Imiquimod (cream)

Sounds like 'im-I-kwi-mod'

Easy-to-read medicine information about Imiquimod cream – what is it, how to use it safely and possible side effects.

Type of medicineAlso called
  • Belongs to a group of medicines known as immune response modifiers or topical immuno-modulators (which means it activates the immune system)
  • Aldara®
  • Apo-imiquimod®

What is imiquimod cream?

  • Imiquimod cream is used to treat skin conditions such as actinic keratoses (also called solar keratoses) and superficial basal cell carcinoma.
  • It belongs to a group of medicines known as immune response modifiers or topical immuno-modulators which works by helping to activate your immune system to fight these abnormal skin growths.
  • Imiquimod cream is also used to treat external genital warts.

How to use imiquimod cream

  • Apply a thin layer of cream to the affected area, and gently rub it in until the cream is absorbed into the skin.
  • Wash your hands thoroughly before and after applying imiquimod cream.
  • How often and for how long you should use imiquimod cream will depend on your skin condition. Imiquimod cream is not usually applied every day but rather a few times a week.   
  • You should usually apply imiquimod cream at night and wash it off in the morning.
  • Cut the top off the sachet or pierce the sachet with a needle and squeeze out a tiny amount of cream onto your fingertip, to apply it to the affected area. 
  • Although the information on the packet states that the sachet is for single use, you could seal it using a paper clip or tape and store in a closed container to prevent the cream drying out. 
  • If you have to apply the cream to a widespread area, it is usually advisable to divide the affected area into smaller areas and to complete treatment in one area before moving on to the next. This will help make the treatment reaction more tolerable. Your doctor will provide further advice about this.
  • Always use your imiquimod cream exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much imiquimod cream to use, how often to use it, and any special instructions.
  • If you forget to apply the cream on your usual day, use it on the next night and then continue with your regular schedule. Never apply the cream more than once a day.

Special instructions

  • You can apply moisturisers and/or make-up as part of your usual skin care routine, after 20 minutes of applying imiquimod cream.
  • Do not apply apply imiquimod cream on broken or sunburnt skin.
  • Take care not to get the cream in your eyes and nostrils or on your lips.
  • Only cover imiquimod cream with a plaster if advised to do so by your doctor, otherwise leave the treated area uncovered. 
  • If using in the genital area wash it off before having sex; imiquimod will also weaken condoms.

Possible side effects

Like all medicines, imiquimod cream can cause unwanted side effects, although not everyone gets them. Often unwanted side effects improve as your body gets used to the new medicine.

Side effectsWhat should I do?
  • Skin redness, itching, and burning
  • Black scabs or ulcers on the skin
  • This is quite common when you first start using imiquimod cream
  • Usually the area will look worse before it gets better
  • Tell your doctor if this becomes very uncomfortable or very sore
  • Flu-like symptoms such as fever, tiredness, muscle aches and pains
  • Feeling unwell
  • Headache

Learn more

The following links provide further information on imiquimod cream:

Medsafe Consumer Information Sheet Aldara 
Imiquimod (Aldara) Patient Information Guide SafeRx, Waitemata DHB
Imiquimod DermNet NZ

Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr J Bycroft. Health Navigator NZ Last reviewed: 21 Oct 2015