What is Imiquimod?
Imiquimod is used in different ways for the three different skin conditions it is used to treat. It is very important that you follow the instructions for your skin condition. Talk to your healthcare provider if you have questions. Imiquimod does not work for everyone. Imiquimod will not cure your genital or perianal warts. New warts may develop during treatment with Imiquimod. It is not known if Aldara Cream can stop you from spreading genital or perianal warts to other people. For your own health and the health of others, it is important to practice safer sex. Talk to your healthcare provider about safer sex practices.
Who should not use Imiquimod?
Imiquimod has not been studied in children under 12 years old for external genital and perianal warts.
Imiquimod has not been studied in children under 18 years old for actinic keratosis or superficial basal cell carcinoma. Children usually do not get actinic keratoses or basal cell carcinoma.
Before using Imiquimod, tell your healthcare provider:
about all your medical conditions, including if you
o are pregnant or planning to become pregnant. It is not known if Imiquimod can harm your unborn baby.
o are breastfeeding. It is not known if Imiquimod passes into your milk and if it can harm your baby.
about all the medicines you take including prescription and non-prescription
medicines, vitamins and herbal supplements. Especially tell your healthcare provider if you have had other treatments for genital or perianal warts, or actinic keratosis, or superficial basal cell carcinoma. Imiquimod should not be used until your skin has healed from other treatments.
How should I use Imiquimod?
Use Imiquimod exactly as prescribed by your healthcare provider. Imiquimod is for skin use only. Do not take by mouth or use in or near your eyes, lips or nostrils. Do not use Imiquimod unless your healthcare provider has taught you the right way to use it. Talk to your healthcare provider if you have any questions.
Imiquimod is used for several skin conditions. Use Imiquimod only on the area of your body to be treated. Your healthcare provider will tell you where to apply Imiquimod and how often and for how long to apply it for your condition. Do not use Aldara Cream longer than prescribed. Using too much Imiquimod, or using it too often, or for too long can increase your chances for having a severe skin reaction or other side effect. Talk to your healthcare provider if Imiquimod does not work for you.
For external genital and perianal warts
Imiquimod is usually used once a day for 3 days a week:
Monday, Wednesday and Friday, or
Tuesday, Thursday and Saturday
For these conditions, Aldara Cream is usually left on the skin for 6 to 10 hours. Treatment should continue until the warts are completely gone, or up to 16 weeks.
For actinic keratosis
Imiquimod is usually used once a day for 2 days a week, 3 to 4 days apart, such as:
Monday and Thursday, or
Tuesday and Friday
For this condition, Imiquimod is usually left on the skin for about 8 hours. Treatment should continue for the full 16 weeks even if all actinic keratoses appear to be gone, unless you are told otherwise by your healthcare provider. The area you treat with Imiquimod should be no larger than approximately the size of your forehead or one cheek (for example 2 inches by 2 inches), unless otherwise directed by your healthcare provider.
For superficial basal cell carcinoma
Imiquimod is usually used once a day for 5 days a week:
Monday, Tuesday, Wednesday, Thursday and Friday
For this condition, Imiquimod is usually left on the skin for about 8 hours. Your healthcare provider will show you how much Imiquimod to apply to your superficial basal cell carcinoma. You should also apply Imiquimod to a small area of skin all around the superficial basal cell carcinoma. This small area of skin should be about the size of your fingertip. Treatment should continue for the full 6 weeks, even if the superficial basal cell carcinoma appears to be gone, unless you are told otherwise by your healthcare provider.
Imiquimod should be applied just before your bedtime. Wash the area to be treated with mild soap and water. Allow the area to dry. Uncircumcised males treating warts under their penis foreskin must pull their foreskin back and clean before treatment, and clean daily during the weeks of treatment.Wash your hands. Open a new packet of Imiquimod just before use. Apply a thin layer of Imiquimod only to the affected area or areas to be treated. Do not use more Imiquimod than is needed to cover the treatment area. Rub the cream in all the way to the affected area or areas. Do not get Imiquimod in your eyes. Do not get Imiquimod in the anus when applying to perianal warts. Female patients treating genital warts must be careful when applying Imiquimod around the vaginal opening. Female patients should take special care if applying Imiquimod at the opening of the vagina because local skin reactions on the delicate moist surfaces can cause pain or swelling, and may cause problems passing urine. Do not put Imiquimod in your vagina or on the skin around the genital wart. Do not cover the treated area with an airtight bandage. Cotton gauze dressings can be used. Cotton underwear can be worn after applying Imiquimod to the genital or perianal area. Safely throw away the open packet of Imiquimod so that children and pets cannot get it. The open packet should be thrown away even if all the Imiquimod was not completely used. After applying Imiquimod, wash your hands well. Leave the cream on the affected area or areas for the time prescribed by your healthcare provider. The length of time that Imiquimod is left on the skin is not the same for the different skin conditions that Imiquimod is used to treat. Do not bathe or get the treated area wet before the right time has passed. Do not leave Imiquimod on your skin longer than prescribed. After the right amount of time has passed, wash the treated area or areas with mild soap and water.
If you forget to apply Imiquimod, apply the missed dose of cream as soon as you remember and then continue on your regular schedule. If you get Imiquimod in your mouth or in your eyes rinse well with water right away.
What should I avoid while using Imiquimod?
Do not cover the treated site with bandages or other closed dressings. Cotton gauze dressings are okay to use, if needed. Cotton underwear can be worn after treating the genital or perianal area. Do not apply Imiquimod in or near the eyes, lips or nostrils, or in the vagina or anus. Do not use sunlamps or tanning beds, and avoid sunlight as much as possible during treatment with Imiquimod. Use sunscreen and wear protective clothing if you go outside during daylight. Do not have sexual contact including genital, anal, or oral sex when Imiquimod is on your genital or perianal skin. Imiquimod may weaken condoms and vaginal diaphragms. This means they may not work as well to prevent pregnancy. For your own health and the health of others, it is important to practice safer sex. Talk to your healthcare provider about safer sex practices.
What are the possible side effects of Imiquimod?
The most common side effects with Imiquimod are skin reactions at the treatment site including:
a sore, blister, or ulcer
skin that becomes hard or thickened
scabbing and crusting
changes in skin color that do not always go away
During treatment and until the skin has healed, your skin in the treatment area is likely to appear noticeably different from normal skin. Side effects, such as redness, scabbing, itching and burning are common at the site where Imiquimod is applied, and sometimes the side effects go outside of the area where Imiquimod was applied. Swelling, small open sores and drainage may also be experienced with use of Imiquimod. You may also experience itching and/or burning. Actinic keratoses that were not seen before may appear during treatment and may later go away. If you have questions regarding treatment or skin reactions, please talk with your healthcare provider.
Superficial Basal Cell Carcinoma
During treatment and until the skin has healed, your skin in the treatment area is likely to appear noticeably different from normal skin. Side effects, such as redness, swelling and a sore are common at the site where Imiquimod is applied. You may also experience itching or burning. Your healthcare provider will need to check the area that was treated after your treatment is finished to make sure that the skin cancer is gone. Superficial basal cell carcinoma can come back. The chances of it coming back are higher as time passes. It is very important to have regular follow-up visits with your healthcare provider to check the area to make sure your skin cancer has not come back. Ask your healthcare provider how often you should have your skin checked. Talk with your healthcare provider if you have questions about your treatment or skin reactions.
External Genital and Perianal Warts
Patients should be aware that new warts may develop during treatment, as Imiquimod is not a cure. Many people see reddening or swelling on or around the application site during the course of treatment. If you have questions regarding treatment or local skin reactions, please talk with your healthcare provider. You have a higher chance for severe skin reactions if you use too much Imiquimod or use it the wrong way. Stop Imiquimod right away and call your healthcare provider if you get any skin reactions that affect your daily activities, or that do not go away. Sometimes, Imiquimod must be stopped for a while to allow your skin to heal. Talk to your healthcare provider if you have questions about your treatment or skin reactions. Other side effects of Imiquimod include headache, back pain, muscle aches, tiredness, flu-like symptoms, swollen lymph nodes, diarrhea, and fungal infections. If the reactions seem excessive, if either skin breaks down or sores develop during the first week of treatment, if flu-like symptoms develop or if you begin to not feel well at anytime, contact your healthcare provider. These are not all the side effects of Imiquimod. For more information, ask your healthcare provider or pharmacist.