Pyogenic granuloma: symptoms, causes, and trusted treatments

Have you found a tiny, bright red bump that bleeds if you even look at it wrong? I've been there with a family member, and it's unnerving. That little overachiever might be a pyogenic granuloma a harmless (yes, benign!) overgrowth of blood vessels that loves to appear after a nick, a hangnail, a bit of friction, pregnancy, or certain medications.

Take a breath. In most cases, it's straightforward to diagnose and treat. In this guide, I'll walk you through what a pyogenic granuloma looks like, why it happens, which treatments actually work, what healing is like, and how to know when it's time to call a dermatologist. My goal: help you feel informed, calm, and confident about your next steps.

What it is

Let's start simple. A pyogenic granuloma (also called "lobular capillary hemangioma" in medical speak) is a small, fast-growing bump made of extra blood vessels. Think of it as a tiny, overly enthusiastic garden of capillaries that popped up after your skin was irritated or your hormones shifted. It's not an infection. It's not cancer. It's just vascular.

And about that name: "pyogenic" means "pus-forming," and "granuloma" suggests a certain type of immune reaction neither of which really applies here. So yes, the name is confusing. The bump is typically smooth, red to pink (sometimes purple), and either dome-shaped or sitting on a thin stalk, like a little lollipop. It bleeds easily because it's packed with fragile vessels.

Who gets them? Anyone can, but they're especially common in children, teens, and during pregnancy. They often show up on fingers, around the nails, on the face, lips or gums, or the nose and toes. Less commonly, they can occur near the eye or under the nail, which can make them extra bothersome and a bit trickier to treat.

Key symptoms

Here are the classic clues you can spot without a medical degree:

• It grows fast often over a few weeks.
• It's red, pink, or purple and looks smooth and shiny.
• It bleeds with the slightest bump or friction, then crusts and bleeds again.
• You may notice a tiny "white collar" of skin at the base (a collarette).

Variations exist. In the mouth (especially during pregnancy), pyogenic granulomas can appear along the gumline as a bright red lump that bleeds when brushing. Around the nails, they can grow where the skin meets the nail plate and can be quite tender. Occasionally, small "satellite" bumps pop up nearby after the original lesion was irritated or partially treated.

Worried it might be acne, a wart, or a mole? Acne usually has a pore and comes with other pimples. Warts have a rough or grainy surface and tiny black dots (clotted capillaries) but don't typically gush blood. Moles don't grow this quickly or bleed so easily unless traumatized. That said, if any spot is changing rapidly or looks odd to you, get it checked peace of mind is priceless.

Are pyogenic granulomas contagious or cancerous? No and no. They're benign and noninfectious. They matter because they bleed, can get crusted or secondarily infected, and may leave a mark if they're constantly irritated. Also, some skin cancers can mimic them, which is why an expert eye (and sometimes a biopsy) is wise.

Main causes

So why do they happen? Picture your skin's repair crew going a bit overboard. Triggers include:

• Minor trauma or irritation: a hangnail, new ring rubbing your finger, aggressive face scrubs, even a bug bite.
• Hormonal shifts: pregnancy is a big one; the gums are a common site.
• Local bacteria on the skin (like Staph) that may nudge inflammation along.
• Preexisting vascular changes or fragile skin from other conditions.

Some medications are linked, too. These include oral or topical retinoids, antiretroviral therapies, and certain cancer or targeted therapies (EGFR, BRAF, mTOR inhibitors, taxanes), as well as some immunosuppressants. If you're on a newer targeted cancer therapy and notice a sudden, bleeding bump around a nail or on the face, tell your clinician they'll know this pattern.

Pregnancy-related pyogenic granulomas (sometimes called "granuloma gravidarum") love the gums and often appear in the second or third trimester. The silver lining: many shrink or disappear after delivery. If they're painful or bleed a lot, your dentist, OB, or dermatologist can guide treatment now vs. later.

If you like reading deeper into clinical details, the overviews from respected sources such as the Cleveland Clinic and the StatPearls chapter on lobular capillary hemangioma are helpful context for both causes and treatments (for example, see the Cleveland Clinic overview and a peer-reviewed StatPearls chapter referenced in professional circles). According to comprehensive reviews from major centers like Cleveland Clinic and clinician-focused summaries like StatPearls, the above triggers are well recognized.

Smart diagnosis

Often, a clinician can confidently diagnose a pyogenic granuloma by sight and history alone: fast growth, easy bleeding, classic color and shape. Dermoscopy (a handheld skin microscope) may reveal uniform red areas and that neat little collar around the base.

When is a biopsy needed? If there's anything atypical unusual color, ulceration that doesn't fit, irregular surface, or a location with higher-risk lookalikes your clinician may remove it completely or take a small sample. A biopsy rules out conditions with overlapping appearances, like amelanotic melanoma, squamous cell carcinoma, basal cell carcinoma, or rare vascular tumors. In immunosuppressed people, infections like bacillary angiomatosis or lesions like Kaposi sarcoma can mimic PGs, and pathology settles the question.

Treatment options

Do pyogenic granulomas go away on their own? Sometimes, especially pregnancy-related gum lesions after delivery. Most others stick around or keep bleeding until treated. The good news: treatment is typically quick and effective.

Office procedures that work

• Complete surgical excision: The bump is numbed and removed in one piece, then the base is closed or allowed to heal. This offers the lowest recurrence and provides tissue for confirmation under the microscope.
• Shave or curettage plus electrocautery: The lesion is shaved off; then the base is gently scraped and cauterized to seal vessels. This is fast and often leaves a small, smooth scar, but recurrence risk can be a bit higher than full excision.
• Cryotherapy or chemical cautery: Freezing or using agents like silver nitrate can help smaller lesions, especially in kids, but often require repeat visits.
• Laser therapy: Pulsed dye (PDL), CO2, or Nd:YAG lasers can be excellent for facial sites and for those who prefer to minimize bleeding during the procedure. Lasers are also handy for children or cosmetically sensitive areas.

How do you choose? It depends on size, location, bleeding, and cosmetic priorities. A tiny lesion on a finger might be shaved and cauterized in minutes. A larger one on the face might be a great candidate for PDL. Something suspicious or stubborn? Full excision provides both a cure and a clear answer under the microscope.

Medical or topical therapies

These can be considered when procedures aren't ideal or as adjuncts:

• Topical timolol: Especially useful around the eye or for small lesions; it's a beta-blocker drop/gel used off-label to shrink vascular growths.
• Imiquimod cream or steroid injections: Case-by-case and variable in effectiveness.
• Sclerosants: Agents that scar down the vessels; more specialized, less common.

These approaches can be helpful, but evidence is mixed, and they often take longer than a quick office procedure. Your dermatologist will match the method to your goals and lifestyle.

Aftercare you can trust

Right after removal, controlling bleeding is the top priority. Expect your clinician to apply pressure and a snug dressing. At home, you'll likely:

• Keep the area clean and dry for 24 hours, then gently wash with soap and water.
• Apply a thin layer of petrolatum or antibiotic ointment if recommended.
• Change the bandage daily or if it gets wet.
• Avoid friction or heavy exercise that pulls on the area for a few days.
• Watch for signs of infection: increasing redness, warmth, pus, fever, or worsening pain.

Scars tend to be small and fade over time. Protecting the spot from sun helps a lot sunscreen is your friend for the next several months, especially on the face and hands.

Recurrence and how to prevent it

Recurrence can happen reports range up to roughly 40% in some series for partial or less definitive treatments. Why? If the base isn't completely treated or the trigger persists (like friction from a ring or ongoing medication influence), the lesion may reappear. Complete excision has the lowest recurrence. Reducing irritation, trimming rough hangnails carefully, and addressing medication triggers (if possible) all help.

Weighing choices

How do you balance quick results, cosmetic outcomes, cost, and downtime? Here's a simple way to think about it:

• Need the lowest chance of recurrence and a definitive diagnosis? Go for complete excision.
• Prefer a fast, in-and-out visit with minimal stitches? Shave/curettage plus cautery can be great for small, classic lesions.
• Concerned about facial scarring or treating a child? Lasers may offer a gentler path with good cosmetic results.
• Not a candidate for procedures right now? Discuss topical options, recognizing they may take longer and need close follow-up.

Special situations matter. During pregnancy, many clinicians delay treatment unless the lesion bleeds frequently, is infected, or interferes with eating or brushing. Nail-unit lesions can be trickier and may require a specialist to protect nail growth. If your pyogenic granuloma is medication-induced and you can't safely stop the drug, your team can time procedures and choose methods with that in mind.

Practical tips

Can't get it removed just yet? No problem here's how to manage in the meantime:

• Keep it covered with a small bandage to prevent snagging and bleeding.
• Minimize friction: switch to softer fabrics, remove rings if it's on a finger, and avoid aggressive exfoliation near facial lesions.
• If it starts bleeding, apply firm pressure with clean gauze for 1015 minutes without peeking. Persistent bleeding beyond that? Seek urgent care.

Prevention is about being kind to your skin. Good oral hygiene helps keep gum lesions calmer if you're pregnant. Moisturize hands so hangnails don't tear. During sports or handiwork, consider protective gloves. And if a medication is known to trigger PGs, talk openly with your clinician about risks, benefits, and early signs to watch for knowledge beats surprise every time.

See a doctor

Most pyogenic granulomas are simple. But please get prompt care if you notice:

• Rapid growth or frequent bleeding.
• Uncertain diagnosis or an unusual-looking spot.
• Signs of infection: spreading redness, warmth, pus, fever.
• Lesions near the eye, under the nail, or on mucosal surfaces (like the gums, lips, or nose).
• You're immunosuppressed or have a history of skin cancer.

One of my relatives had a fast-growing, bleeding bump on a finger that kept catching on sweaters. A quick shave and cautery later, it was gone and the relief was enormous. The key was not waiting too long and dealing with constant bleeding and worry.

Expert insight

What do dermatologists weigh before choosing a procedure? A few practical things:

• Size and shape: stalked lesions are often easy to shave; broad-based ones may be better excised.
• Site: face and nail units call for finesse; lasers or precise excision can shine here.
• Bleeding risk: some methods control bleeding better during the procedure.
• Personal factors: pregnancy, medications, and your preferences about scars and downtime.

Data worth knowing: complete excision generally carries the lowest recurrence; shave/curettage plus cautery is efficient but can recur more often; many pregnancy-related gum lesions regress postpartum; and certain drug classes are well documented triggers. Most importantly, if anything looks atypical, biopsy is encouraged. It's about safety, certainty, and shared decision-making.

If you enjoy reading primary sources or want to discuss options with your clinician using the same language they use, you may find overviews from major medical centers and peer-reviewed summaries helpful for context. For instance, clinician references such as StatPearls and accessible patient-focused pages like Cleveland Clinic describe appearance, causes, diagnosis, and treatment in a way that aligns with what you'll hear in the office.

Final thoughts

Pyogenic granuloma may sound dramatic, but it's a benign, fixable bump. If you're dealing with a small red spot that bleeds with the tiniest nudge, a clinician can usually diagnose it quickly and remove it safely. Treatments range from simple cautery to laser to complete excision; the best choice depends on where it is, how big it is, how much it bleeds, your cosmetic goals, and whether pregnancy or medications are in the mix. There's always a balance: faster, simpler options may carry a higher chance of recurrence, while full excision lowers that risk but can leave a small scar.

If you're unsure what you're looking at, don't guess especially if the spot is changing fast or looks different from anything you've had before. Book a visit with a dermatologist or your primary care clinician. Ask every question you have. This is your skin, your comfort, and your peace of mind. And if you've walked this road already, what helped you most a quick shave and cautery, a laser session, or full excision? Your experience could be exactly what someone else needs to hear.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.