Currently imiquimod (Aldara) is only FDA approved for superficial basal skin cancers less than 2 cm in diameter and not on the hands or face. The efficacy of imiquimod for treating these small thin skin cancers is 75-80 %. Imiquimod is not FDA approved for treatment of nodular, sclerosing, and certain other types of basal cell skin cancers or for the treatment of basal cell skin cancer on the face, hands, or feet.
The National Cancer Institute states: “Superficial basal cell carcinoma is usually treated by surgical removal. Imiquimod should be used for treatment of sBCC only when surgery is medically less appropriate, because the chances of effectively treating sBCC are generally greater with surgery. Patients treated with imiquimod for sBCC should have regular follow-up visits after treatment to make sure the skin cancer is completely treated.”
Our practice does not prescribe Aldara and if you wish to consider this option, please review the pros and cons carefully with your primacy care physician or dermatologist. If you have previously been treated with Aldara and your skin cancer has recurred, we recommend that you schedule an in-person office visit prior to scheduling surgery. Recurrences following Aldara can be deceptively extensive as the Aldara may only eliminate the superficial portion of the cancer while the remaining cancer spreads beneath the surface of the skin. For this reason, we advise against trying to schedule excision by uploading photos to our website.