Imiquimod is an immune response modifier. It is manufactured as a 5% cream called Aldara. Imiquimod is mainly used to treat actinic keratoses, some basal cell and squamous cell skin cancers, genital warts and molluscum. Your doctor may prescribe it for some other uses.
Imiquimod works by stimulating the immune system to release a number of chemicals called cytokines, which are important in fighting viruses and destroying cancer cells.
Aldara comes in boxes of 12 individual sachets or foil packs. The FDA mandates that these are “For Single Use,” but this is costly and unnecessary. Many patients get two, three and four applications from a single foil pack.
How To Use
Here’s a method that was recommended to me by Doug Johnson a dermatologist from Honolulu.
1. Make a small pin hold in a corner of the foil pack (click photo to enlarge).
2. Squeeze out a tiny amount of Aldara.
3. Rub well into treatment area with a finger and leave on overnight.
4. Fold over packet edge and secure with paper clip. Store in a cool place.
It’s simple, frugal, and allows you to use the product more economically.
What to Expect
After a few days, the areas treated with Aldara will be come inflamed. (See photos below) The effects may 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. An exaggerated response may clear the skin lesion sooner than expected - sometimes in as few as three or four applications. In some patients, surrounding untreated areas also become inflamed but this will settle when treatment is discontinued.
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
These are unusual, but may include flu-like symptoms, such as low- grade fever, fatigue, headache, nausea, diarrhoea and muscle pain. These are generally mild and may be treated with Tylenol. However, if they are troublesome, stop applying imiquimod cream and contact your doctor. Enlarged lymph nodes can rarely appear in sites near the treated area. The systemic side effects should resolve within a few days of stopping treatment. They may also resolve with continuing treatment.
Length of Treatment will depend on the frequency of use, the area treated and an individual’s response to the agent. There are many protocols for use and each physician has his or her personal modifications.
Final Results
Healing after treatment is usually excellent. In spite of the marked inflammation there is rarely any permanent mark at the treatment site.
Photos of a Severe Reaction
Superficial Skin Cancer after 9 days
Same Lesion after 3 weeks
Same area 3 weeks after stopping Aldara