Pyogenic Granuloma

What is a pyogenic granuloma?

A pyogenic granuloma (granuloma pyogenicum) is a noncancerous (benign), raised tumor on your skin or mucous membranes. Pyogenic granulomas tend to ooze, and they break and bleed easily.

The name pyogenic granuloma is actually inaccurate. Pyogenic means pus-producing, and a granuloma is a cluster of white blood cells reacting to infection, causing a lump.

But pyogenic granulomas are rarely related to infection, and they don’t generally contain white blood cells or pus.

The condition is more accurately called lobular capillary hemangioma, a tumor consisting of abnormal blood vessels.

Who might get a pyogenic granuloma?

Pyogenic granulomas affect people of all ages, races and sexes. They’re generally more common in children around 6 years old, teens, young adults and people who are pregnant.

In people who are pregnant, they’re often called granuloma gravidarum, granuloma of pregnancy or epulis gravidarum.

How common are pyogenic granulomas?

Pyogenic granulomas are relatively common, particularly during pregnancy. Scientists aren’t sure exactly how common they are, though, because many cases aren’t reported.

Is a pyogenic granuloma a tumor?

A pyogenic granuloma is a tumor made up of abnormal blood vessels, but it isn’t cancerous.

What causes pyogenic granuloma?

The exact cause of pyogenic granulomas is unknown.

They often happen along with:

• Hormonal changes, such as pregnancy or the use of birth control pills.
• Infection with the bacteria Staphylococcus aureus (staph infection).
• Minor injury or irritation to your skin or mucous membranes (such as poor oral hygiene or piercings).

The skin condition has also been linked to the use of certain types of medications, including:

• Antineoplastics (medications used to fight cancer).
• Antiretrovirals (often used for HIV).
• Immunosuppressants.
• Retinoids (vitamin A compounds often used to improve or heal skin).

Where do pyogenic granulomas occur?

They can appear anywhere on your skin or mucous membranes. Mucous membranes are thin linings of cavities and canals that leave your body. Examples include the lining of your mouth and nose.

Common sites for pyogenic granulomas are:

• Face.
• Mouth (gums), lips, tongue or nose.
• Fingers and toes.

What does a pyogenic granuloma look like?

A pyogenic granuloma starts as a small, fleshy bump protruding from your skin or mucous membranes. It usually grows quickly, from a few millimeters (the tip of a crayon) to about a half-inch (the tip of a finger).

Pyogenic granulomas have been described as looking like ground beef. They may be pink, red, reddish-brown or purple. They often develop a scaly, white “collar” around the bottom.

At maturity, the growths are often attached to your skin by a stalk-like structure (pedunculated). But they can also attach directly to your skin (sessile).

The surface of a pyogenic granuloma starts smooth but can become bumpy or crusty. The lesions are delicate, so they ooze, break and bleed easily.

Are pyogenic granulomas contagious?

Pyogenic granulomas aren’t contagious. Most people get only one pyogenic granuloma at a time, but sometimes, several appear at once.

How is a pyogenic granuloma diagnosed?

To diagnose lobular capillary hemangioma, your healthcare provider will:

• Ask about any injury or irritation to the area.
• Examine your skin or mucous membrane.
• Inquire whether you’re pregnant.
• Review all medications you’re taking.

Most healthcare providers will diagnose the condition based on that information alone. But they may also take a sample of the tissue (biopsy) and examine it under a microscope.

Is there a cure for pyogenic granuloma?

Generally, the only way to cure pyogenic granuloma is to:

1. Remove the lesion.
2. Eliminate any suspected triggers, such as medications, piercings or dental problems causing irritation in your mouth.

In people who are pregnant, granulomas typically disappear after delivery.

How do you get rid of pyogenic granulomas?

Your healthcare provider may recommend a medication or procedure to treat pyogenic granulomas.

Topical medications applied to your skin to shrink pyogenic granulomas include:

• Chemicals such as silver nitrate, phenol and trichloroacetic acid (TCA).
• Eye drops such as timolol for a granuloma in your eye.
• Imiquimod skin cream.
• Steroid injections into the lesion.

Procedures that can remove granulomas include:

• Cryotherapy, to freeze it away.
• Curettage, to scrape it away, and cautery, to seal the skin with heat.
• Laser treatment to destroy the abnormal tissue.
• Surgical excision, to cut the granuloma out of your skin.

How can I reduce my risk of pyogenic granuloma?

Scientists don’t fully understand what causes pyogenic granuloma, but the condition is linked to certain things. As such, the following strategies may reduce your risk:

• Avoid medications that are associated with the condition.
• Don’t injure your skin (with piercings, for example).
• Practice good oral hygiene.
• Wash and bandage any cuts, scrapes and burns to prevent infection.

What can I expect if I have a pyogenic granuloma?

The prognosis (outlook) is good with pyogenic granuloma. Lesions associated with pregnancy typically go away on their own. Other types usually require treatment but respond well.

These lesions don’t turn cancerous or shorten your lifespan. But they can get infected, especially if you pick at them. And they can leave scars after removal.

Can you get a pyogenic granuloma multiple times?

Even after successful treatment, you can develop another pyogenic granuloma in the same area or elsewhere on your body. According to some studies, the recurrence rate can be as high as 40%.

How do I take care of a pyogenic granuloma?

Most people with pyogenic granulomas should seek treatment. If you don’t seek treatment, keep the growth covered with a bandage to prevent bleeding and infection.

Contact your healthcare provider if you develop any signs of a skin infection, such as:

• Increasing pain or tenderness on or near the lesion.
• Pus draining from the area.
• Red or brown streaks on your skin.
• Swelling near the lesion.

A note from Cleveland Clinic

A pyogenic granuloma is a noncancerous, raised tumor on your skin or mucous membranes. The lesions consist of abnormal blood vessels, and they break and bleed easily. If you have a pyogenic granuloma, talk to your healthcare provider about medications and procedures that can help.