Imiquimod (Aldara)
This treatment regime is based on our own experience and differs from the manufacturers recommendations. This is general advice only and your treatment may differ - please follow your doctors instructions.
Background:
Imiquimod works by stimulating the immune system to destroy cancer cells. Imiquimod is particularly useful for superficial basal cell carcinoma.
When used to treat skin cancers and pre-cancerous lesions it results in inflammation, which destroys the lesion. The degree of inflammation is quite variable from person to person.
Treatment should be carefully monitored, because the cream may need to be applied more or less frequently than originally planned or for a shorter or longer course, depending on response. Once the inflammation has settled there is generally a good or excellent cosmetic result with little scarring.
Treatment Length (this differs from manufacturer’s instructions, your doctor will advise)
The cream is best applied in the evening. Wash your hands before and after applying it.
Pierce the sachet with a needle and squeeze out a small amount of cream onto your fingertip. Apply this to the affected areas. Apply to the skin lesion(s) only, not the surrounding skin.
Although the information on the packet states that the sachet is for single use, you could seal it using a paper clip or tape and store in a closed container to prevent the cream drying out.
Imiquimod may be used at any time of year. However, when outdoors, you should protect yourself from the sun with clothing and sunscreen as usual.
Monitoring
Please email Dr Christian a photo of the area you are treating after two weeks to christian@skincancerdoctors.co.nz. Also tell him how you are feeling and confirm how long you have been applying the cream for. If you feel you are having a strong reaction or are otherwise concerned please email a photo sooner. Expect a reply within 24 hours.
What to expect
Areas treated with imiquimod will become inflamed. The effects include itching, burning, redness, ulceration (sores), scabbing, flaking and pain. These reactions indicate that the cream is likely to be effective - if there is no inflammation, imiquimod is unlikely to clear the lesions.
If you develop a severe reaction with black scabs and ulceration, stop applying the cream and arrange to see your doctor as soon as possible.
Systemic side effects
When using imiquimod cream, 'flu-like’ symptoms may develop, such as fever, fatigue, headache, nausea, diarrhoea and muscle pain. These are generally mild and may be treated with paracetamol. However, if they are troublesome, stop applying imiquimod cream and contact your doctor. Side effects should resolve within a few days of stopping treatment. They may also resolve with continuing treatment.
Image Gallery
These are all good reactions to the aldara and gives you an idea of what to expect during treatment. These are not infected, they are showing the expected inflammation from applying the cream.
Background:
Imiquimod works by stimulating the immune system to destroy cancer cells. Imiquimod is particularly useful for superficial basal cell carcinoma.
When used to treat skin cancers and pre-cancerous lesions it results in inflammation, which destroys the lesion. The degree of inflammation is quite variable from person to person.
Treatment should be carefully monitored, because the cream may need to be applied more or less frequently than originally planned or for a shorter or longer course, depending on response. Once the inflammation has settled there is generally a good or excellent cosmetic result with little scarring.
Treatment Length (this differs from manufacturer’s instructions, your doctor will advise)
- Actinic keratosis i.e. sun damaged skin
- Apply once daily on three days per week (Mon Wed Fri) for six weeks
- Basal cell carcinomas (superficial) and Bowen's disease:
- Apply once daily on five days per week (Mon to Fri) for six weeks
The cream is best applied in the evening. Wash your hands before and after applying it.
Pierce the sachet with a needle and squeeze out a small amount of cream onto your fingertip. Apply this to the affected areas. Apply to the skin lesion(s) only, not the surrounding skin.
Although the information on the packet states that the sachet is for single use, you could seal it using a paper clip or tape and store in a closed container to prevent the cream drying out.
Imiquimod may be used at any time of year. However, when outdoors, you should protect yourself from the sun with clothing and sunscreen as usual.
Monitoring
Please email Dr Christian a photo of the area you are treating after two weeks to christian@skincancerdoctors.co.nz. Also tell him how you are feeling and confirm how long you have been applying the cream for. If you feel you are having a strong reaction or are otherwise concerned please email a photo sooner. Expect a reply within 24 hours.
What to expect
Areas treated with imiquimod will become inflamed. The effects include itching, burning, redness, ulceration (sores), scabbing, flaking and pain. These reactions indicate that the cream is likely to be effective - if there is no inflammation, imiquimod is unlikely to clear the lesions.
If you develop a severe reaction with black scabs and ulceration, stop applying the cream and arrange to see your doctor as soon as possible.
Systemic side effects
When using imiquimod cream, 'flu-like’ symptoms may develop, such as fever, fatigue, headache, nausea, diarrhoea and muscle pain. These are generally mild and may be treated with paracetamol. However, if they are troublesome, stop applying imiquimod cream and contact your doctor. Side effects should resolve within a few days of stopping treatment. They may also resolve with continuing treatment.
Image Gallery
These are all good reactions to the aldara and gives you an idea of what to expect during treatment. These are not infected, they are showing the expected inflammation from applying the cream.
An example of the appearance after treatment has settled
