Imiquimod is a topical cream used in the treatment of genital warts. It works by summoning the immune cells to attack abnormal growths, such as warts. Imiquimod can also be used off-label to treat other types of warts and herpes that is resistant to the antiviral drug, Acyclovir.
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Written by Dr Kim Langdon, MD
Information last reviewed 06/21/19
Imiquimod is a topical cream that is used to treat external genital warts in people over the age of 12. Imiquimod can be used to fight the warts, but it doesn’t cure the underlying virus that causes the warts. You apply Imiquimod cream at night and it helps to encourage the immune cells to attack the warts.
Imiquimod works by stimulating the immune system to identify abnormal cells. This produces inflammation and encourages the immune system to combat genital warts.
Imiquimod works by helping the immune system to identify abnormal cells. Therefore, Imiquimod can be used for genital warts, actinic keratosis and basal cell carcinoma (an early form of skin cancer).
Imiquimod is designed for external use only. Before applying Imiquimod topical, wash your hands and the area of skin to be treated. Allow to dry. To treat genital warts, see the following instructions:
Note: Do not use Imiquimod on areas of broken, wounded, or burned skin.
Imiquimod can also be used for other conditions such as Actinic keratosis and superficial basal cell carcinoma. Always follow the instructions provided by the prescribing physician.
Get medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Up to 10% of people experience the following side effects of Imiquimod:
Dermatologic: Localized redness (58% to 100%), including flaking, scaling (18% to 93%) crusted skin ( 4% to 93%), skin scarring (local; 5% to 84%), ulcer ( 4% to 62%)
Infections: Fungal infection (2% to 11%)
Skin: Localized edema (12% to 78%), application site discharge (22% to 51%), local itching (3% to 32%), burning (9% to 26%)
Respiratory: Upper respiratory tract infection (15% to 33%)
Other, less serious side effects include:
2.5% and 3.75% cream: Apply thin layer once daily before bedtime for 2 weeks to the skin of the affected area
5% cream: Apply 2 times per week prior to normal sleeping hours, to a treatment area. Maximum to be prescribed for 16-week
Aldara is usually applied 2 times per week for 16 weeks.
Zyclara is applied daily for 2 weeks followed by 2 weeks without treatment. Use the medicine at night and leave it on for 8 hours. Wash off the medicine in the morning with water and a mild soap.
Superficial basal cell carcinoma:
Usually applied 5 times per week (such as Monday through Friday) for a full 6 weeks. Rub in the cream. Use the medicine at night and leave it on for 8 hours. Wash off the medicine with water and soap.
Imiquimod can interact with a number of other drugs. You should let your doctor know if you are taking any other medication and you should avoid combining Imiquimod with any of the following medications:
There are three main brands of Imiquimod cream and generic Imiquimod is also available. These different brands contain different strengths of Imiquimod are combined with different ingredients.:
Imiquimod is able to treat the wart, but not the underlying cause. Genital warts are caused by types of HPV. Imiquimod will not remove the HPV virus from your body, therefore after using Imiquimod some people will still get new genital warts.
The length of time you need to use Imiquimod for varies between different conditions, however for genital warts, Imiquimod is used as follows:
You may still be contagious whilst using Imiquimod, so it is important to practice safe sex. In addition, a condom may not cover all areas where the Imiquimod has been applied, so you should avoid sex when using Imiquimod, to prevent the cream transferring to your partners skin.
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