Aldara for non-melanoma skin cancer

Basal cell carcinoma is the most common type of skin cancer worldwide and one of the most curable if treated early.Common treatments include electro-drying and curettage (cautery and curettage of the lesion), surgical excision, and Mohs surgery (a precision surgical technique).

Another form of treatment, called Aldara (imiquimod) topical cream, was approved by the U.S. Food and Drug Administration in 2004 for the treatment of superficial basal cell carcinoma (sBCC). It works by gently peeling away the lesions and can also be used to treat actinic keratosis (solar keratosis) and genital warts.

Indications for use

Aldara cream is the only topical formulation used to treat SBCC in adults with normal immune systems. Recommended when other removal methods are not suitable (eg, multiple lesions on the face). Aldara activates the immune system to produce a protein called interferon-alpha to directly attack cancer cells.

Premarketing studies showed that Aldara was able to clear sBCC in 75% of treated individuals; in comparison, placebo cleared only 2% of treated sBCC. Nearly 80 percent of patients who were successfully treated with Aldara remained cancer-free two years later.

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While research is still ongoing, research suggests that Aldara may be effective in treating early-stage melanoma, also known as melanoma in situ, if no other surgical option is available.

Treatment Precautions

Aldara isn’t for everyone. Tell your healthcare provider if you are taking other forms of treatment for SBCC, actinic keratosis, genital warts, or any other skin condition. If so, it is recommended that you wait until your current treatment is complete and your skin has healed before starting Aldara.

Aldara may also worsen certain inflammatory skin conditions, such as psoriasis.

It is not known whether Aldara can harm the fetus during pregnancy or pass it to the baby through breast milk. If you are pregnant or planning to become pregnant, discuss the benefits and potential consequences of Aldara with your healthcare provider.


Aldara is for use on the skin only, never in or near the eyes, lips, nostrils or open wounds.

Aldara is usually used only once a day, five days a week. It should stay on the skin for eight hours or overnight. Do not cover the treated area with a bandage or other occlusive dressing. After eight hours, wash affected skin with mild soap and water.

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Treatment should continue for the full six weeks. Continue to use Aldara even if the basal cell lesions disappear, unless otherwise instructed by your dermatologist.

drug side effects

The most common side effect of Aldara is local skin reactions, which account for about one-third of all cases. Skin disease symptoms may include:

  • redness
  • swelling
  • pain, blisters, or ulcers
  • thickening or hardening of the skin
  • changes in skin color
  • peeling skin
  • scabs and scabs
  • itching and/or burning

The area being treated may look worse before it gets better. Avoid sunlight (or sunlamps) as this may make symptoms worse. When outdoors, cover affected areas with protective clothing or hats. In some cases, any changes in skin color or texture may be permanent.

Other potential side effects include headache, back pain, muscle aches, tiredness, fever, swollen lymph nodes, diarrhea, and fungal infections.

Contact your healthcare provider right away if you have a severe skin reaction, flu-like symptoms, or ulcers that begin during the first week of treatment.

In rare cases, patients may not respond to Aldara; this may indicate that the drug is not working for them. Patients should contact their doctor if they do not respond after using Aldara for one week.

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Frequently Asked Questions

  • Is there any indication that Aldara is working?

    There are some signs that Aldara is working. Watch how your skin reacts to the cream; sometimes it causes redness, burning, itching, swelling, and tenderness, which then scabs and peels as the skin heals. If a person does not exhibit these reactions after following the directions for the cream, the cream may not be effective for them.

  • How does imiquimod work?

    Imiquimod (Aldara) is used as a topical cream by stripping lesions that arise from superficial basal cell carcinoma. It also boosts the body’s immune system to help remove these lesions as well as genital and anal warts.

  • How long does imiquimod take to work?

    Working hours for imiquimod (Aldara) will vary. Even if the lesions disappear before treatment is complete, in many cases, imiquimod should be continued throughout the six-week period, or unless otherwise instructed by the dermatologist.