Keloids are an abnormal proliferation of scar tissue. There are a variety of therapies available to both treat and prevent keloids. Unfortunately, keloids are often difficult to treat and frequently recur. One drug therapy of interest called Aldara is a prescription topical cream that has been shown to decrease the reappearance of surgically excised keloids. Aldara, also known by its generic name imiquimod, is an immunomodulatory drug that stimulates your immune system. This promotes the activation of immune cells that in turn encourage healing of the scar.
Preparation and Application
Wash your wound with a gentle soap and water.
Pat the area gently with a towel.
Allow the entire area to dry thoroughly for a minimum of 10 minutes.
Wash your hands with soap and water before you apply the medication.
Cut a packet of Aldara and squeeze a small amount of cream onto your fingertip or a cotton tip applicator. Apply a thin layer to your wound and rub it in until the cream has been absorbed by the skin. This should be done every other night before you go to bed.
Wash your hands again to remove any excess cream.
Allow the cream to remain on your skin overnight for about eight hours. Keep the area dry and avoid swimming or bathing after you have applied the cream.
Remove the medication in the morning by washing the affected area again with a gentle soap and water.
Aldara should not be applied to your eyes, nostrils or lips, as this may cause irritation. Aldara may make your skin more sensitive to the sun, so it is recommended to wear sunscreen if you go outside and to avoid tanning. You should begin your treatment one week after your sutures are removed, or as directed by your doctor. The length of treatment may vary, but one study published in 2007 in the “Journal of the Medical Association of Thailand” found a positive benefit after eight weeks of application every other night. Researchers discovered that 28.6 percent of patients had a recurrence of keloids after surgical excision was followed by the application of five percent imiquimod for eight weeks.
The most serious side effect documented is hypotension, and it occurred after the application of more than 16 packets of Aldara. Aldara is a pregnancy class C drug, which means that it may potentially be harmful to the fetus and should only be used if the benefits outweigh the risks. The safety of Aldara in breastfeeding women has not been established, and therefore one should weigh the benefits and risks of using it while breastfeeding. Aldara has not been studied in patients less than 12 years of age. Talk to your pediatrician to determine if it is appropriate for your child. Since Aldara is an immunomodulatory drug, you may experience flu-like symptoms such as fever, chills, malaise and body aches. Tell your doctor if this occurs. You may have to discontinue use of the drug until your symptoms resolve. The most common side effects of Aldara are localized skin reactions such as redness, burning, itching, dryness, crusting, scabbing, swelling, ulceration, excoriation and induration. Notify your doctor if you experience any of these symptoms.