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Traditional therapy for pyogenic granuloma is procedural. In young children it can require a general anesthetic and may be complicated by scarring, dyspigmentation, and recurrence. We report a series of 10 children, highlighting the safety and efficacy of topical 5% Imiquimod as an alternative noninvasive treatment of pyogenic granuloma. Ten children with a mean age of 2.5 years and 10.8 week duration of facial pyogenic granuloma lesion were recruited. Treatment regime with topical Imiquimod 5% cream varied in frequency of application and duration according to clinical response. Clinical outcome in the majority of the children was satisfactory. Three had no evidence of disease and five had small hypopigmented or erythematous lesions which were continuing to improve and more acceptable then a surgical scar. One child required a prolonged treatment course, and one progressed to surgical excision when prolonged treatment failed. There were no systemic side effects noted in any of the patients and no recurrence noted with resolution sustained over an average of 9.6 months of follow-up. Imiquimod is a safe, cost-effective, and clinically effective management option in the treatment of pyogenic granuloma.

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