If you have a red bump on your skin that bleeds easily, you may have a pyogenic granuloma. These can appear after you’ve had an injury to your face, hands, arms, or other body parts.
They are noncancerous and small ones often go away on their own, although sometimes a doctor may remove them.
How To Recognize a Pyogenic Granuloma
Pyogenic granulomas are benign, or noncancerous, red lumps with moist surfaces that appear on your skin. They bleed easily due to having many blood vessels and can appear after you’ve had an injury to your face, hands, or arms. In rare cases, they can also develop after getting a burn.
Although they are mostly red, they can range in color, and may also appear pink or purple depending on how long they’ve existed.
Pyogenic granulomas are mostly made of vascular, or blood vessel, tissue, as well as skin. Despite the name, they are not true granulomas. A granuloma is a cluster of immune cells that grows as there's something that causes constant inflammation.
Granulomas develop due to inflammation, but it’s still uncertain why and how pyogenic granulomas grow. This is why these growths are more accurately called lobular capillary hemangiomas.
Where Do Pyogenic Granulomas Come From?
It’s still uncertain what causes pyogenic granulomas, but it’s known that they aren’t caused by bacteria. Made up of blood vessels, they are likely your blood vessel system’s response to an injury.
It’s been theorized that oral pyogenic granulomas form due to microorganisms invading the site of your injury or chronic irritation, although microorganisms are rarely found within these growths.
Some medications may also cause you to grow pyogenic granulomas. These include isotretinoin (Accutane) and acitretin (Soriatane or Neotigason), as well as topical retinoids. Antiretrovirals may also cause pyogenic granulomas.
Where Do Pyogenic Granulomas Grow?
These growths can appear on your:
They can also develop inside your body. They may appear on your esophagus, stomach, intestines, and in your veins.
Pyogenic granulomas are particularly common in pregnant women and children. They are also common in those taking oral contraceptives and the drugs acitretin (Soriatane), isotretinoin (Accutane), and indinavir (Crixivan). Compared to others, pregnant women are more likely to have a pyogenic granuloma in their mouths.
Among people in their twenties, women are more likely to get these bumps than men due to female hormones.
A pyogenic granuloma stands out from other skin lumps because it can resemble raw hamburger meat. It can also grow rapidly within a few weeks.
If you suspect you have a pyogenic granuloma, contact your doctor. While pyogenic granulomas are benign, some cancers can look like pyogenic granuloma. You need to get an accurate diagnosis of your condition as quickly as possible so you can get proper treatment as needed.
Some conditions may also have symptoms that look like pyogenic granulomas:
- Granulation tissue (Tissue that is part of the wound healing process).
- Hemangioendothelioma (A rare cancer that grows from blood vessel cells).
- Masson tumor (A noncancerous tumor that appears on the head, neck, and upper body).
- Spitz nevus (A benign tumor that can mimic melanoma, or skin cancer).
- Foreign body
- Neurofibroma (A tumor of the nerves that causes soft bumps on or under the skin).
- Eccrine poroma (A noncancerous tumor that grows in the sweat glands).
Your doctor will arrange for a biopsy to determine if:
- You have a pyogenic granuloma
- Your pyogenic granuloma is benign
- You have another condition
How To Remove a Pyogenic Granuloma
After you’ve been diagnosed with pyogenic granuloma, your doctor may arrange to remove it.
There are four main ways to remove it:
- It will be scraped off with a tool called a curette and lightly cauterized (burned) to lower the chances of re-growth. You will be numbed during this process so you will not feel any pain.
- Your pyogenic granuloma will be removed using chemicals such as silver nitrate, phenol, and Trichloroacetic acid (TCA).
- Laser surgery can also remove it, although this is not the best method.
- Full thickness surgical excision can remove your growth effectively. This is when a cut is made in the skin and a portion is removed. The wound is then sewn together with stitches.
You can also opt to use the following topical treatments to remove the lump:
- Cryotherapy (When extreme cold is used to freeze abnormal tissue).
- Imiquimod (Zyclara, Aldara) cream 5%
- Timolol (TIMOPTIC-XE) gel 0.5%
- Intralesional steroid injection
Multiple small growths can form after treatment since pieces of the lump can spread through nearby blood vessels.
Accordingly, you may need more than one treatment before your pyogenic granuloma goes away for good. Young adults are more likely to have a re-growth.
What Happens If I Don’t Treat a Pyogenic Granuloma?
If you don’t get treatment, it may continue to bleed and cause pain. Since the surface of the lump is thin, bleeding is often unavoidable. Most people with this condition have to cover their growths with band-aids to prevent bleeding.
Additionally, you can develop severe anemia if you leave a pyogenic granuloma in your intestines or stomach untreated.
Generally, it’s rare for pyogenic granulomas to go away on their own. While small pyogenic granulomas may gradually go away, larger growths will need to be treated.
Some bumps will shrink over time, particularly ones that develop during pregnancy or while you were taking a certain medication.