Aldara

What is Aldara?

Aldara is a cream you apply to your skin, containing an active ingredient called imiquimod. Aldara cream is widely used to treat various skin conditions like actinic keratosis, pyogenic granuloma, superficial basal cell carcinoma (a type of skin cancer that grows on the top layer of the skin) and genital warts.

Actinic keratosis (also known as solar keratosis) is a skin condition that happens when your skin gets damaged from too much sun exposure. It shows up as rough, scaly patches on your skin, usually in areas that are often exposed to the sun, like your face, scalp, arms, and hands. While it’s not usually serious, it’s still important to get it checked by a doctor. This is because it can sometimes turn into skin cancer if left untreated.^[1]
Pyogenic granuloma is a common, harmless skin overgrowth that can appear as a small, red bump on the skin. It’s usually caused by a minor injury to the skin, such as a cut or a bug bite, or by certain medications like contraceptive pills. Despite its name, pyogenic granuloma is not an infection and doesn’t have pus. It’s usually not a serious condition and doesn’t cause cancer (it’s a benign skin growth) or spread to other people. It doesn’t have any long-term risks either. And while it’s not usually painful, it does often cause oozing and bleeding.^[2]

How does Aldara work for actinic keratosis?

Aldara cream contains an active ingredient called imiquimod. Imiquimod works by boosting your immune system to fight off and destroy the affected skin cells. Within 5 days of starting your treatment, you might experience redness, swelling, burning, itching and tenderness. As your skin heals, you may notice scabs (crusty covers that form on wounds to protect and heal the skin) and flaking (when dry skin peels off in small pieces). These reactions are signs that the medicine is doing its job. If you don’t have any reaction, Aldara is likely not effective for you.

What doses of Aldara are there for actinic keratosis?

There’s only one dosage available for actinic keratosis, which is Aldara cream 5%. Each box of Aldara cream contains either 12 or 24 small sachets made of polyester and aluminium foil for single use. Inside each sachet you’ll find 250mg of a white to slightly yellow cream containing 12.5mg of the active ingredient, imiquimod.

How to use Aldara for actinic keratosis

Here are a few steps to follow when using Aldara cream for actinic keratosis or pyogenic granuloma.

• Before bedtime, wash your hands and the skin area you are about to treat with soap and water. Dry well before the application of the cream.
• Open a new sachet of Aldara cream and squeeze a small amount onto your fingertip.
• Gently apply the cream to the affected area. Rub it in until the cream disappears.
• After applying the cream, discard the opened sachet and wash your hands with soap and water.
• Leave the cream on your skin for at least 8 hours. Avoid showering or bathing during this time.
• After this time has passed, wash the area where the cream was applied using mild soap and water.

To use Aldara cream for genital warts and actinic keratosis, apply it three times a week, for instance on Monday, Wednesday and Friday. Just one sachet is enough to cover an area of around 25 cm2 (about 4 square inches). For other conditions, your prescriber may advise that you use it more or less frequently.

Unless your doctor advises you otherwise, you should continue the treatment for four weeks. Once the four weeks have passed, your doctor will examine your skin. If some of the lesions are still present, you might need an extra four weeks of treatment.

When will Aldara start working?

Aldara typically takes some time to start working for actinic keratosis. Usually, you can expect to see the effects around five days after you begin the treatment, but this depends from person to person. This is when your skin starts to become red, swollen and sensitive at the application site. It might peel, crack, blister and form scabs. You might also feel a burning, itching or stinging sensation. Don’t worry, these are all good signs and they indicate that the medication is doing its job. In fact, the stronger the inflammation, the better the outcome.

What should I do if I make a mistake when using Aldara?

If you happen to apply too much Aldara cream, just wash off the excess with mild soap and water. Once your skin reactions have gone, you can continue with your treatment as usual.

Don’t worry if you happen to miss a dose. Just apply the cream as soon as you remember (if it’s on the same day) and then continue with your regular schedule. But don’t use the cream more than once a day.

If you accidentally swallow Aldara cream, it’s important to contact your doctor immediately and follow their advice. Aldara cream isn’t meant to be taken internally and can cause unwanted effects.