Patient Instructions for Aldara (Imiquimod) Treatment of Genital Warts
Imiquimod 5% cream should be applied with a finger at bedtime, three times a week for up to 16 weeks, with the treatment area washed with mild soap and water 6-10 hours after application. 1, 2
Application Instructions
- Apply Aldara (imiquimod) 5% cream with a clean finger at bedtime, only on the days prescribed (three times per week) 1, 2
- Only apply to external genital warts - avoid internal application 2
- Wash the treatment area with mild soap and water 6-10 hours after application (typically in the morning) 1, 2
- Continue treatment until warts are completely cleared or for a maximum of 16 weeks 2
- Many patients see clearance of warts by 8-10 weeks or sooner 1
Special Considerations
- If possible, have your healthcare provider apply the first treatment to demonstrate proper technique and identify which warts should be treated 1
- Female patients should take special care when applying cream near the vaginal opening, as local skin reactions on delicate moist surfaces can cause pain, swelling, or urinary difficulties 2
- Uncircumcised males treating warts under the foreskin should retract the foreskin and clean the area daily 2, 3
- Avoid sexual contact (genital, anal, oral) while the cream is on the skin 2
- Imiquimod may weaken condoms and vaginal diaphragms, so concurrent use is not recommended 2
Expected Side Effects
- Local skin reactions are common and typically mild to moderate 2, 4
- You may experience redness (erythema), irritation, burning, itching, erosion, and flaking at the application site 2, 4, 5
- These reactions are normal and indicate the medication is working by stimulating your immune system 4, 6
- Some patients may experience flu-like symptoms including malaise, fever, nausea, muscle aches, and rigors 2
When to Contact Your Healthcare Provider
- If skin reactions become severe or intolerable 2
- If you experience any signs or symptoms at the application site that restrict daily activities 2
- If you have difficulty passing urine (especially for female patients) 2
- If new warts develop during therapy (imiquimod is not a cure but a treatment) 2
Important Notes
- Imiquimod works by stimulating your immune system to fight the virus causing the warts 4, 6
- Complete clearance occurs in approximately 37-50% of patients using the recommended regimen 4
- Recurrence of warts after successful treatment occurs in about 13-19% of patients 4, 5
- The safety of imiquimod during pregnancy has not been established 1
- Localized hypopigmentation (lightening) or hyperpigmentation (darkening) of the skin may occur and could be permanent in some patients 2
Follow-up
- While routine follow-up visits are not required for self-administered therapy, a follow-up visit after several weeks of treatment can help assess your response and address any concerns 1
- If warts have not improved substantially after 8 weeks, consult your healthcare provider about possibly changing treatment approaches 1