Aldara Skin Cancer Treatment: A Patient’s Perspective

This pictorial chronicles a course of Aldara cream 5% (Imiquimod) to my face and nose to remove precancerous lesions (solar keratosis) and superficial basal cell carcinomas (BCC). The treatment is the prelude to further Mohs surgery to remove a biopsy confirmed superficial multifocal BCC and a 0.4 mm thick micronodular BCC to the upper left side of my nose.

Why bare my soul and skin here?

Becoming a near total recluse during this treatment I put my mind to good use by putting this together. It is not my intention to upset but to educate, especially when so many are unaware of the physical changes that occur as a result of Aldara cream skin cancer treatment. Formulating this has also helped take my mind off the treatment and my almost shaved head.

Why Aldara?

1. Best approach for my extensive facial skin lesions
2. Recommended by my treating doctor (Mohs surgeon and Dermatologist)

What’s Aldara?

Aldara is an immune response modifier – that is, it works by stimulating the immune system to treat certain diseases of the skin, such as skin cancer. The subsequent inflammation, as you can see in the pictures below, is a sure sign that Aldara is doing its job of destroying skin lesions.

An added benefit of Aldara treatment is that skin lesions not visible to the eye become visible and treated at the same time as the visible skin lesions.

Aldara application instructions

Once daily, except for rest days, an amount of Aldara the size of a pinhead was gently rubbed into a section of skin with a clean fingertip. Being careful not to go over areas already covered, this was repeated until all sections of my face and nose had absorbed the thin film of cream. All of this was done before going to bed and washed off ten hours later.

Please note: These instructions are specifically for me, as Aldara treatments can vary depending on the condition, patient and doctor.

	My Aldara cream application regime
	Weeks	Mon	Tue	Wed	Thu	Fri	Sat	Sun
Face	4	yes	no	yes	no	yes	no	no
Nose	6	yes	yes	yes	yes	yes	no	no
	Tue & Thu – add extra to nose

	Amount of Aldara cream 5% (Imiquimod) used
Face & nose days	Entire contents of one 250mg sachet
Nose only days	Pinhead amount

On a side note spreading that extremely small amount of Aldara about was a hard task, but not as hard as winning The Ashes (Test cricket series played between England and Australia) which we lost just recently.

Face and nose Aldara treatment phases

Week 2	Week 2	Week 2

Face and nose skin reaction due to two weeks of Aldara treatment

Week 2 + 5 days rest	Week 2 + 5 days rest	Week 2 + 5 days rest

Face and nose treatment suspended to allow skin to rest

Week 4	Week 4	Week 4

Severe facial skin reaction to Aldara by the end of the four week face treatment. Note the extreme inflammation and swelling to my face, nose, lower jowls and throat.

Week 4 + 7 rest days	Week 4 + 7 rest days	Week 4 + 7 rest days

Marked improvement after resting with only red blotchy skin, moderate facial swelling and minor sores on face.

Nose - Week 2	Nose - Week 4	Nose – Week 5

Progressive nasal reaction to Aldara and rest
Final two weeks of Aldara treatment commenced week five but not yet completed.

Image thumbnails – Click to enlarge
All images copyrighted to me – permission needed to publish and link back required

I was advised at the end of week four that if the swelling increased I was to attend my local doctor or hospital. Thank heavens it didn’t come to that. Valium (diazepam), my wife’s tendering loving care, staying indoors, Nurofen Plus, Panadol, sleeping tablets, writing and photographing local wildlife here and there and everywhere helped take the edge off the pain and discomfort.

Superficial multifocal and micronodular basal cell carcinomas

Insert revealing a biopsy confirmed superficial multifocal basal cell carcinoma
and a 0.4 mm thick micronodular Basal cell carcinoma to my nose (reference)

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Mohs surgery to remove both nasal basal cell carcinomas is expected to take place late March, although I believe this could be put back until my nose heals well enough for surgery.

Further updates will be forthcoming once my face and nose have fully recovered from the Aldara treatment. I will also be posting an article on my Mohs surgery.

One last thing, my Fujifilm FinePix S8000fd digital camera died so I’ll have to resort to using my father’s Box Brownie for future posts.

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To our friends in New Zealand, especially Christchurch, our prayers and thoughts are with you during your time of grief and despair as a result of the recent earthquake.

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Check out my personal articles on:
Skin Cancer Nose No Boundaries	Melanoma - The Silent Killer	Skin Cancer Nose No Boundaries - Part II
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