What to Know About Aldara Cream (Imiquimod) for Basal Cell Carcinoma
Aldara (imiquimod) is a topical cream that targets and kills cancer cells in the skin. Learn how Aldara treats basal cell carcinoma, including the side effects.
imiquimod
Used for Actinic Keratosis, HPV, Warts
Used for Actinic Keratosis, HPV, Warts
Imiquimod 5% cream (Aldara) is a prescription cream that's applied to the skin. It's used to treat actinic keratosis on the face or scalp and a type of skin cancer called superficial basal cell carcinoma in adults. It also treats genital and anal warts in people ages 12 years and older. Imiquimod 5% is usually applied onto the affected skin several times a week. The most common side effects are skin itching, irritation, and burning.
What is Imiquimod 5%?
What is Imiquimod 5% used for?
- Actinic keratosis on the face or scalp in adults
- Superficial basal cell carcinoma in adults
- Genital and anal warts in adults and children ages 12 years and older
How Imiquimod 5% works
Imiquimod 5% is a topical skin product. It's known as an immune response modifier.
It's not exactly clear how imiquimod 5% cream works. It's thought to turn on certain parts of your immune system. When you apply it to your skin, certain immune cells move to the treated area. These immune cells help fight certain types of skin cancer, skin damage from the sun, and genital warts.
When does Imiquimod 5% start working?Time passed since treatment started:
Drug facts
| Common Brands | Aldara |
|---|---|
| Drug Class | Topical skin product |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Imiquimod 5% essentials
Side effects of Imiquimod 5%
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Skin redness
- Flaky, scaly, or dry skin
- Scabbing or crusting
- Swollen skin
- Ulcer or sore on the skin
- Oozing from the skin
Less Common Side Effects
- Upper respiratory tract infection
- Headache
- Stomach upset
When do Imiquimod 5% possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Skin redness, dry skin, scabbing, and other skin reactions
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.
The following Imiquimod 5% side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Blisters on the skin
body aches or pain
chills
difficulty with breathing
ear congestion
itching in the genital or other skin areas
loss of voice
open sores or scabs on the skin
pain or tenderness around the eyes and cheekbones
redness of the skin (severe)
scaling
shortness of breath or troubled breathing
skin rash
stuffy or runny nose
tightness of the chest or wheezing
unusual tiredness or weakness
Less common
Abdominal or stomach pain
ankle, knee, or great toe joint pain
bladder pain
bloody or cloudy urine
blurred vision
difficult, burning, or painful urination
dizziness
fainting
fast or irregular heartbeat
frequent urge to urinate
hoarseness
joint stiffness or swelling
lower back or side pain
lump in the abdomen or stomach
nervousness
persistent non-healing sore
pink growth on the skin
pounding in the ears
reddish patch or irritated area
severe headache
shiny bump on the skin
slow or fast heartbeat
swollen, painful, or tender lymph glands in the neck, armpit, or groin
white, yellow or waxy scar-like area
Incidence not known
Blue lips and fingernails
convulsions
coughing that sometimes produces a pink frothy sputum
dilated neck veins
extreme fatigue
fast, irregular, or pounding heartbeat
headache
irregular breathing
nausea or vomiting
pain in the shoulders, arms, jaw, or neck
slurred speech
sudden and severe inability to speak
suicide
sweating
swelling of the face, fingers, feet, or lower legs
temporary blindness
weakness in the arm or leg on one side of the body
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Confusion
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Burning or stinging of the skin (mild)
flaking of the skin
mild headache
pain, soreness, or tenderness of the skin (mild)
rash
redness of the skin (mild)
swelling at place of application
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Get your GoodRx coupon
$152.13
GoodRx discount
$29.76
Pros and cons of Imiquimod 5%
Pros
- Applied directly onto the affected areas
- Can use at home
- Can treat areas of damaged skin without a procedure (for actinic keratosis or basal cell carcinoma)
Cons
- Need to remember to wash off the next morning
- Can cause skin irritation where it's applied
- Treatment can take several weeks or months
Pharmacist tips for Imiquimod 5%
- Imiquimod 5% cream is used a few times a week, not every day. How often you use it depends on the skin condition you're treating. Choose a schedule that's easy to remember.
- Only apply imiquimod 5% onto your skin. Don't get it in or around your mouth, lips, nose, or eyes. Also don't put it inside your anus or vagina. These areas are sensitive and can get irritated easily. If the cream gets in your eyes or anywhere where it doesn't belong, rinse the area well with water.
- Imiquimod 5% cream can cause skin reactions where you apply it. This can include redness, itching, burning, dry skin, swelling, oozing, or flaking. If your skin gets very irritated, wash the cream off with soap and water and tell your prescriber. They can recommend ways to help manage the irritation.
- Local skin reactions can make the treated skin look different while using imiquimod 5% cream. These reactions usually go away after your skin heals. But some people have had lighter or darker skin there and this can sometimes be permanent. Talk to your prescriber if you're concerned about these skin changes.
- Imiquimod 5% cream can make your skin more sensitive to the sun. Avoid tanning beds and limit your time in the sun while using this medication. Wear protective clothing and use sunscreen when you're outdoors. If you get a sunburn, wait until your skin heals before using the cream on that area again.
How to use imiquimod 5%:
- Before applying imiquimod 5% cream: Wash the affected area(s) with mild soap and water. Let it dry completely for at least 10 minutes.
- How to apply imiquimod 5% cream: Apply just before going to bed. Be sure to use a new packet of cream each time. Rub it in gently until you can't see it anymore. Throw away the opened packet, even if there's some cream left.
- After applying: Leave imiquimod 5% cream on your skin for about 8 hours. For genital or anal warts, leave on for 6 to 10 hours. Then, wash it off with mild soap and water.
- Don't cover the treated areas with tight bandages or dressings. This might raise the risk of side effects from imiquimod 5% cream.
For actinic keratosis on the face or scalp:
- Apply imiquimod 5% cream 2 times a week. Keep using the cream for 16 weeks (about 4 months), or as directed by your prescriber.
- Only use imiquimod 5% cream on the affected areas on the face or scalp. Treat one area at a time (only on the face or only on the scalp, but not both at the same time).
For superficial basal cell carcinoma:
- Apply imiquimod 5% cream 5 times per week. For example, you can use it every night Monday through Friday. Keep using the cream for 6 weeks, unless your prescriber gives you other instructions.
- Apply the prescribed amount of imiquimod 5% cream to the affected area. Use the cream only on spots of skin cancer on your torso, neck, arms (not hands), or legs (not feet). Also apply the cream to the skin around the spots of skin cancer, as directed by your prescriber. This helps treat the skin cancer fully.
For genital and anal warts:
- Apply a thin layer of imiquimod 5% cream to each wart 3 times per week. Examples are Monday, Wednesday, and Friday or Tuesday, Thursday, and Saturday. Keep using the cream until all your warts go away or up to 16 weeks (about 4 months).
- It's possible to get new genital and anal warts while using imiquimod 5% cream. If you notice any new genital or anal warts, tell your prescriber.
- For women: be careful when applying imiquimod 5% cream around your vagina. Don't get it inside your vagina. The cream can cause pain or severe swelling in this area, which can make it hard to urinate.
- For men who aren't circumcised: If you're treating warts under the foreskin, be sure to clean under the foreskin every day. Gently pull it back and wash the area well.
- Don't have vaginal, anal, or oral sex while you have imiquimod 5% cream on your skin. The cream can get on your partner and irritate their skin. The cream can also make condoms and vaginal diaphragms work less well to prevent pregnancy.
- If your skin gets irritated from imiquimod 5% cream, you can cover the treated area with loose cotton gauze or wear cotton underwear. This might help make your skin more comfortable.
Risks and warnings for Imiquimod 5%
Imiquimod 5% can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Local skin reactions
Imiquimod 5% can cause severe local skin reactions after a few uses. This can include oozing, blisters, and peeling. It can also make certain inflammatory skin problems worse. If this happens, tell your prescriber. They might recommend you to take a break from the medication.
If you're using imiquimod 5% cream for genital warts on the outside of the vagina, severe swelling around the area can make it hard to urinate. If this happens, let your prescriber know. They can help decide if you should pause or stop treatment.
Don't use imiquimod 5% cream on skin that hasn't fully healed after surgery or another skin treatment.
Minimize or avoid ultraviolet (UV) light
Imiquimod 5% can make the treated skin more sensitive to the sun. It can also be more sensitive to sunlamps, tanning beds, and other sources of ultraviolet (UV) light. This can make it easier for your skin to get sunburned.
Avoid direct sun exposure and tanning beds while using imiquimod 5%. Also, use sunscreen and wear protective clothing, such as a hat, when you go out. If you get a sunburn, wait until it heals before using imiquimod 5% again in that area. If you need to be out in the sun for a long time for your job or if you tend to get sunburned easily, talk to your prescriber.
Flu-like symptoms
Some people have had flu-like symptoms while using imiquimod 5% cream. These include tiredness, fever, nausea, muscle aches, or chills. If this happens, tell your prescriber. They might decide to pause treatment until your symptoms improve.
Imiquimod 5% dosage
The average cost for 24 packets of 5% of Imiquimod 5% is $29.76 with a free GoodRx coupon. This is 80.44% off the average retail price of $152.13. 
Packet
Packet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5% | 24 packets | $29.76 | $1.24 |
Interactions between Imiquimod 5% and other drugs
Imiquimod 5% may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Imiquimod 5%. Please note that only the generic name of each medication is listed below.
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Imiquimod 5% cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
What are alternatives to Imiquimod 5%?
There are a number of medications that your doctor can prescribe in place of Imiquimod 5%. Compare a few possible alternatives below.
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