You Were Told You Need a LEEP. You May Still Have Another Option.
Imiquimod is a nonsurgical LEEP alternative treatment for women with squamous CIN2 or CIN3 who want to preserve cervical tissue.
Being told you need a LEEP can make it feel as though the decision has already been made.
It may not be.
Imiquimod is an immune-based medication that can treat high-grade cervical dysplasia without removing part of the cervix. Published clinical studies show that it can cause CIN2 and CIN3 to regress in a meaningful proportion of women.
You do not need to prove that a LEEP would be impossible for you. If you have squamous CIN2 or CIN3 and want a nonsurgical option, that is enough reason to explore imiquimod.
We will review your results, examine the cervix, explain what the evidence means for you, and stay involved throughout treatment.
Imiquimod Treatment Program — $2,200 + applicable pathology fees
No Hitchcock Family Medicine membership required.
Get More InformationWhat is imiquimod?
Imiquimod is a medication that activates the local immune response.
The goal is to help your immune system recognize and respond to the HPV-associated cells causing the dysplasia.
Treatment takes place over 16 weeks. The medication is introduced gradually, and we remain involved to help manage side effects and adjust the schedule when needed.
Imiquimod is FDA-approved for several other conditions but not specifically for cervical dysplasia. Its use on the cervix is considered off-label.
Off-label does not mean unstudied. Imiquimod has been evaluated for cervical dysplasia in randomized clinical trials and systematic reviews.
Does Imiquimod Actually Work?
Yes—for a meaningful proportion of women.
Imiquimod is not an experimental idea based only on theory. Randomized trials and systematic reviews have measured its effect on both cervical dysplasia and high-risk HPV.
What Could Imiquimod Make Possible for You?
The studies answer an important question: Can imiquimod cause high-grade cervical dysplasia to regress without removing cervical tissue?
Yes, it can.
For some women, treatment leads to complete regression. For others, the dysplasia improves but does not disappear completely. Some do not respond. We cannot know your individual result before treatment, which is why careful follow-up matters.
Results have generally been more favorable for CIN2 than CIN3, but women with either diagnosis may choose to try imiquimod after understanding the expected likelihood of success.
Trying imiquimod is not choosing to ignore or postpone treatment. It is choosing to begin with an active, nonsurgical treatment while preserving the ability to make a different decision later if the dysplasia remains.
Who Can Choose Imiquimod?
Imiquimod may be considered if you:
– Have biopsy-confirmed squamous CIN2 or CIN3
– Want to avoid removing cervical tissue
– Understand that treatment may not work
– Are willing to complete a 16-week treatment course
– Are comfortable with close post-treatment follow-up
– Accept that an excisional procedure may still be needed
CIN3 does not automatically take imiquimod away as an option. It does mean that the expected likelihood of success is lower and should be understood clearly.
When excision is necessary?
We do not offer imiquimod for:
– Adenocarcinoma in situ (AIS)
– Suspected or confirmed microinvasive or invasive cervical cancer
– A cervix that cannot be adequately evaluated to exclude invasive disease
These are safety boundaries, not a narrow set of qualifications that every other woman must prove she meets.
Imiquimod treatment is a process, not a single procedure. We start by making sure it is a reasonable option for you, stay involved throughout treatment, and then carefully reassess the cervix afterward.
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START WITH A COMPLETE IN-PERSON EVALUATION
Before recommending imiquimod, we review your Pap, HPV, biopsy, colposcopy, and previous treatment history and carefully evaluate the cervix. We need to understand not only what the pathology says, but where the abnormality is located and whether the cervix can be adequately evaluated.
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TREATMENT OVER 16 WEEKS
Treatment is gradually increased to improve tolerability. Our typical schedule begins once weekly, increases to twice weekly, and then progresses to three times weekly as tolerated. We remain involved throughout treatment to help with side effects and adjust the schedule when appropriate.
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RE-EVALUATE THE CERVIX
After treatment and recovery, we evaluate the result. Follow-up may include colposcopy, HPV testing, cytology, and biopsy. We need to answer two questions: Did the dysplasia regress — and what should happen next?
Imiquimod Treatment Program
$2,200
The program includes:
– Initial cervical dysplasia consultation
– Review of your cervical screening, colposcopy, and biopsy records
– In-person evaluation of the cervix
– The 16-week treatment program
– Follow-up and treatment guidance during therapy
– Management of treatment-related side effects
– Post-treatment cervical reassessment
Applicable pathology fees are additional.
You do not need to be a Hitchcock Family Medicine member. Women may travel to Chattanooga for evaluation and treatment.
Start with your resultsWritten and medically reviewed by Matthew Hitchcock, MD
Board-Certified Family Physician
Last reviewed: August 26, 2026
Have cervical dysplasia results and not sure what comes next?
You do not need to know exactly what kind of appointment or treatment you need before contacting us.
If you have an abnormal Pap or HPV result, need a colposcopy, have been diagnosed with CIN1, CIN2, or CIN3, have been told you may need a LEEP, or want a second opinion about your options, start with the results you already have.
Our team will review your request and help you understand the appropriate next step.
