Aldara (Imiquimod) for Genital Warts: How It Works and How to Use It
▶ In short — Aldara cream for warts
Aldara (imiquimod 5% cream) is a prescription treatment for external genital and perianal warts. Rather than destroying wart tissue directly, it works by stimulating your skin's immune system to clear the HPV-infected cells. It's applied three times a week at night and washed off after 6–10 hours, for up to 16 weeks. It works more slowly than Warticon but tends to have a lower recurrence rate.
Part of the Access Doctor Genital Warts guide.
What Is Aldara Used For?
Aldara is the brand name for imiquimod 5% cream. For sexual health, it is licensed to treat external genital and perianal warts — warts on the outside of the genitals and around the anus — caused by the human papillomavirus (HPV). It is one of the two main patient-applied ("cream for genital warts") treatments in the UK, alongside Warticon.
Imiquimod is also used, at different regimens, for certain skin conditions such as actinic keratosis and superficial basal cell carcinoma. This guide covers its use for genital warts. Aldara is not suitable for warts inside the vagina, urethra, cervix or rectum — internal warts must be treated at a sexual health clinic.
Get a first episode confirmed. Several harmless skin conditions can look like genital warts. If this is your first episode, a clinical assessment is recommended to confirm the diagnosis and screen for other STIs before starting treatment at home.
How Does Imiquimod Work?
This is what makes Aldara different from Warticon. Warticon (podophyllotoxin) is a cytotoxic agent — it directly destroys wart tissue. Aldara is an immune-response modifier: it doesn't attack the wart itself. Instead, it prompts the skin's local immune system to produce interferon-alpha and other immune signals that recognise and clear the HPV-infected cells.
Because it recruits your own immune system rather than chemically burning the tissue, imiquimod works more gradually — but that same immune activation is thought to be why it has a lower recurrence rate, making it a common choice for warts that keep coming back after other treatments.
3×
applications per week, at night
6–10 hrs
left on before washing off
16 wks
maximum treatment length
How to Apply Aldara: Step-by-Step
1
Wash and dry the area
Wash the warts and surrounding skin with mild soap and water, and dry thoroughly. Apply at bedtime.
2
Apply a thin layer to the warts
Squeeze out a small amount and rub a thin layer into each wart until the cream disappears. Use only enough to cover the warts — not the healthy skin around them.
3
Wash your hands
Wash your hands thoroughly straight after applying. Do not cover the area with a dressing.
4
Leave on for 6–10 hours
Leave the cream on overnight (6 to 10 hours). Avoid sexual contact while the cream is on the skin — it can weaken condoms and diaphragms and transfer to a partner.
5
Wash it off in the morning
After 6–10 hours, wash the area with mild soap and water to remove the cream.
6
Repeat 3 times a week
Use on 3 non-consecutive days each week (for example Monday, Wednesday, Friday) until the warts clear, for up to 16 weeks.
Sachets are single-use. Each Aldara sachet is for one application — discard it after use, even if some cream remains. Do not apply more often than three times a week; more frequent use increases skin reactions without clearing warts faster.
Get Aldara Prescribed Online
Access Doctor provides Aldara (imiquimod) for external genital warts following a confidential online consultation with our GPhC-registered pharmacist independent prescribers. Discreet next-day delivery.
Start Your Consultation →Treatment Course and How Long It Takes
Aldara is a slow-and-steady treatment. Warts often take several weeks to respond, and the course can run for up to 16 weeks. Many people notice improvement around the 8–10 week mark. Keep going with the three-times-a-week routine unless a prescriber advises otherwise.
| Detail | Instruction |
|---|---|
| Frequency | 3 times a week, on non-consecutive days |
| When | At bedtime; leave on 6–10 hours |
| Maximum course | Up to 16 weeks |
| If not cleared by 16 weeks | Stop and see your prescriber or a sexual health clinic — do not extend |
Side Effects of Aldara
Local skin reactions are expected with imiquimod — in fact, some inflammation is a sign the immune response is working. Common reactions at the application site include:
- Redness, itching and a burning sensation
- Flaking, scabbing or mild skin breakdown as warts clear
- Swelling, or small open areas (erosions) that heal after a break
- Less often: headache, tiredness or flu-like feelings
Reactions usually settle if you pause for a few days. If a reaction is severe, your prescriber may advise a short break before continuing.
Stop and seek advice if you get severe skin breakdown, heavy bleeding, intense pain, or signs of skin infection (spreading redness, pus, fever). Wash the cream off and contact your prescriber or call 111. In an emergency, call 999.
Who Cannot Use Aldara?
- Pregnancy and breastfeeding — not recommended; discuss alternatives (some clinic-based options are safe in pregnancy) with a clinician
- Internal warts — not for warts inside the vagina, urethra, cervix or rectum
- Broken, inflamed or infected skin — do not apply until the skin has healed
- Children — for adults only
- Known allergy to imiquimod or any ingredient in the cream
Aldara vs Warticon: Which Is Better for Genital Warts?
Both are patient-applied creams for external genital warts, but they work in opposite ways — and that drives when each is chosen.
| Feature | Aldara (imiquimod 5%) | Warticon (podophyllotoxin) |
|---|---|---|
| How it works | Immune-response modifier — stimulates the immune system to clear HPV cells | Cytotoxic — directly destroys wart tissue |
| Speed | Slower — up to 16 weeks | Faster — typically up to 4 weeks |
| Schedule | 3 times a week, at night | Twice daily, 3 days on / 4 days off (max 4 cycles) |
| Recurrence | Lower — immune activation helps prevent return | Higher |
| Often chosen for | Recurrent warts, or where Warticon hasn't fully cleared them | First-line, when faster clearance is wanted; lower cost |
Neither is universally better — it depends on your warts, treatment history and preference. For the alternative in depth, see our Warticon guide. Your prescriber will recommend the most suitable option during your consultation.
Treat Genital Warts Online
Aldara or Warticon, prescribed by GPhC-registered pharmacist independent prescribers after a confidential online consultation. Discreet next-day delivery across the UK.
View Genital Warts Treatment →Frequently Asked Questions
What is Aldara cream used for?
Aldara (imiquimod 5% cream) is used to treat external genital and perianal warts. It is also licensed for some skin conditions such as actinic keratosis and superficial basal cell carcinoma, but for warts it treats those on the outside of the genitals and around the anus. It is not suitable for warts inside the vagina, urethra or rectum.
How does Aldara (imiquimod) work on genital warts?
Unlike treatments that destroy wart tissue directly, imiquimod is an immune-response modifier. It stimulates your skin's local immune system to produce interferon and other substances that attack the HPV-infected cells causing the warts. Because it works with your immune system, it acts more slowly than Warticon but is associated with a lower recurrence rate.
How do you apply Aldara cream for warts?
Apply a thin layer of Aldara to clean, dry warts three times a week (for example Monday, Wednesday, Friday) at bedtime. Rub it in until it disappears, wash your hands, and leave it on for 6 to 10 hours — then wash the area with mild soap and water. Do not cover with a dressing. Continue until the warts clear, for up to 16 weeks.
How long does Aldara take to work on genital warts?
Aldara works gradually. Warts may take several weeks to clear, and treatment can continue for up to 16 weeks. Many people see improvement within 8 to 10 weeks. If the warts have not cleared after 16 weeks, stop and speak to your prescriber or a sexual health clinic rather than continuing.
Is Aldara or Warticon better for genital warts?
Neither is universally better. Warticon (podophyllotoxin) works faster — usually within 4 weeks — and is lower cost. Aldara (imiquimod) works more slowly, over up to 16 weeks, but stimulates the immune system and tends to have a lower recurrence rate, so it is often chosen for warts that keep coming back. Your prescriber will recommend the best option for you.
Can I buy Aldara for genital warts online?
Aldara is a prescription-only medicine in the UK. You can obtain it through a GPhC-registered online pharmacy such as Access Doctor after a confidential online consultation with a pharmacist independent prescriber. Aldara is suitable for external warts only; internal warts must be assessed and treated at a sexual health clinic.
References
- British Association for Sexual Health and HIV (BASHH). UK National Guideline on the Management of Anogenital Warts. bashh.org/guidelines
- NHS. Genital warts. nhs.uk/conditions/genital-warts
- NICE. Clinical Knowledge Summary: Anogenital warts. cks.nice.org.uk
- Electronic Medicines Compendium. Aldara 5% Cream: Summary of Product Characteristics. medicines.org.uk/emc
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Aldara is a prescription-only medicine — a clinical consultation is required before it can be supplied. If this is a first episode of genital warts, or your symptoms are changing, seek in-person assessment. In a medical emergency, call 999.