Granuloma annulare

Types of granuloma annulare

Here are some of the main types of granuloma annulaire:

Localised granuloma annulare

The most common type, localised granuloma annulare, appears in just one or two areas, tends to affect children and young adults, and usually gets better on its own after a few months.

Pink, purple or skin-coloured patches typically appear on the fingers, backs of the hands, feet, ankles or elbows. 

They form rings that grow slowly until they're about 2.5-5cm (1-2 inches) across. As the rings get bigger, they become flatter and more purple in colour before eventually fading.

When to see your GP

See your GP if you have an unexplained rash that doesn't disappear within a few weeks.

They'll usually be able to diagnose granuloma annulare from the appearance of your rash.

A skin biopsy may be needed to diagnose the rarer types of granuloma annulare. A small sample of affected skin is taken so it can be studied under a microscope in a laboratory.

A blood glucose test may also be recommended. This is because in rare cases granuloma annulare can be linked to diabetes.

Treating granuloma annulare

Unfortunately, there's no really effective treatment for granuloma annulare. But in most cases, treatment isn't necessary because the rash will disappear on its own within a few months to two years.

For more severe cases, you could ask your doctor about the following treatments:

• steroid creams or ointments may help, but they must be used carefully because long-term use can thin the skin
• cryotherapy (freezing the bumps) may be an option for treating very small patches, but it can be painful and cause permanent scarring
• ultraviolet light treatment and powerful medicines (such as steroid tablets, antibiotics, antimalarial medicines, isotretinoin, ciclosporin and dapsone) have been reported to help in individual cases of widespread granuloma annulare, but for most people the symptoms of granuloma annulare don't justify using these treatments as they all have significant side effects

If you find the appearance of the rash upsetting, you could try using skin camouflage products. Watch this video about skin camouflage and how it can be used to cover marks and scars.

What causes granuloma annulare?

The tissue underneath the top layer of skin (dermis) becomes hypersensitive and inflamed. It's not clear what causes the skin to react in this way.

Granuloma annulare isn't caused by allergies and doesn't run in families. It's sometimes associated with diabetes, although this is rare.