[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Other dermatological medicines](https://durgical.com/en/pharmacology/classes/other-dermatological-medicines/) › Imiquimod # Imiquimod ## Other dermatological medicines? Other dermatological medicines An immune-response cream that activates toll-like receptor 7 in the skin. Used for genital warts, actinic keratoses and superficial basal cell carcinoma. Updated Nov 1, 2026 ## Quick facts **Group** [Other dermatological medicines](https://durgical.com/en/pharmacology/classes/other-dermatological-medicines/) **Target** Toll-like receptor 7 (TLR7) on immune cells of the skin **Used for** External genital and perianal warts **Key effects** Redness · Itching and burning · Fatigue **Monitor** Severity of local skin reactions · Flu-like symptoms **ATC** D06BB10 No doses: the clinician sets them by the current guideline. On this page - The basics Mechanism of action - Indications - Adverse effects - Pharmacokinetics - Memory aid - Safety Contraindications - Key interactions - What is monitored - Administration and safety - Pregnancy and breastfeeding - Nursing care - Study Test yourself - Connections Connections ## Mechanism of action ◎**Toll-like receptor 7 (TLR7) on immune cells of the skin**Imiquimod ⓘ The figure shows rhesus monkey TLR7 (very close to the human receptor) with imiquimod bound; no human TLR7-imiquimod structure is used here. **Target in 3D:** Toll-like receptor 7 (TLR7) on immune cells of the skin. PDB structure 5ZSF (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/5ZSF) · Drag to rotate · pinch to zoom Imiquimod is an imidazoquinoline that acts as a ligand at toll-like receptor 7. Stimulated mononuclear cells release interferon-α, and macrophages produce interleukins (IL-1, IL-6, IL-8) and TNF-α. These cytokines drive an innate and cell-mediated immune response against HPV-infected cells and atypical or malignant keratinocytes. Local inflammation at the treated site (redness, crusting, erosion) is common and expected. - Imiquimod activates TLR7 on immune cells in the skin - Cells release interferon-α, TNF-α and interleukins - An immune response attacks HPV-infected or atypical cells - Warts, actinic keratoses or superficial BCC clear ## Indications - External genital and perianal warts in immunocompetent people [Viral warts (verruca) →](https://durgical.com/en/conditions/viral-warts/) - Actinic keratoses on the face or scalp in immunocompetent adults [Actinic keratosis →](https://durgical.com/en/conditions/actinic-keratosis/) - Biopsy-confirmed superficial basal cell carcinoma when surgery is less appropriate [Basal cell carcinoma →](https://durgical.com/en/conditions/basal-cell-carcinoma/) ## Adverse effects ### Common - Redness, flaking, scabbing, swelling and erosion at the site (expected) - Itching and burning - Fatigue, fever and headache - Increased sunburn ### Serious (rare, important) - Intense local inflammation with weeping and ulceration; severe vulvar swelling with urinary retention - Flu-like systemic reaction (malaise, fever, nausea, myalgia, rigors) - Localised, sometimes permanent depigmentation ## Contraindications - None absolute in the label; not used inside the vagina, anus, mouth or eyes ## Key interactions **Condoms and vaginal diaphragms** The cream can weaken them, so they may fail as contraception or protection. **Sunlight, sunlamps and UV therapy** Heightened sunburn; treatment waits until the skin has recovered from any sunburn. ## What is monitored - Severity of local skin reactions; treatment can pause for a few days if they are severe - Flu-like symptoms - Clearance of the lesion at the end of the course; lesions that persist are reassessed ## Administration and safety - Applied as a thin layer at bedtime on the scheduled days, left on for several hours, then washed off with soap and water. - Topical use only; not inside the vagina, anus, mouth or eyes. - Hands are washed before and after; only non-occlusive dressings (cotton gauze) are used. - Sexual contact is avoided while the cream is on genital skin. ## Pregnancy and breastfeeding Case reports have not shown a clear risk, but human data are limited. ## Nursing care - Explain that redness and crusting are common and expected, and how to recognise a reaction severe enough to pause treatment. - Teach sun protection and to avoid tanning beds during treatment. - Warn that condoms and diaphragms can be weakened. - Ask women with genital warts to report swelling that makes urination difficult. ## Pharmacokinetics **Absorption** Minimal absorption through the skin. **Onset and duration** Lesions clear over weeks of treatment. ## Memory aid IMIQUIMOD = I Make Interferon: TLR7, then warts, AK and superficial BCC go. Inflammation is the treatment. ## Test yourself Think of the answer, then tap the question to see it. ## What receptor does imiquimod act on, and what does that trigger? Toll-like receptor 7; immune cells release interferon-α, TNF-α and interleukins that attack infected or atypical cells. ## What are the three labelled uses of imiquimod cream? External genital and perianal warts, actinic keratoses on the face or scalp, and superficial basal cell carcinoma. ## What contraceptive warning goes with imiquimod? It can weaken condoms and vaginal diaphragms. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/imiquimod/) [More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology) ## Connections ## Related conditions 3 - [Viral warts (verruca)](https://durgical.com/en/conditions/viral-warts/) - [Actinic keratosis](https://durgical.com/en/conditions/actinic-keratosis/) - [Basal cell carcinoma](https://durgical.com/en/conditions/basal-cell-carcinoma/) [← Back to the class: Other dermatological medicines](https://durgical.com/en/pharmacology/classes/other-dermatological-medicines/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Imiquimod Topical: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a698010.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [DailyMed - IMIQUIMOD cream](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=663e39a9-a29e-473f-89ec-4c7c6bc27b8a) (DailyMed (U.S. National Library of Medicine), 2025); [Crystal structure of monkey TLR7 in complex with imiquimod](https://www.rcsb.org/structure/5ZSF) (RCSB Protein Data Bank, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/imiquimod/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/imiquimod/