5FU (Efudix) and Imiquimod (Aldara) Creams Imiquimod

Summary

Both 5FU (Efudix) and Imiquimod (Aldara) Creams destroy sun damaged cells. 5 F-U cream is mainly used to treat solar keratoses and imiquimod cream to treat flat basal cell carcinomas.

What are the advantages of 5FU (Efudix) and Imiquimod (Aldara) Creams ?

They can be used at home and leave a good cosmetic result.

What are the disadvantages of 5FU (Efudix) and Imiquimod (Aldara) Creams ?

They are both powerful destructive medicines that cause the treated skin to become red, sore and weepy for several weeks and sometimes even cause skin ulceration and bleeding. The cure rate is lower than that of surgical procedures.

Which areas respond best to 5FU (Efudix) and Imiquimod (Aldara) Creams ?

5FU (Efudix) cream works best on the face and scalp and rather poorly on other body sites. Imiquimod cream works well everywhere but can cause such severe and prolonged irritation and weeping and so can be unpleasant to use on the face. Both treatments work well on single areas of Bowen's disease on the leg but strangely less well if there are multiple areas.

Are 5FU (Efudix) and Imiquimod (Aldara) Creams safe?

Yes, both treatments are safe but imiquimod cream may cause some side-effects that are not confined to the skin.

Do 5FU (Efudix) and Imiquimod (Aldara) Creams hurt?

Both treatments produce soreness but occasionally imiquimod causes pain.

How should I prepare to use 5FU (Efudix) and Imiquimod (Aldara) Creams ?

No particular preparation is needed for either treatment. Occasionally, when using 5-FU on the forearms, hands or legs, pre-treatment for two weeks with tretinoin is needed.

What is involved during 5FU (Efudix) and Imiquimod (Aldara) Cream treatment?

5FU (Efudix) cream is usually applied twice a day until the treated area begins to weep. Treatment is then stopped and it takes six to eight weeks for the skin to settle and turn white again. 5-FU should be rubbed into all of the treatment areas with a fingertip. It is important to apply it to all the skin and not just visible lesions. Afterwards rinse the finger thoroughly with water.

Imiquimod cream comes in sachets. Pierce the sachet and squeeze out a small blob of cream onto your finger and apply it to the area that requires treatment. Then seal the sachet with a paper clip and put it in a cool place.

When treating a flat basal cell carcinoma, apply the imiquimod cream five times a week for six weeks.

Is there any important after care after using 5FU (Efudix) and Imiquimod (Aldara) Creams?

Once treatment has finished, apply sunscreen to any exposed treated areas daily for a few weeks.

How many treatments with 5FU (Efudix) and Imiquimod (Aldara) Creams will I need?

If treating solar keratoses, the treatment will probably need to be repeated after a few years.

What side-effects do 5FU (Efudix) and Imiquimod (Aldara) Creams produce?

Both 5-FU and imiquimod cream produce redness, and swelling at the treatment site. This is followed by ulceration, weeping and crusting and sometimes bleeding. Occasionally, 5-FU will produce a severe eczema or the treatment site will become infected.

Imiquimod cream will occasionally produce mild as fever, fatigue, headache, nausea, diarrhoea and muscle pain.

Who shouldn't use 5FU (Efudix) and Imiquimod (Aldara) Creams?

Neither cream should be used during pregnancy or breastfeeding.