

Actinic (solar) keratosis

You usually put imiquimod cream on to the affected area once a day, 3 days a week for 4 weeks.

If you still have areas of actinic (solar) keratosis you may repeat this process for another 4 weeks. Your doctor will let you know if this is the case.

Side effects

How often and how severe the side effects are can vary from person to person. They also depend on what other treatment you are having. 

When to contact your team

Your doctor, nurse, or pharmacist will go through the possible side effects. They will monitor you closely during treatment and check how you are at your appointments. Contact your advice line as soon as possible if:

  • you have severe side effects 
  • your side effects aren’t getting any better
  • your side effects are getting worse
Early treatment can help manage side effects better.

We haven't listed all the side effects here. Remember it is very unlikely that you will have all of these side effects, but you might have some of them at the same time.

The following side effects are based on you having the imiquimod cream for basal cell carcinoma. The side effects may be different if you are having imiquimod cream for actinic (solar) keratosis. Speak to you doctor, nurse or pharmacist for more information. 

Common side effect

Your skin might be itchy with this treatment. This side effect happens in more than 10 in 100 people (more than 10%).

Let your doctor or nurse know if you have this.

Occasional side effects

These side effects happen in between 1 and 10 out of every 100 people (between 1 and 10%). You might have one or more of them. They include:

  • small bumps on the skin that contain fluid, pus (pustules) or other matter. This could mean there is an infection.
  • swollen lymph nodes
  • back pain
  • problems at the application site including pain, redness, rash, burning, bleeding, tingling, prickling, bumps

Rare side effects

These side effects happen in fewer than 1 in 100 people (fewer than 1%). You might have one or more of them. They include:

  • feeling moody and irritable
  • feeling sick
  • dry mouth
  • flu-like symptoms
  • at the site of application swelling, leaking fluid, inflammation, scabs, small cysts, breakdown of the skin
  • tiredness and lacking energy

Coping with side effects

We have more information about side effects and tips on how to cope with them.

What else do I need to know?

Other medicines, food and drink

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

Contraception and pregnancy

It is unknown whether treatment may or may not harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment. Let your team know straight away if you or your partner falls pregnant while having treatment.

Talk to your doctor or nurse about effective contraception you can use during treatment. Ask how long you should use it before starting treatment and after treatment has finished.

Breastfeeding

It is not known whether this drug comes through into the breast milk. Doctors usually advise that you don’t breastfeed during this treatment.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

You can report any side effect you have to the Medicines Health and Regulatory Authority (MHRA) as part of their Yellow Card Scheme.

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