Imiquimod

Imiquimod cream (5% strength) is an FDA-approved topical cream for use in genital warts, skin cancer, and pre-cancerous lesions. It affects the immune system by stimulating the production of a protein (interferon-α), which also helps break down collagen.5

Some research suggests that another way imiquimod could treat keloids is by helping regulate the dysfunctional accumulation of cells in keloids by stimulating normal levels of apoptosis. In one report, patients experienced reduced recurrence rates after surgery, but other later studies showed that imiquimod failed to prevent keloids from developing or reoccurring. 5

In one clinical study, all the patients who used imiquimod following chest surgery developed keloids.5 Another reported that use of 5% imiquimod cream failed to prevent body keloids from recurring after they were removed by surgery.21

However, experts note that in contrast to areas of the body that are subject to high-tension, 5% imiquimod cream appears to work well to prevent recurrence after surgical removal of keloids from the external ear (including ear lobes). Considered a low-tension area, in one study patients who used imiquimod after surgery experienced a less than 3% recurrence rate; another study showed no recurrence in keloids removed solely from the ear lobe.3,17

Adverse side effects linked to imiquimod treatment include hyperpigmentation and irritation in up 50% of patients.3,17

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Regulated cell death, a normal part of a functioning cell cycle.
Aldara® and Zyclara™ are two brand names of imiquimod cream.