Pyogenic Granuloma

What Is a Pyogenic Granuloma?

Pyogenic granulomas are relatively common skin growths that are small, round, and usually bloody-red in color. They tend to bleed because they contain a very large number of blood vessels. They’re also known as lobular capillary hemangioma, or granuloma telangiectaticum.

These skin growths mainly affect children and young adults, although they can develop in people of all ages. They are also fairly common in pregnant women. The hormone changes that occur during pregnancy can cause these growths to develop.

A pyogenic granuloma starts off as a lesion with a rapid growth period that usually lasts a few weeks. It then becomes a raised, reddish nodule that’s typically smaller than 2 centimeters. The growth you have can appear smooth, or it might have a crusty or rough surface, particularly if it bleeds a lot.

They’re benign (noncancerous) and can be safely removed through various methods.

Where Do Pyogenic Granulomas Occur?

Pyogenic granulomas are commonly found on the:

  • hands
  • fingers
  • arms
  • face
  • neck

They can also grow on the:

  • lips
  • eyelids
  • back
  • genitals

In rare cases, they can grow on the conjunctiva or cornea in your eye. The conjunctiva is the clear tissue over the white area of your eye. The cornea is the clear covering over your pupil and iris.

When they occur in pregnant women, they often grow on the gums and are called “pregnancy tumors.”

What Causes a Pyogenic Granuloma?

These growths mostly occur after injuries, but the reason for this isn’t known. Other causes of pyogenic granulomas include trauma caused by bug bites or by scratching your skin roughly or frequently. The hormone changes your body goes through when you’re pregnant can also cause pyogenic granulomas. Certain medications can also cause this condition, such as

  • indinavir sulfate (Crixivan)
  • isotretinoin (Accutane)
  • acitretin (Soriatane)
  • some birth control pills

How Serious Is a Pyogenic Granuloma?

Pyogenic granulomas are always benign. Frequent bleeding is the most common type of complication.

However, pyogenic granulomas can also grow back after being removed. According to the American Osteopathic College of Dermatology (AOCD), pyogenic granulomas grow back in up to half of all cases, especially in young adults who have them in the upper back area. In rare cases, several lesions can appear in the area where the pyogenic granuloma was removed. If the granuloma isn’t removed completely, the remaining parts can spread to your blood vessels in the same area.

How Is a Pyogenic Granuloma Diagnosed?

Your doctor will likely be able to diagnose a pyogenic granuloma based on its appearance. Your doctor might do a biopsy, which involves taking a tissue sample, for a more accurate diagnosis. A biopsy also helps rule out malignant, or cancerous, medical conditions that can cause a similar kind of growth, such as squamous cell carcinoma, basal cell carcinoma, and melanoma.

How Is a Pyogenic Granuloma Treated?

How a pyogenic granuloma is treated depends on its size and location:

Small Pyogenic Granulomas

You might not need treatment for small pyogenic granulomas. These often go away on their own.

Large Pyogenic Granulomas

If you have a bigger growth, your doctor will most likely scrape it off and lightly cauterize or burn it. Cauterizing helps stop bleeding and can reduce the risk of it growing back.

According to the AOCD, the most effective way to remove pyogenic granulomas involves surgically removing the entire growth and using stitches to close the wound. This is a more invasive procedure than scraping one off.

Alternatively, your doctor might apply a chemical, such as silver nitrate, to the pyogenic granuloma to help with the bleeding.

These growths can also be removed using laser surgery.

Don’t pick at the granulomas or try to remove them on your own. They tend to bleed for a long time, and so having a doctor remove them with proper instruments and cautery tools is a must. 

Pyogenic Granulomas on the Eye

Pyogenic granulomas that grow on your eye can be surgically removed or treated with ointments containing corticosteroids, which help reduce inflammation.

Pyogenic Granulomas During Pregnancy

If you’re pregnant, your doctor might recommend waiting to see if these growths disappear on their own after delivery. Ultimately, this approach is the safest for the growing fetus.

Developing Treatments

Researchers are studying noninvasive treatments for pyogenic granulomas, particularly for children. Recent studies have found that a topical medication called timolol, applied as a gel to the nodule, is effective at treating the lesion without negative side effects.

Long-Term Outlook

Pyogenic granulomas are always benign, but it’s normal to be a little concerned, especially if the nodule is bleeding. They can also be a cosmetic concern for some people. You should talk to your doctor about any concerns you have. They can make sure the growth is benign and start discussing your treatment options with you.

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