Imiquimod for basal cell carcinoma: what to know

Basal cell carcinoma is a common skin cancer that can appear as a pearly bump, a scaly patch or a sore that repeatedly crusts. Imiquimod works through a local immune response rather than physically removing the lesion. It is not appropriate for every BCC: depth, subtype, size, site and recurrence history affect the choice. Surgery or another treatment may be safer when a lesion is deeper, high-risk or in a sensitive location.

Follow the prescribed schedule precisely and apply the cream to the marked area, not to nearby normal skin. Wash hands after use and protect the area from unnecessary sun exposure. Redness, swelling, crusting and tenderness can develop during treatment. Do not pick crusts or apply steroid, antibiotic or cosmetic products unless the treating clinician approves them. Attend the planned review even if the surface looks improved, because appearance alone cannot confirm clearance.

Tell your clinician about severe pain, extensive ulceration, bleeding that does not settle with gentle pressure, or a reaction extending well outside the marked area. Get urgent help for breathing difficulty, sudden facial swelling, confusion or fever with rapidly worsening redness and pain.

Ask whether the biopsy identifies a superficial BCC, why imiquimod is preferred for your site, how the treatment area was defined, when follow-up will occur, and what happens if residual tumour is suspected. Ask how to manage irritation without masking a concerning change.