Topical Therapy for Vaginal Precancer
Topical therapy is medicine placed directly onto the affected area. This might be done to treat vaginal precancer, also called vaginal intraepithelial neoplasia (VaIN). It¡¯s not used to treat invasive vaginal cancer.
Drugs used as topical therapy for vaginal precancer
Two drugs are used most often for topical therapy.
Imiquimod
Imiquimod (Aldara) is a cream that can be applied to the area of VaIN. Imiquimod acts by boosting the body¡¯s immune system. A few studies using this treatment have been done for people with VaIN. Imiquimod was shown to help clear VaIN and HPV infections.
Fluorouracil
Fluorouracil (5-FU) is a chemotherapy drug that can be put directly on the lining of the vagina. This is repeated weekly for about 10 weeks or given nightly for 1 to 2 weeks. This treatment can cause severe vaginal and vulvar irritation. It might not work as well as ablation therapy or removing the area of abnormal cells with surgery, but it can be used when other treatments are not a good option.
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- References
Developed by the ÌÇÐÄTV¹ÙÍø Cancer Society medical and editorial content team with medical review and contribution by the ÌÇÐÄTV¹ÙÍø Society of Clinical Oncology (ASCO).
Adams TS, Maluleke JC, Cuello MA. Cancer of the vagina: 2025 update. Int J Gynaecol Obstet. 2025;171 Suppl 1(Suppl 1):48-59.
Holschneider CH, Berek JS. Vaginal intraepithelial neoplasia. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/vaginal-intraepithelial-neoplasia on September 8, 2026.
Inayama Y, Yamanishi Y, Nakatani E, et al. Imiquimod for vaginal intraepithelial neoplasia 2-3: A systematic review and meta-analysis. Gynecol Oncol. 2021;160(1):140-147.
Kiviharju M, Riska A, Kalliala I, et al. Randomised trial on treatment of vaginal high-grade squamous intraepithelial lesion: Self-administered vaginal imiquimod and laser vaporisation. Int J Cancer. 2025;157(7):1458-1464.
Tranoulis A, Laios A, Mitsopoulos V, Lutchman-Singh K, Thomakos N. Efficacy of 5% imiquimod for the treatment of Vaginal intraepithelial neoplasia-A systematic review of the literature and a meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2017;218:129-136.
Last Revised: October 23, 2026
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