GRANULOMA ANNULARE



Serving Hamilton, Stoney Creek, Grimsby and surrounding areas.


General Information

Granuloma Annulare:

  • Appears as raised circles or bumps on the skin.
  • Is not contagious.
  • Is not "ringworm" or caused by a fungus.
  • Is not associated with any internal symptoms or diseases.
  • Only appears in the skin and nowhere else.
  • Is not caused by diet.
  • Does not cause scarring.
  • Is of unknown cause.
  • May last months to years and then may disappear.
  • Does not usually itch, burn, sting or hurt.
  • Has no cure.
  • Occurs in children as well as adults.
  • Is most common on the hands, arms, legs and feet.
  • Is extremely rare on the face.

Treatment:

Topical Corticosteroids (Steroids, Cortisone):

  • Cortisone creams (topical corticosteroids), lotions and gels are moderately effective.
  • They are used twice daily on the affected areas until the spots become flat.  At that point use should be stopped.
  • Topical corticosteroids must be used for at least a month to see if they are going to be effective.
  • The most common side effect would include, but not be limited to: thinning of the skin in the area to which they are being applied.  Skin thinning may appear as bruising, stretch marks or dimpling.

Intralesional Steroids (Cortisone Injections):

 
  • Cortisone injections work much better than the creams, gels and lotions.
  • The cortisone is injected directly into the spot.
  • A lesion 5 cm (2 inches) in diameter would require about 8 injections.
  • The injections are repeated at monthly intervals.
    The main side effect from the injections includes, but is not limited to: thinning of the skin.
  • Skin thinning may appear as bruising, stretch marks or dimpling.
  • Skin thinning will usually resolve spontaneously once treatment is stopped.

Phototherapy (Light Therapy):

  • If granuloma annulare is extensive (more than 20 lesions) UVB or PUVA light treatments may be used.
  • They are helpful 50% of the time but carry the risk of sunburn and long term use increases the risk of skin cancer.
  • These treatments are usually done 2 to 3 times per week for a minimum of 6 to 12 weeks.

Oral Medications (Pills):

  • If there are many spots (several hundred) treatment is very disappointing.
  • A wide variety of oral medications (pills) have been tried but nothing has even been proven to be helpful.
  • Granuloma Annulare will eventually disappear on its own without treatment. It is harmless and does not scar. Sometimes it is best to leave the spots untreated especially in young children