Imiquimod (Aldara cream)

Imiquimod is a cream that, when applied to the skin, activates the immune system to recognise abnormal cells and causes inflammation, which removes them.

This cream is designed to treat some skin cancers (superficial basal cell carcinoma) and areas of sun-damaged skin that can turn into skin cancers (i.e. lentigo maligna, Bowen’s disease and actinic keratoses). It is also used to treat genital warts. Please ask a member of staff if you require more information.

How to apply the cream

The cream comes in little sachets. In most situations, only a small area is being treated, and there is enough cream to last two days.

Cut the corner off the sachet. Apply the cream to the affected area plus about 2cm of skin around it. If there is cream left, this can be stored for one day in the fridge and used the following day.

In this way, you will only need 15 sachets to treat a smallish area five days a week for six weeks.

Imiquimod cream should be applied sparingly to the affected area once a day, five days a week for six weeks.

After around 7-10 days, the treated areas will start to become red and inflamed. The appearance of crusting and redness of the skin should not prevent you from continuing with treatment unless this becomes very disabling or disfiguring.

Side effects

The cream may cause ‘flu-like symptoms with headache, generalised aches and pains and a temperature. In some patients, it also causes pain in the arms and legs. If these symptoms occur, try to persist with the cream and take paracetamol to alleviate the symptoms.

After treatment

• After the cream is stopped, the skin inflammation and crusting will slowly settle spontaneously over the next 10-14 days
• Wash the area normally
• Do not continue to apply the Imiquimod after six weeks

Further information

• DermNet
• British Association of Dermatologists – patient information