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Local treatments target specific Kaposi sarcoma (KS) lesions or areas of lesions. They don’t affect your whole body like some other treatments do. This type of treatment is often used to treat a few skin lesions in one spot to help with symptoms or improve how the area looks.

Observation or surveillance

Watching KS lesions closely without treating them might be an option for some people, especially if there are no more than a few lesions and they aren’t causing problems.

Observation is also often reasonable once local or whole-body treatments bring KS lesions under control. Treatment can be started again at some point if needed.

If you have HIV-related KS or transplant-related KS, observation might be an option as long as your immune system is functioning well from treatment with antiretroviral therapy (ART) or transplant medicines.

Topical medicines

Medicine can be put directly on your skin to treat some KS lesions.

Alitretinoin (cis-retinoic acid)

Alitretinoin is a retinoid drug related to vitamin A. It can be put on KS skin lesions as a gel, typically 2 to 4 times a day for at least a few months.

Side effects include irritation, redness, swelling, itching, and sensitivity to sunlight in areas where it’s applied.

Imiquimod

This drug causes a localized immune reaction. It can be put on your skin as a cream to treat KS skin lesions. It’s typically applied at least a few times a week for several weeks, although schedules can vary.

Side effects include irritation, itching, and redness where it’s applied.

Cryosurgery (cryotherapy)

Cryosurgery, also known as cryotherapy or cryoablation, is the use of very cold temperatures to freeze and destroy a KS lesion. It can be useful for small KS lesions, especially on the face. It isn’t as helpful for large or deep lesions.

For this treatment, liquid nitrogen is applied to the tumor to freeze and kill the cells.

After the dead area of skin thaws, it may swell, blister, and crust over. The wound may take several weeks to heal, and the skin of the treated area may be lighter after treatment.

Radiation therapy

Radiation therapy can be used as a local treatment for KS. For more on this type of treatment, see Radiation Therapy for Kaposi Sarcoma.

Surgery

If you have no more than a few small KS lesions on your skin, one option may be to remove them with surgery. A drawback of surgery is that the lesion might recur (come back) in the same place.

Surgery may also be an option for a single KS lesion that is blocking the urinary system or the air entering the lungs.

Surgery to remove KS skin lesions can be done in different ways:

Simple excision

The skin is first numbed with a local anesthetic. The tumor is then cut out with a surgical knife, along with some surrounding normal skin. The remaining skin is carefully stitched back together, leaving a small scar.

Curettage and electrodesiccation

The tumor is removed by scraping it with a curette, a small instrument with a sharp looped edge on one end. The area is then treated with an electric needle (electrode) to try to destroy any remaining cancer cells. This process can be repeated. Learn more about it in Curettage and Electrodesiccation.

Intralesional chemotherapy

For this treatment, a small amount of a chemotherapy drug is injected directly into the KS lesion(s). Very little of the drug is absorbed into your body, so you avoid many of the side effects normally seen with chemotherapy.

The most common drug used for intralesional chemotherapy in KS is vinblastine. Other chemo drugs that might be used include bleomycin and doxorubicin.

Side effects: The most common side effects of intralesional chemotherapy are swelling, blistering, and pain at the injection site.

Photodynamic therapy (PDT)

For PDT, a liquid drug is applied to your skin. The drug collects in the tumor cells over several hours or days and makes the cells sensitive to certain types of light. A special light source is then focused on the tumor(s), causing the cells to die.

Side effects: PDT can cause redness and swelling on your skin in the area where it is applied. It can also make your skin very sensitive to sunlight for some time, so you may need to take precautions to avoid severe burns.

For more information, see Photodynamic Therapy.