Medically reviewed by Dr. A.M. van Coevorden, dermatologist
Granuloma annulareBumps in a ring, without scaling.
Granuloma annulare is a benign skin condition in which small, skin-coloured to red bumps together form a ring; annulare means ring-shaped. The patches usually sit on the backs of the hands, the feet or the arms and mainly affect children and young adults. The condition is not contagious, usually causes no symptoms and often clears by itself, although that can take months to several years.
What is granuloma annulare?
You usually see one or a few rings of small, smooth bumps, skin-coloured to pinkish red, without scaling. The ring slowly grows larger. Preferred sites are the backs of the hands, the tops of the feet, the fingers and the arms; the face is rarely involved. The patches usually don't itch or hurt, though they can be somewhat tender. There is also a rare, widespread form with many patches across the body; that form can itch and occurs more often in older adults and in people with diabetes.
A ring on the skin quickly suggests a fungal infection, but there is a difference: with ringworm the edge scales, with granuloma annulare the bumps are smooth and do not scale.
How does granuloma annulare develop?
The cause is unknown. Under the microscope, an inflammation in the connective tissue of the skin is visible; it is probably a reaction pattern of the immune system that can be set off by various triggers, such as an insect bite, skin damage, a vaccination or sunlight. Often no trigger can be identified. Granuloma annulare is not caused by a pathogen and is therefore not contagious.
What can you do yourself?
Little, and here that is good news: granuloma annulare is harmless, does not need treatment and leaves no scars. The patches often clear by themselves, though that takes patience: months to several years. Protect the patches against damage and friction, because new patches can appear on damaged skin. Beyond that, waiting is a perfectly valid choice.
When to see a dermatologist or doctor?
Have the patches assessed if you are unsure what they are; granuloma annulare can resemble a fungal infection or another skin condition, and a dermatologist usually sees the difference immediately from the picture. In case of doubt, a small piece of skin can be examined. Treatment is only worthwhile if the patches are tender or bother you a lot: the dermatologist can prescribe a corticosteroid ointment, inject or freeze the patches, and for the widespread form tablets or light therapy are possible.
Frequently asked questions
Is granuloma annulare contagious or dangerous?
No, neither. Granuloma annulare is not caused by a pathogen, so you cannot pass it on. The condition is benign and never turns into anything serious.
Does granuloma annulare clear by itself?
Often yes. In a large proportion of people the patches clear by themselves, without scars, but that can take months to several years. A patch can also return later after clearing.
What is the difference between granuloma annulare and ringworm?
Both cause a ring on the skin, but with ringworm, a fungal infection, the edge scales and the patch usually itches. With granuloma annulare the bumps are smooth, without scaling, and rarely itch. A dermatologist can tell the difference from the picture.
Does granuloma annulare need treatment?
No, only if it bothers you. The condition is harmless and often clears by itself. For symptoms, the dermatologist can give a corticosteroid ointment, freeze the patches or, for the widespread form, suggest tablets or light therapy.
When should you see a dermatologist about these rings?
If you are unsure whether it is granuloma annulare, if the patches change quickly or become tender, or if they bother you. The dermatologist usually makes the diagnosis directly from the picture and discusses whether treatment is worthwhile.
Sources and more information
- Granuloma annulare (nvdv.nl)