Aldara Cream

Aldara (imiquimod) cream is a prescription topical immunomodulator indicated for the treatment of external genital and perianal warts, superficial basal cell carcinoma, and actinic keratosis. It works by stimulating the body’s local immune response to target abnormal skin cells, offering a non-invasive therapeutic option with high clearance rates. This medication represents a significant advancement in dermatological treatment, providing patients and clinicians with a well-tolerated alternative to surgical or destructive procedures.

Features

• Contains 5% imiquimod as the active pharmaceutical ingredient
• Available in single-use packets or multi-use pump dispensers
• White-to-light-yellow oil-in-water emulsion cream formulation
• Typically applied before bedtime and washed off after 6-10 hours
• Requires refrigeration for storage stability
• Prescription-only medication with specific dosing regimens

Benefits

• Provides a non-invasive treatment alternative to surgical procedures
• Stimulates the body’s own immune system to target abnormal cells
• Demonstrates high clearance rates for approved indications
• Offers convenient at-home application with physician supervision
• May reduce recurrence rates compared to destructive therapies
• Minimal scarring potential compared to surgical interventions

Common use

Aldara cream is primarily prescribed for three dermatological conditions. For external genital and perianal warts (condylomata acuminata), it is applied three times per week until clearance or for up to 16 weeks. In the treatment of superficial basal cell carcinoma, the cream is applied five times per week for six weeks, with the treatment area covering the tumor plus a 1cm margin of surrounding skin. For actinic keratosis, typically on the face or scalp, application occurs twice weekly for 16 weeks. Clinical studies demonstrate complete clearance rates ranging from 45-85% depending on the condition and patient factors.

Dosage and direction

Apply a thin layer of Aldara cream to the treatment area, rubbing in thoroughly until absorbed. For genital/perianal warts: apply three times weekly (e.g., Monday, Wednesday, Friday) before bedtime, leaving on for 6-10 hours before washing off with mild soap and water. For superficial basal cell carcinoma: apply once daily, five days per week (e.g., Monday through Friday) for six weeks. For actinic keratosis on face or scalp: apply twice weekly (e.g., Monday and Thursday) for 16 weeks. Use the supplied single-use packet or pump dispenser according to prescribed measurements. Wash hands before and after application unless treating hands.

Precautions

Avoid contact with eyes, lips, and nostrils. Do not apply to open wounds or broken skin. Sexual contact should be avoided while the cream is on the skin. This medication may weaken condoms and diaphragms. Sun exposure should be minimized during treatment, and sunscreen should be used routinely. The treatment area should not be covered with occlusive dressings unless directed by a physician. Patients should be monitored for severe skin reactions and systemic symptoms such as flu-like symptoms. Immunocompromised patients may require special consideration and monitoring.

Contraindications

Aldara cream is contraindicated in patients with known hypersensitivity to imiquimod or any component of the formulation. It should not be used in patients with autoimmune diseases or those undergoing immunosuppressive therapy without careful risk-benefit assessment. The medication is not recommended for treatment of urethral, intravaginal, cervical, rectal, or intra-anal human papillomavirus disease. Use during pregnancy is generally contraindicated unless potential benefits justify potential risks to the fetus. Nursing mothers should avoid application to the breast area and consider discontinuing nursing during treatment.

Possible side effect

Local skin reactions are common and may include erythema (70-85% of patients), erosion (25-40%), edema (15-25%), scaling (15-25%), and flaking (10-20%). Application site reactions such as itching, burning, and pain occur frequently. Systemic effects may include fatigue (10%), headache (5-10%), fever (2-5%), myalgia (2-5%), and influenza-like symptoms. Less common reactions include ulceration, scabbing, and skin discoloration. Severe local reactions may require treatment interruption. Most reactions are mild to moderate and resolve within weeks after treatment cessation.

Drug interaction

No formal drug interaction studies have been conducted with Aldara cream. However, concomitant use with other topical medications applied to the same area may increase irritation and should be avoided. The immunostimulatory effects might theoretically interact with other immunomodulators or immunosuppressive agents. Patients using topical corticosteroids concurrently may experience altered response to treatment. No interactions with systemic medications have been reported, but caution is advised when using with other medications that affect immune function.

Missed dose

If a dose is missed, apply it as soon as remembered unless it is nearly time for the next application. Do not apply double the amount to make up for a missed dose. Resume the regular dosing schedule. If multiple doses are missed, contact your healthcare provider for guidance on resuming treatment. Consistent application according to the prescribed schedule is important for optimal efficacy, but occasional missed doses are not typically critical to overall treatment success.

Overdose

Topical overdose may result in severe local skin reactions including intense erythema, edema, and erosion. Systemic absorption following topical application is minimal, making systemic overdose unlikely. If accidental ingestion occurs, gastric lavage and supportive measures may be indicated based on the amount ingested. Medical attention should be sought if significant amounts are ingested or if severe local reactions develop. There is no specific antidote for imiquimod overdose.

Storage

Store Aldara cream in the refrigerator between 2°C and 8°C (36°F-46°F). Do not freeze. Keep in the original container tightly closed. The medication may be temporarily stored at room temperature up to 25°C (77°F) for periods not exceeding two months. Protect from light. Keep out of reach of children and pets. Discard any unused medication after the treatment course is completed or after the expiration date printed on the packaging.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Aldara cream is a prescription medication that should be used only under the supervision of a qualified healthcare professional. Individual results may vary, and not all patients will experience the same outcomes. Always follow your healthcare provider’s instructions regarding use, dosage, and treatment duration. Report any adverse reactions to your physician promptly.

Reviews

Clinical studies demonstrate patient satisfaction rates of 70-80% with Aldara cream treatment. Many patients appreciate the non-invasive nature of the therapy compared to surgical options. Dermatologists report favorable outcomes with appropriate patient selection and management of expected skin reactions. Some patients note that the local skin reactions can be significant but generally manageable with proper guidance. Long-term follow-up studies show sustained clearance rates for many patients, particularly when treatment protocols are followed completely under medical supervision.