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Laser Surgery For A Face Lesion?

by Sue Hubbard, M.D.

I received an email from a mother who’s 11 year old son had been diagnosed as having a pyogenic granuloma on his face.  She had seen a dermatologist and had been referred to a plastic surgeon to have it removed.

She wanted to know if there were other options as she was told that it would leave a scar and it was only 3mm in size. She also wondered if it might just go away on it’s own.

A pygoenic granuloma is also know as a lobular capillary hemangioma.  It is a collection of rapidly proliferating capillaries, that are benign, and are most prevalent in children 1 – 5 years of age. These appear as a firm, cherry red lesion and they vary in size from a few millimeters to several centimeters  They are very likely to bleed if bumped or irritated. They are commonly located on the head and neck and vary in size.  They may also be found on fingers and occasionally on the trunk of the body.

I did a little research with Dr. Margaret Lemak, a Houston dermatologist with a pediatric background.  She has seen a lot of these and does recommend that they be removed if they are in an area that is easily bumped which would cause bleeding. When these bleed they bleed A LOT and it is often hard to get them to stop.

In this case, the boy is a fairly serious soccer player, so he is at risk for getting it hit or bumped. Dr. Lemak says that  there are several different therapeutic options including cryotherapy (freezing), or shave excision with cautery of the base or surgical excision.

But, she states, for lesions on the face which may scar she would recommend seeing a cosmetic dermatologist who is familiar with pyogenic granulomas and explore the possibility of laser therapy.  She feels that there will likely be less scarring if handled with a laser, but re-iterates that you need to make sure that the doctor is an expert in laser therapy.  There are also some pediatric plastic surgeons who are quite familiar with laser therapy for skin lesions.

Lastly, she says that she has seen a child at one her son’s basketball game who had a pyogenic granuloma that was hit during a game.  The bleeding was “impressive” and all over the gym, from a little lesion, but remember it IS a collection of blood vessels.  So, better to get it taken care of before soccer season!

That’s your daily dose for today. We’ll chat again soon!

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