Aldara/g

Aldara cream contains imiquimod 5%, an immune response modifier used for the treatment of external genital and perianal warts (condylomata acuminata), superficial basal cell carcinoma, and actinic keratoses. Rather than destroying affected tissue directly, imiquimod stimulates the body's own immune system to recognise and clear the abnormal cells.

How does Aldara work?

Imiquimod activates toll-like receptor 7 on dendritic cells and macrophages, triggering a cascade of pro-inflammatory cytokines including interferon-alpha, tumour necrosis factor, and various interleukins. This innate immune activation is followed by a cell-mediated adaptive immune response directed against virus-infected or abnormal cells. The resulting localised inflammation is a sign that the immune system is responding.

What conditions does Aldara treat?

For genital warts, Aldara can clear the visible warts and may reduce recurrence rates compared with ablative treatments because it generates an immune memory. For superficial basal cell carcinoma and actinic keratoses, it provides a non-surgical treatment option with good cosmetic outcomes.

How to Apply Aldara

Apply a thin layer of Aldara (imiquimod) cream to the treatment area at bedtime and leave it on for approximately six to ten hours. Wash off in the morning with mild soap and water. The area may become red, sore, or scabbed during treatment, this is a normal immune response and shows the cream is working.

Application Frequency by Condition

Treatment schedules vary depending on the condition being treated:

• Genital warts: three times per week (e.g. Monday, Wednesday, Friday) for up to 16 weeks
• Superficial basal cell carcinoma: five times per week for six weeks
• Actinic keratoses: three times per week for four weeks

Genital warts: apply three times per week for up to 16 weeks. Superficial BCC: five times per week for six weeks. Actinic keratoses: three times per week for four weeks. Each sachet is single-use. Apply only enough to cover the treatment area with a thin film.

Expected local reactions

• Redness and erythema
• Erosion and ulceration
• Scabbing and crusting
• Swelling
• Burning or stinging

Systemic effects

Flu-like symptoms including headache, fatigue, and myalgia may occur, particularly during the first week. These usually settle with continued treatment.

The local skin reaction is a sign that the immune response is working, but if it becomes severe (deep erosion, significant pain, or signs of infection), take a rest period of several days before resuming. Aldara is for external skin use only and should not be applied to internal mucosal surfaces. Sexual contact should be avoided while the cream is on the skin, and barrier contraceptives may be weakened.

Contraindicated in known hypersensitivity to imiquimod or any excipient. Not recommended for internal genital or anal warts, or for urethral, vaginal, or cervical lesions.