Granuloma Annulare: Symptoms, Causes, Prevention, And Treatment Options

Granuloma annulare is a harmless, chronic skin condition that occurs primarily in children and young adults. Most commonly, the condition appears as a small ring of reddish bumps.

Learn more about what causes granuloma annulare plus how to prevent and treat it.

What Is Granuloma Annulare?

Granuloma annulare is a benign, chronic skin condition. Similar to a rash, granuloma annulare typically appears as a small ring of red lumps or bumps. The inflammatory skin condition is most common in children and young adults, and is usually found on the feet, hands or forearms.

Granuloma annulare is not contagious, nor is it harmful. Some people can experience slight discomfort and itching, and may be embarrassed by the rash’s appearance.

Left untreated, granuloma annulare will generally clear on its own, although it can keep recurring for years.

What Are the Symptoms of Granuloma Annulare? 

There are 5 main types of granuloma annulare, each manifesting with slightly different symptoms:

• Localized Granuloma Annulare is the most common type. These ring-shaped rashes of tiny bumps occur on the legs and feet, hands and forearms.

• Generalized Granuloma Annulare occurs throughout the body, including on the trunk. Bumps may develop into plaques which are areas where the skin has thickened.

• Perforating Granuloma Annulare is identified by bumps that become papules, discharging damaged collagen from the skin.

• Subcutaneous Granuloma Annulare is known for bumps deep under the surface of the skin, which form nodules on the shins, hands or scalp.

Symptoms of granuloma annulare may be difficult to discern from other inflammatory skin conditions such as eczema or psoriasis.

When To See A Doctor?

It’s always a good idea to get a doctor’s diagnosis if you notice a developing rash, or growing and changing lumps or bumps under your skin.

If your skin condition is itchy or uncomfortable, either physically, cosmetically or emotionally, seeing a doctor can help you find the proper treatment.

If there’s any doubt you might have a skin condition other than granuloma annulare, your doctor may order a skin biopsy. In this case, they will remove a small piece of skin to view more closely under a microscope, in the hopes of ruling out any harmful conditions.

What Causes Granuloma Annulare?

Researchers have yet to find a specific cause for granuloma annulare, but the condition is often triggered by skin injuries. The rash-like skin bumps may appear after skin trauma, insect bites, infections or sunburn.

Who Is Susceptible to Developing Granuloma Annulare?

Anyone can develop granuloma annulare, but it’s far more common in children and young adults. Women are also more likely to develop granuloma annulare than men.

Those taking certain medications, or people with diabetes, thyroid disease or a weakened immune system may also be at greater risk.

Can Granuloma Annulare Be Prevented?

Since the exact cause is not yet understood, there is no known way to prevent granuloma annulare. Avoiding skin injury or sunburn and protecting the overall health of your immune system can lower your risk of developing this inflammatory skin condition.

How Is Granuloma Annulare Treated?

Granuloma annulare is not harmful, so no treatment is necessary. The skin bumps will likely resolve on their own without treatment, but it may take years. Even as bumps fade, they will often recur in the same location. In addition to preventing recurrences, treatment can help relieve itching, pain or embarrassment associated with the skin condition.

Your doctor or dermatologist may treat your granuloma annulare with one or more of the following treatment options:

• Corticosteroids and other medicated topicals can be prescribed to help bumps clear more quickly. Prescription-strength ointments are more powerful than over-the-counter options. In some cases, your doctor might inject the area with corticosteroids to reduce inflammation.

• Cryotherapy uses extreme cold to freeze skin lesions. This treatment destroys overgrowing cells, and may help prevent new bumps or plaques from forming.

• Laser therapy uses heat to destroy and remove damaged skin cells. The treatment can also help promote skin cell turnover, letting newer, healthier skin cells take the place of older ones.

• Light therapy uses lights of different wavelengths to constrict blood vessels and reduce redness. It’s also appropriate as a full-body treatment in cases of generalized granuloma annulare.

• Oral medications may be necessary for generalized flare-ups. Medications may include antibiotics, antimalarials, or medications to help suppress the immune system and restore it to balance.

Granular annulare is a chronic condition that will not be resolved overnight. With treatment, however, many patients see a complete clearing of their redness and bumps, with no recurrence, within two years.

Adam Smithee, MD is a Board Certified Dermatologist who grew up just up the road from Austin in Round Rock, Texas. Dr. Smithee is experienced in treating both adult and pediatric patients, from eczema to skin cancer to more complex dermatologic conditions. He is committed to treating all patients with a compassionate and patient centered approach while providing them with the most up to date information about their condition and treatment options.