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Imiquimod (Aldara®)

Imiquimod (Aldara®) is a topical immune response modifier that works to increase your body's immune response in a certain skin area. It has been widely used in the treatment of warts, genital warts, actinic keratoses, and skin cancers under a plan of care coordinated with an experienced dermatologist. Since it typically comes in small sachets, one may wish to use a clean safety pin to poke a hole at the top, apply the necessary amount, roll up the remainder of the unused sachet, and place it in the refrigerator for the next application.

For warts/genital warts, imiquimod is initially applied at night three times per week (Monday-Wednesday-Friday) and may be increased to every night application. Inflammation, redness, and irritation is expected as the body begins to ramp up the immune system to attack the wart. This treatment may be applied with topical salicylic acid plaster.

For actinic keratoses, imiquimod may be applied twice a week for a period of time determined by your physician. One sachet should be sufficient enough to cover an area equivalent to the back of one's hand. The advantage of this treatment to 5-fluorouracil, is the twice weekly application rather than twice-a-day x 3 week application of 5-fluorouracil.

The use of topical imiquimod for basal cell carcinomas and squamous cell carcinomas should only be done under the supervision of an experienced dermatologist. Your dermatologist will determine the best frequency of treatments and treatment time depending on the specific subtype of skin cancer you have.

Imiquimod should not be used under a bandage or occluded unless directed by your physician.

Don Mehrabi MD, FAAD
Dermatologist, Certified by the American Board of Dermatology
Los Angeles, California

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