How is pyogenic granuloma (lobular capillary hemangioma) treated?

Updated: Feb 21, 2020
  • Author: Joseph C Pierson, MD; Chief Editor: William D James, MD  more...
  • Print

If a clear provoking traumatic factor exists for the pyogenic granuloma (lobular capillary hemangioma) development, remove it. Cases of pyogenic granuloma attributed to use of medications may regress upon withdrawal of the causative agent. Guidelines for the prevention and treatment epidermal growth factor receptor inhibitor–related lesions have been published. [65]

Topical and systemic beta-adrenergic receptor antagonists have successfully treated cutaneous and mucosal pyogenic granulomas. [66, 67, 68, 69, 70]

Topical imiquimod cream, [71] alitretinoin gel, [72] and ingenol mebutate [73] have been successfully used to treat pyogenic granulomas. Oral valacyclovir resolved a giant lesion showing herpes simplex virus type–I antigens by immunohistochemistry in 2 weeks. [10] A report from Turkey described a patient with multiple pyogenic granulomas who showed clear improvement with oral erythromycin treatment. [74]

Simple table salt, [75] injectable sclerosing agents, [76] chemical cauterization with silver nitrate, [77] topical phenol for periungual lesions, [78] and photodynamic therapy with 5-aminolevulinic acid intralesional injection [79] have all been used.

Pyogenic granulomas with satellitosis that recurred after surgical excision have responded to intralesional [80] and systemic [81] steroids.

A recurrent giant pyogenic granuloma on the palm was successfully treated with intralesional bleomycin. [82]

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!