Pyogenic granuloma are an overgrowth of a large number of small blood vessels beneath the skin. They are harmless and does not increase the risk for cancer. They are usually under 1 cm in diameter. They grow quickly in a matter of days and within a few weeks they stop growing. They look like small, raised, bright red/pink or purple bumps on skin. They can bleed easily. People of all ages are susceptible to them, though they tend to be more common in children and youngsters. They are not hereditary or contagious (that is, they do not spread from person to person). Often there is no obvious cause. Sometimes they follow minor cuts to skin that heal improperly, or upon getting pricked by a thorn. They also occur during pregnancy, usually in the mouth on the gums.
Treatment For Pyogenic Granuloma
No treatment is needed if it occurs in pregnant women because it tends to heal spontaneously. Similarly, pyogenic granulomas that are small tend to shrivel and disappear with time and may not require any treatment. However, pyogenic granulomas that are large need to be treated with one of the following measures.
You can get rid of the pyogenic granuloma by freezing it using liquid nitrogen. But doing so will mean you will not have a specimen to check and verify in a laboratory to ensure that the diagnosis is correct and you do not have to worry about the growth any longer.There is a slight chance of a hypertrophic scar developing in the treated area. The treated area of the skin could also lose pigmentation.
Pyogenic granuloma can be treated with sclerotherapy using sodium tetradecyl sulphate as a sclerosant. The other agent that is used for this purpose is monoethanolamine oleate. The chemical is injected into the blood vessels, which leads to their shrinkage. But just as is the case with cryotherapy, a specimen is not obtained to study under the microscope to verify the diagnosis and rule out any other more serious condition. The chance of scar formation in the treated area is very less.
This is a simple procedure, which involves cauterization with the help of silver nitrate. The mass is removed bluntly. Pressure is used to stop bleeding. Then the base of exposed lesion is cauterized with applicators containing silver nitrate.After treatment, you have to keep the treated area absolutely dry for a couple of weeks. You may require one to three sessions of such treatment for complete resolution to take place.
Curettage And Electrical Cautery
The pyogenic granuloma can be scraped or scooped off with a curette (sharp instrument resembling a spoon). But before doing so, the area is made numb or insensitive to pain by injecting or spraying a local anesthetic around the area of curettage. After curettage, you will see a bleeding area that is left behind. This needs to be cauterized or electrically burnt so that bleeding will stop and the risk of recurrence is reduced.
Sometimes curettage and cautery relieves the problem only temporarily and the pyogenic granuloma comes back. In such a case, the growth needs to be removed in toto surgically. This is followed by closing the wound left behind with stitches or sutures.This is a more effective treatment than curettage and cautery, with less risk of recurrence. However, some studies report a 10-15% chance of recurrence even with surgical excision.
Laser therapy can be used in treating pyogenic granuloma, with the help of a diode laser. Other less preferable modes of laser therapy are those done using pulsed dye laser and Nd:YAG laser. It is less invasive than surgery and is a sutureless procedure. Postoperative pain is also minimal. You can go back to your normal routine within minutes of this treatment in contrast to surgical excision.
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