Aldara (Imiquimod) Topical: Uses, Side Effects, Dosage

What Is Aldara?

Aldara (imiquimod) is a prescription topical cream that works as an immunomodulator. As an immunomodulator, Adlara treats certain skin diseases by stimulating the immune system.

Imiquimod is also available under the brand name Zyclara.

Drug Facts

Generic Name: Imiquimod

Brand Name(s): Aldara, Zyclara

Drug Availability: Prescription

Therapeutic Classification: Immune modulator

Available Generically: Yes

Controlled Substance: N/A

Administration Route: Topical

Active Ingredient: Imiquimod

Dosage Form(s): Cream

What Is Aldara Used For?

The Food and Drug Administration (FDA) has approved Aldara to treat:

Actinic keratosis, also called solar keratosis, on the face and scalp in adults
Condyloma acuminata (external genital warts) around the genital or anal area in patients 12 years of age or older
Small superficial basal cell carcinoma (a certain kind of skin cancer), when surgery is not the best option

Aldara (Imiquimod) Drug Information - Illustration by Zoe Hansen — Verywell / Zoe Hansen

How to Use Aldara

Use Aldara exactly as prescribed by your healthcare provider. The dosing schedule depends on what you are using it for (see Dosage section).

To apply, rub the cream into the treatment area until the cream is no longer visible. Don’t put a bandage over the treatment area. It is a good idea to wash your hands before and after applying the cream.

Apply Aldara before your regular sleeping hours. Leave it on for about eight hours for basal cell carcinoma or actinic keratosis and about six to 10 hours for genital warts. After that, wash off the cream with mild soap and water.

Aldara should only be used for external genital warts. You should keep the cream from coming into contact with your eyes, lips, or nostrils.

Storage

Aldara comes in single-use packets. Throw away any unused or partially used packets. Do not reuse a partially used packet. Store at temperatures between 39 F and 77 F, and do not freeze.

Off-Label Uses

Your healthcare provider may prescribe this medication off-label for conditions not specifically mentioned in the product label.

Potential off-label uses for Aldara include common skin warts and herpes-simplex infection that is resistant to acyclovir, the usual therapy.

How Long Does Aldara Take to Work?

For external genital warts, it usually takes eight to 10 weeks for warts to disappear with Aldara use, but they may clear as early as four weeks.

For actinic keratosis, it usually takes four weeks of applying Aldara to work. However, although lesions will resolve during treatment, new lesions may develop.

For superficial basal cell carcinoma, Aldara treatment typically lasts for six weeks.

What Are the Side Effects of Aldara?

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Some people may experience side effects from using Aldara. Talk to your healthcare provider about any reactions you may have and seek medical attention if your symptoms are severe.

Common Side Effects

Skin reactions at the treatment area are common and may include skin redness, burning, itching, flaking, scaling, or ulceration. Let your healthcare provider know if you have a reaction.

Less commonly, people have reported flu-like symptoms associated with imiquimod. These may accompany skin reactions.

You may be more susceptible to sunburns while using Aldara. Be careful about sun exposure (including tanning beds and sunlamps). Wear sunscreen and protective clothing while you are on treatment.

Severe Side Effects

Skin reactions can sometimes be severe. In women, a skin reaction on the vulva can lead to severe swelling, which can cause difficulties with urination. Seek medical attention if you have a severe reaction to Aldara.

Report Side Effects

Aldara may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

(800) 332-1088

Dosage: How Much Aldara Should I Use?

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For topical dosage form (cream):
- For actinic keratosis:
  - Adults—If you use Zyclara®, apply a thin film to the affected area of skin once a day at bedtime for 2 weeks. Your doctor will repeat the treatment after you go 2 weeks without medicine. If you use Aldara®, apply a thin film to the affected area of skin once a day at bedtime 2 times per week for 16 weeks. Your doctor will tell you which days are best during the week.
  - Children—Use and dose must be determined by your doctor.
- For skin cancer:
  - Adults—Apply a thin film to the affected area of skin once a day at bedtime 5 times per week for 6 weeks. Your doctor will tell you which days are best during the week.
  - Children—Use and dose must be determined by your doctor.
- For external warts:
  - Adults and children 12 years of age and older—If you use Zyclara®, apply a thin film to the wart once a day at bedtime for up to 8 weeks or until the wart is gone. If you use Aldara®, apply a thin film to the wart once a day at bedtime 3 times per week. Your doctor will tell you which days are best during the week. Use the medicine until the wart is gone, but for no longer than 16 weeks.
  - Children younger than 12 years of age—Use and dose must be determined by your doctor.

Modifications

If you have a skin reaction, your healthcare provider may recommend changing your dose of imiquimod or stopping treatment.

Other reasons to interrupt or modify therapy include flu-like symptoms, vulvar swelling, or sunburns. Talk to your provider if you are especially sun-sensitive, or if your job requires significant sun exposure, as you may need to be particularly cautious when using imiquimod.

Missed Dose

If you forget a dose, you can apply your dose the following day before bedtime. If it is nearly time for your next dose, skip the missed dose. Don’t double your dose to make up for a missed dose. In general, the treatment period should not be prolonged to make up for a missed dose.

Overdose: What Happens If I Use Too Much Aldara?

Call your healthcare provider or get medical help if you accidentally apply too much Aldara cream, since too much can increase your risk for skin reactions.

What Happens If I Overdose on Aldara?

If you think you or someone else may have overdosed on Aldara (imiquimod), call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after using imiquimod, call 911 immediately.

911

Precautions

It is very important that your doctor check the progress of you or your child at regular visits for any unwanted effects that may be caused by this medicine.

Stop using this medicine and check with your doctor right away if you or your child have a skin rash, burning, pain, redness, swelling, bleeding, oozing, scabbing, or peeling on the skin where the medicine was applied.

Stop using this medicine and check with your doctor right away if you have severe swelling near the opening of the vagina. This may cause painful urination, trouble in passing urine, or not able to urinate.

Stop using this medicine and check with your doctor right away if you or your child have severe skin irritation or flu-like symptoms, such as diarrhea, fever, chills, headache, nausea, muscle or joint pain, or unusual tiredness or weakness.

Avoid exposing your skin to sunlight, sunlamps, or tanning beds while you are using this medicine. Always use sunscreen or sun-blocking lotions and wear protective clothing and hats.

If you are being treated for external warts, avoid having genital, oral, or anal sex while the medicine is on your skin. Make sure you wash the cream off your skin before you engage in any sexual activity. The medicine contains oils that can weaken latex (rubber) condoms and diaphragms, which will prevent them from working properly.

Imiquimod is not a cure for genital warts. New warts may develop while you are using the cream. Imiquimod will also not keep you from spreading genital warts to other people.

Do not use cosmetics or any other skin care products on the treated areas, unless directed to do so by your doctor.

What Are Reasons I Shouldn’t Take Aldara?

You should not use Aldara if you are allergic to imiquimod or some other component of the cream.

Information is limited on whether Aldara is safe to use during pregnancy, and it may be best to avoid treatment with this medication if pregnant. Let your healthcare provider know if you are breastfeeding, since it is unknown whether imiquimod gets into breast milk.

What Other Medications Interact With Aldara?

There are no known significant drug interactions with Aldara. Make sure your prescribing health provider is aware of all the medications and supplements that you are taking.

Let your provider know if you are undergoing photodynamic therapy (a type of light therapy) for a skin condition since Aldara can make you light-sensitive.

What Medications Are Similar?

Imiquimod is also available under the brand name Zyclara, which contains a different concentration of imiquimod (3.75%) than Aldara (5%). Topical fluorouracil cream (available as Efudex) is another class of drug which may also be used to treat actinic keratosis.

Other topical drugs which may be used to treat genital warts include podophyllotoxin (also known as Condylox or podofilox) and sinecatechin (sold as Veregen in the United States).

Frequently Asked Questions

What is Aldara used for?

Aldara comes as a topical cream and works as an immunomodulator. That means that it stimulates your immune system to help treat certain skin conditions. Aldara is currently approved to treat actinic keratosis, genital warts, and some limited forms of basal cell carcinoma, a type of skin cancer.
What are the side effects of Aldara?

Aldara (imiquimod) can cause local skin reactions like redness, itching, or burning. The skin reactions can be severe and may require a dose adjustment or interruption of therapy. Tell your healthcare provider if you get a skin reaction related to Aldara.

Aldara may make your skin sun-sensitive, so use sunscreen and wear protective clothing to prevent sunburns. Some patients experience flu-like symptoms with Aldara, though this is less common.

How Can I Stay Healthy While Taking Aldara?

Aldara (imiquimod) is a safe and convenient method to treat actinic keratosis, external genital warts, and limited forms of basal cell carcinoma (a type of skin cancer).

Make sure you use the medication as prescribed. Use sunscreen and protective clothing, as Aldara can increase your sun sensitivity. As always, when you are prescribed a new medication, make sure your healthcare provider knows what other medications, supplements, and therapies you are taking.

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Food and Drug Administration. Aldara label.
UpToDate. Treatment of Actinic Keratosis. UpToDate.
UpToDate. Condylomata acuminata (anogenital warts): Management of external condylomata acuminata in men.
UpToDate. Imiquimod: Drug Information.
Inova Pharmaceuticals. Aldara Cream 5%.

By Rony Kampalath, MD
Rony Kampalath, MD, is board-certified in diagnostic radiology and previously worked as a primary care physician. He is an assistant professor at the University of California at Irvine Medical Center, where he also practices. Within the practice of radiology, he specializes in abdominal imaging.

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Aldara (Imiquimod) – Topical