The Efficacy of 5% Imiquimod Cream in the Prevention of Recurrence of Excised Keloids
Apirag Chuangsuwanich MD*, Suriya Gunjittisomrarn MD*
Affiliation : * Division of Plastic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University
Objective : To evaluate the efficacy of 5% imiquimod cream in the prevention of recurrence of excised keloids.
Materials and Methods : The patients with keloids that had occurred over 1 year and could be excised and
primary sutured were enrolled in the study. Imiquimod 5% cream was applied to the scar 7 days after stitches
removal. The patients were follow-up for recurrence and drug side effect at 4, 6, 8, 16, and 24 weeks
Results : Forty-five patients enrolled to the study but only 35 patients finished the study. The keloids were at
the pinnas in 22 patients, at the backs or shoulders in 7 patients, and at chest walls or necks in 6 patients.
Imiquimod 5% cream was applied on the wound area 2 weeks after the operation, at alternate night for 8
weeks. The follow-up period ranged from 6 to 9 months. Ten of the treated keloids recurred (28.6% recurrent
rate). The lesion at the pinna had the lowest recurrent rate (2.9% recurrent of the total patients). The highest
recurrent rate occurred at the chest wall or neck (83.3% recurrent of the chest wall or neck or 14.3% of the
total patients). Side effects were found in thirteen patients (37.1%). These were abrasions of the skin around
the wound areas in ten patients and hyperpigmentation of the skin around the wounds in three patients.
Conclusion : Imiquimod 5% cream could effectively prevent recurrence of the excised keloids, especially in the
area that had less tension such as pinna.
Keywords : Keloid, Imiquimod, Scar
