Zyclara
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Reviewed on Oct 05, 2023. by Dr Alexandra Cristina Cowell Writer & Clinical Content Reviewer Next review due on October 06, 2026.
Dr Alexandra Cristina Cowell

Last updated on Oct 05, 2023.

Product info

  • Zyclara 3.75% cream treats actinic keratosis by stimulating immune responses.

  • It activates the immune system to destroy damaged cells and prevent cancer progression.
  • Apply Zyclara nightly for two weeks, rest two weeks, then repeat for six weeks.
  • et it the next working day.

Zyclara Imiquimod

What is Zyclara?

Zyclara 3.75% cream is a treatment for actinic keratosis. It contains the active ingredient imiquimod, which stimulates your immune system to clear your symptoms. Actinic keratosis (also called solar keratosis) is a skin condition that’s identified by dry, scaly patches of skin, often caused by sun damage. The patches can be rough, itchy, and range in colour. Although most of the time it’s not serious, continued exposure to the sun can lead to skin cancer, so it should be treated early on. [1]

How does Zyclara work?

Zyclara’s active ingredient, imiquimod, is an immune response modifier. This means it activates your immune system and induces a response. This response kills the damaged cells and promotes anti-tumour activity, helping to prevent the condition from becoming cancerous. [2]

What doses of Zyclara are there?

There’s only one dose of Zyclara available: 3.75%, which comes in individual sachets with 250mg of cream. The clinician will recommend the dosage, with the maximum being two sachets per application. If this dosage isn’t working for you though, let our clinician know. They’ll discuss future options with you.

Treated trusted sources:

  1. National Health Service (2023). Actinic keratoses.
  2. anda J, Bermudez R. Imiquimod. [Updated 2022 Jul 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
treated.com This page was written by The Treated Content Team.
Dr Alexandra Cristina Cowell 1218322
This page was medically reviewed by Dr Alexandra Cristina Cowell on October 06, 2023. Next review due on October 06, 2026.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

Zyclara Imiquimod

How to apply Zyclara

Always follow your clinician’s advice when applying Zyclara.

  • Apply the cream before going to bed.
  • Wash both your hands and the affected area with mild soap and water. Then allow them to dry.
  • Open a new sachet and squeeze it onto your fingertips. Don’t use more than two sachets in a single application.
  • Apply a thin layer to the affected area and rub gently until it’s absorbed. Try to avoid contact with your eyes, lips and nostrils.
  • After application, wash your hands with soap and water again.
  • Leave Zyclara on your skin for eight hours. During this time, don’t shower or wash the affected area.
  • After eight hours have passed, wash the affected area with soap and water.

How long do I have to use Zyclara?

Zyclara is used in two-week periods for a total of six weeks. The treatment starts with a daily application for two weeks, followed by a rest period of two weeks. It then continues with another two weeks of daily application. After this, the treatment ends.

If your actinic keratosis does come back, it can be treated again with Zyclara for two more cycles. However, between the two cycles, there should be a 12-week treatment pause.

It’s important to note that your symptoms may become more visible or prominent at the beginning of your treatment. This is because Zyclara ‘unmasks’ previously hidden scars before treating them. So don’t worry if you notice this, it’s a normal part of the treatment which actually means it’s working properly.

What if I make a mistake while using Zyclara?

If you accidentally use too much cream on the affected area, wash away the excess with soap and water. If you forget to apply a dose, wait until the next night to apply it. Don’t apply it more than once a day. If you have leftover sachets after the two weeks, don’t use them, Zyclara shouldn’t be continued after this period.

treated.com This page was written by The Treated Content Team.
Dr Alexandra Cristina Cowell 1218322
This page was medically reviewed by Dr Alexandra Cristina Cowell on October 06, 2023. Next review due on October 06, 2026.

How we source info.

When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.

Zyclara Imiquimod

Zyclara isn’t suitable for everyone, and there are some things that you need to be aware of when using it.

Here’s all the official info on it. If anything is unclear, let our clinician know, and they can talk with you about it.

Zyclara Imiquimod

FAQ: Zyclara

Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.

What are the side effects of Zyclara?

Answer:
Like all medicines, Zyclara can cause side effects that can affect some people.

Common side effects include:

  • Local skin reactions such as redness, scabbing, scaling, dryness, swelling, ulcers and reduced pigmentation on the application site

  • Headaches, dizziness

  • Loss of appetite

  • Swollen glands

  • Diarrhoea, vomiting or nausea

  • Flu-like symptoms including fevers

  • Muscle and joint pain

  • Chest pain

  • Insomnia

  • Tiredness

  • Viral infections

  • Increase in blood glucose levels


For more information on side effects, please check the patient leaflet.

How effective is Zyclara?

Answer:
In a 2019 study, 15 patients received 3.75% imiquimod cream for their actinic keratosis, with each patient consistently using imiquimod for two weeks, followed by a two-week rest period before another two weeks of treatment. The results were analysed at the eight-week mark.

By the end of the eight weeks, all 15 patients had an average lesion (scar) reduction of 87%.[1] The study also noted that there was a 16% increase in lesions during the start of the treatment. This is because imiquimod unmasks lesions that are invisible to the naked eye before treating them.[1] So if you notice that your symptoms seem to be worsening when you start using Zyclara, don’t worry. This is a normal part of the treatment, which shows that it’s working properly.

The study also shared similar findings to a 2010 study that consisted of 160 patients. The patients who used imiquimod had an 82% reduction in lesions by the end of the eight weeks. [2]

How is Zyclara different from other treatments for actinic keratosis?

Answer:
There are other treatments available for actinic keratosis, such as Aldara, Efudix and Solaraze.

Aldara contains the same active ingredient as Zyclara, but at a 5% strength. So although they both work in a similar way, Aldara has been shown to cause more severe side effects. [3]

In addition, other topical treatments like Efudix and Solaraze contain different active ingredients and are used differently. Zyclara is only used for the face and balding scalp, so if you have symptoms in another area, a treatment like Efudix is more suitable.

Depending on the grade and area affected, our clinicians will help decide what's best for you. And if one treatment isn’t suitable for you, there are alternatives you can try.

Can I use Zyclara when I’m pregnant?

Answer:
If you’re pregnant or planning to have a baby, let our clinicians know and they’ll advise you on what to do. If you’re breastfeeding or plan to breastfeed, don't use Zyclara unless told otherwise.

Is Zyclara only available with a prescription?

Answer:
Yes, Zyclara is only available with a prescription. That’s because it’s not safe for everyone to use, and a clinician will need to tell you how to use it safely.

Treated trusted sources:

  1. Befon, A., Tzanetakou, V., Panagiotopoulos, A., Chasapi, V., Antoniou, C., & Stratigos, A. J. (2019). Imiquimod 3.75% for field‐directed therapy of actinic keratosis: Results of a prospective case‐series study in Greece. International Journal of Dermatology, 58(9), 1040-1044
  2. Swanson N, Abramovits W, Berman B, et al Imiquimod 2.5% and 3.75% for the treatment of actinic keratoses: results of two placebo‐controlled studies of daily application to the face and balding scalp for two 2‐week cycles. J Am Acad Dermatol 2010; 62: 582–590.
  3. Shoimer I, Rosen N, Muhn C. Current management of actinic keratoses. Skin Therapy Lett 2010; 15: 5–7.

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