The appearance of an oral pyogenic granuloma can be distressing, because any unidentified growth in the mouth often triggers worried thoughts of oral cancer. Here’s what you need to know.

What is an oral pyogenic granuloma?

First, the good news: an actual oral pyogenic granuloma is always benign. It may mimic cancerous growths, but once identified as a pyogenic granuloma, you can rest assured that it is non-cancerous.

Pyogenic granuloma appears most commonly on the neck, upper torso, hands, and feet. When it appears in the mouth, this is referred to as an oral pyogenic granuloma.

Regardless of where it appears, pyogenic granulomas have similar symptoms:

  • Resembles raw ground beef in color and texture
  • Averages half an inch in size
  • Oozes and bleeds
  • A shape like a small blueberry on the skin or it may have a thinner stalk at the base
  • Grows rapidly over several weeks
  • Appear mostly in the very young (up to young adulthood) and the very old

Adolescents may see these growths occur mainly on the upper back. This type of granuloma is most likely to recur after removal and to send out small “satellites” through blood vessels that create new pyogenic granulomas. Oral pyogenic granuloma does not appear to multiply via “satellite” except in very rare cases.

Local blood vessels feed these growths, which may explain their generally blood-red appearance. Some pyogenic granulomas may have a brown, blue, or grey tint, but the most common color is red.

What causes pyogenic granulomas?

The causes of pyogenic granuloma are not well understood, but there are some contributing factors to its development.

  • Trauma: In most cases, they develop at the site of small injury that punctures the skin (like as a pinprick).
  • Infection: Infection contributes to the development of pyogenic granulomas. Staphylococcus aureus is frequently present in the lesion.
  • Drug-induced: They sometimes develop as a reaction in patients on an oral retinoid (acitretin or isotretinoin) or a protease inhibitor.
  • Viral infection: Viral infection is more of a hypothetical cause than one that is backed by much research. Most likely the presence of a virus contributes to their development.

Pregnancy pyogenic granuloma

Pregnancy tumors in the mouth affect between two and ten percent of expectant moms. They can be referred to as an oral pregnancy tumor, a pregnancy granuloma, or a pyogenic granuloma. These tumors are inflamed nodes of tissue that may be triggered by excessive progesterone levels in pregnancy, along with other factors.

As with other dental concerns during pregnancy, oral pregnancy tumors occur most frequently during the second trimester.

Women taking oral contraceptives that increase progesterone levels may also increase their chances of developing oral pyogenic tumors. The presence of this hormone makes women more susceptible to this type of lesion anywhere on the body.

It is important to note that pyogenic granulomas on any area of the body develop due to a combination of factors. For example, just because you have a minor puncture wound does not mean you will automatically develop a pyogenic granuloma. Similarly, just being pregnant does not mean you will automatically develop oral pyogenic granuloma.

Do pyogenic granulomas go away on their own?

In many cases, pyogenic granulomas do recede on their own, usually within six to 18 months.

If left untreated and allowed to go away on their own, there is a high chance of scarring as a result. This is less of a concern if the pyogenic granuloma is oral or located in an otherwise hidden area of the body.

How do you treat a granuloma?

For some patients, pyogenic granuloma treatment is not necessary. The lesions may go away on their own over time. When this happens, reoccurrence is less likely.

However, if the lesions are constantly being aggravated to bleeding, or oral pyogenic granulomas are making it difficult to eat or speak, there are some pyogenic granuloma treatments available. These may include:

  • Imiquimod cream: This cream is often prescribed for certain types of basal skin cell carcinoma and seems to be most effective for treating pyogenic granulomas in children.
  • Topical 1% propranolol ointment: This beta-blocker may inhibit activity through the blood vessels that feed granulomas and is effective when used early in children with pyogenic granuloma. This application is still in the experimental phase of treatment.
  • Laser surgery: Laser surgery is less invasive than traditional surgery, removing the lesion and burning the base. Pulse dye lasers shrink smaller pyogenic granulomas.
  • Cryotherapy: This freezes off small lesions and uses no chemicals. For expectant mothers, this may be a good option.
  • Silver nitrate: Silver nitrate chemically removes small lesions.
  • Surgical removal: Your dentist scrapes off the pyogenic granuloma and cauterizes the blood vessel that feeds to reduce the chances of reoccurrence. In some cases, the surgery removes a small amount of skin under need the lesion as well.

Of these methods, the highest success rate for removal without reoccurrence is with surgical removal beneath the skin.

How to remove pregnancy pyogenic granuloma

For pregnancy oral pyogenic granuloma, it is best to wait until after the baby is born to proceed with treatment. In many cases, the oral pyogenic granuloma will disappear after birth. More importantly, these granulomas are more likely to reoccur if your dentist removes them during pregnancy, as one of the main contributing factors (hormone production) is still present.

Still, if pyogenic granuloma is making daily life challenging or uncomfortable, it may be best to remove them. Some oral cancers can mimic oral pyogenic granuloma, so once removed its best to biopsy the tissue.

Pyogenic granuloma removal aftercare and recovery

Once treated, the pyogenic granuloma recovery period is brief. Pyogenic granuloma treatment is minimally invasive.

You may experience some soreness or redness at the removal site. You can treat this with ice and over-the-counter non-steroidal anti-inflammatory drugs. Talk to your dentist if you have any additional concerns after removal.

AZ Dentist is your Phoenix area family dentist. We can help treat your oral pyogenic granulomas with the least invasive method possible. Get in touch today!

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