The ‘aggressive types’ of BCC are usually treated with surgery.
Superficial BCC may be treated topically.
The number one topical treatment is ©Aldara cream, although fluorouracil 5% cream and PDT are occasionally used.
©Aldara cream is the branded version of Imiquimod cream and works by stimulating the immune system to get rid of the cancer cells.
The cream is in the region of 80% to 85% effective.
A starting-point treatment regime is 5 overnight applications per week for 6 weeks. The cream will make the skin red and inflamed. You actually want a good reaction for the cream to work. However, a severe reaction could leave the skin with permanent loss or increase of pigment. Your doctor will carefully advise you on how to use the cream and may advise a week’s break if the reaction is too severe. Treating wider areas can result in flu-type symptoms.
As a result of all of this, surgery may appear to be a better alternative than six weeks of inflamed, itchy, and/or sore skin – particularly when considering the higher rate of recurrence after topical treatment.
For patients prone to many BCCs, non-surgical treatments without biopsy are a viable option – there are pros and cons to this approach, but a subset of patients can benefit from this strategy.