An effective treatment option

First-line topical therapy for HPV

Imiquimod, Aldara, ZyclaraApproved by the FDA in 1997, Imiquimod is a prescription medication for the treatment of anogenital warts.  It is also used in the treatment of Actinic Keratosis and early stages of Basal cell carcinoma.

Available as a cream, imiquimod is an acceptable and effective alternative to other common treatment options for HPV genital warts, including cryotherapy.

Along with podophyllotoxin, imiquimod is currently the first-line option for topical treatment of genital warts.  Both of these medications can be applied by patients themselves in the comfort of their home.

One major benefit of Aldara and Zyclara is that the medication can be applied at home by the patient.  There is no need for visits at a medical facility.

It is usually applied at bedtime and washed off in the morning, 2-5 times a week for up to 16 weeks

The medication does not have a direct effect on the warts, rather it acts as an immune system modulator that stimulates the immune system to fight HPV.

Available in 2%, 3.75% and 5% dosing strengths.  The 3.75% cream is preferred by most clinicians due to better results than the 2% dose and fewer side effects than the 5% concentration.

Not a cure

It is important to realize that imiquimod only treats the genital warts.  It does not cure HPV infection.

What to expect…

Imiquimod is effective in about 50% of patients with genital warts (1).

When you begin therapy, you may feel intense itching for a few days.  This, however, tends to go away with time.

You may also experience skin burning, which may become severe with subsequent applications of the drug.

Warts tend to disappear within the first 30 days of therapy.

Successfully treated warts tend to recur in about 30-40% cases (2). This recurrence rate is still considered better than that associated with other treatment options.

Success rate

Imiquimod does not work for everyone.  Best results are seen in individuals with HPV types 6 and 11.

Success of therapy depends largely on the type of HPV that a person is infected with (3):

  • HPV-6: 76%
  • HPV-11: 67%
  • HPV 6 and 11: 35%
  • Other unclassified HPV types: 6%

Common side-effects

  • Skin redness
  • Itching
  • Skin eruptions or ulcerations
  • Dispigmentation or hyperpigmentation

Other things to consider

Imiquimod cream may weaken latex barrier devices, such as condoms and diaphragms (4).

Imiquimod is a prescription medication.  You should not self-medicate without your doctor knowledge.

There is some evidence suggesting that removal or reduction in the number of genital warts through therapy may make a person less prone to infecting others.  It does not, however, completely eliminate the risk of passing on the infection to others (5).

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