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.
How it works
Imiquimod works by stimulating the immune system to destroy cancer cells. Imiquimod is particularly useful for actinic keratoses, superficial basal cell carcinoma, and in situ squamous 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 - your doctor will advise
For Actinic keratoses; apply once daily on three days per week (M,W,F) for six weeks.
For Basal cell carcinomas (superficial) and Bowen's disease; apply once daily on five days per week (M,T,W,T,F) for six weeks.
How to apply
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 tiny amount of cream onto your fingertip. Apply this to the affected areas. Apply to the skin lesion(s) only, not the surrounding skin. Please keep it at least 1cm away from the edge of your eyes and mouth. Although the information on the packet states that the sachet is for single use, you could seal it using apaper 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. You may wash you face as usual and swim in the ocean, but not in public pools.
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.
Monitoring
Your doctor will ask you to follow up with them 1 week after starting or sooner if you have any concerns. This is usually with a photo sent to their email address - bruce@skincancerdoctors.co.nz or christian@skincancerdoctors.co.nz or alternatively you may choose to book a consultation.
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.
How it works
Imiquimod works by stimulating the immune system to destroy cancer cells. Imiquimod is particularly useful for actinic keratoses, superficial basal cell carcinoma, and in situ squamous 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 - your doctor will advise
For Actinic keratoses; apply once daily on three days per week (M,W,F) for six weeks.
For Basal cell carcinomas (superficial) and Bowen's disease; apply once daily on five days per week (M,T,W,T,F) for six weeks.
How to apply
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 tiny amount of cream onto your fingertip. Apply this to the affected areas. Apply to the skin lesion(s) only, not the surrounding skin. Please keep it at least 1cm away from the edge of your eyes and mouth. Although the information on the packet states that the sachet is for single use, you could seal it using apaper 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. You may wash you face as usual and swim in the ocean, but not in public pools.
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.
Monitoring
Your doctor will ask you to follow up with them 1 week after starting or sooner if you have any concerns. This is usually with a photo sent to their email address - bruce@skincancerdoctors.co.nz or christian@skincancerdoctors.co.nz or alternatively you may choose to book a consultation.
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
