Pyogenic Granuloma:
A parent's guide to condition and treatment information

If the diagnosis of pyogenic granuloma is suspected, the doctor may perform a skin biopsy. The procedure involves:

1. Numbing the skin with an injectable anesthetic.
2. Sampling a small piece of skin by using a flexible razor blade, a scalpel, or a tiny cookie cutter (called a "punch biopsy"). If a punch biopsy is taken, a suture or two may be placed and will need to be removed 6–14 days later.
3. Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).

Pyogenic granulomas associated with medications usually shrink (regress) when the medicine is stopped or the dosage is lowered. Depending on the size of the pyogenic granuloma, location, and symptoms, the doctor may decide that no treatment is necessary for people who can safely stop or lower the dose of the triggering medication.

Although pyogenic granuloma is a harmless condition, it is frequently removed due to its tendency to bleed, its tenderness to the touch, and its distressing appearance. However, pyogenic granulomas may go away on their own without treatment.

If the pyogenic granuloma is obvious, the physician may choose to treat it immediately after obtaining a biopsy. Such treatments include:

• Scraping and burning (curettage and cauterization). After numbing with local anesthetic, the area is scraped with a sharp instrument (a curette) and burned with an electric needle (cautery)
• Silver nitrate solution
• Topical imiquimod cream (Aldara®)
• Laser treatment
• Freezing with liquid nitrogen (cryotherapy)
• Surgical removal (excision)

Approximately 40% of pyogenic granulomas can come back after treatment, especially those lesions located on the trunk of teens and young adults. A pyogenic granuloma that comes back (recurs) is best treated by surgical removal.