Granulation Tissue: Causes and Treatment Options

Granulation tissue formation in wounds?

Hello Dr.
Zheng,
I would like to ask you a question.
A year ago, I had a small wound about three centimeters in size near my lower abdomen and pubic hair, possibly due to an accidental scrape.
The wound formed a scab that itched a bit, and I unconsciously scratched it, resulting in a small, red, raised growth that looks very unattractive.
Recently, I have suddenly started to feel some itching! I have previously seen reports about similar growths, some of which are due to individual predispositions, while others are caused by improper contact or sexual activity.
However, I have never experienced such a situation, nor was the wound caused by sexual activity! Given the location of the wound, I really lack the courage to see a doctor.
Could you please advise me on what treatment options are available? Thank you!

Xiaolan, 30~39 year old female. Ask Date: 2001/05/16

Dr. Zheng Lizhen reply Dermatology

Based on your description, your issue may be keloids.
The formation of keloids is related to individual predisposition and occurs when there is inadequate regulation during wound healing, leading to the development of this thickened scar tissue.
Treatment for keloids includes intralesional steroid injections, which can be effective, but pain is a significant drawback, and a small percentage of women may experience menstrual cycle changes.
Other treatment options include cryotherapy, topical retinoids, radiation therapy, and silicone sheets, among others.
For prevention, it is advisable to avoid unnecessary surgeries, minimize injuries, treat acne promptly, and refrain from getting ear piercings.

Reply Date: 2001/05/16

More Info

Granulation tissue is a type of connective tissue that forms during the healing process of wounds. It is characterized by the presence of new blood vessels, inflammatory cells, and fibroblasts, which are essential for tissue repair. In your case, the development of a red, protruding growth, often referred to as a "granulation tissue," can occur as a response to irritation or injury, such as the scratching of a healing wound.

The initial injury you described, which occurred about a year ago, likely triggered the formation of granulation tissue as part of the normal healing process. However, continuous irritation from scratching can lead to an overproduction of this tissue, resulting in the red, raised area you are experiencing. This can also explain the recent itching sensation, as granulation tissue can be sensitive and prone to irritation.

There are several factors that can contribute to the formation of granulation tissue, including:
1. Chronic Irritation: Repeated trauma or irritation to the area, such as scratching, can stimulate the growth of granulation tissue.

2. Infection: If the area becomes infected, it can lead to increased inflammation and the formation of granulation tissue.

3. Underlying Conditions: Certain medical conditions, such as diabetes or vascular diseases, can affect the healing process and lead to abnormal granulation tissue formation.

In terms of treatment options, here are some recommendations:
1. Avoid Irritation: The first step is to stop any actions that may be irritating the area, such as scratching. Keeping the area clean and dry can help reduce inflammation and promote healing.

2. Topical Treatments: Over-the-counter topical treatments, such as hydrocortisone cream, may help reduce itching and inflammation. However, it is essential to use these products cautiously and not overapply them.

3. Surgical Removal: If the granulation tissue is bothersome or does not resolve with conservative measures, a healthcare provider may recommend surgical excision. This procedure can be performed in a doctor's office and typically involves minimal discomfort.

4. Cauterization: In some cases, cauterization (burning the tissue) may be used to remove granulation tissue. This method can help reduce the size of the tissue and alleviate symptoms.

5. Consultation with a Healthcare Provider: Given the location of the granulation tissue and your concerns about seeking medical attention, it is crucial to find a healthcare provider who can address your fears and provide a comfortable environment for examination. They can assess the tissue, rule out any underlying issues, and recommend appropriate treatment.

6. Follow-Up Care: After treatment, follow-up care is essential to ensure proper healing and to monitor for any recurrence of granulation tissue.

In conclusion, while granulation tissue is a natural part of the healing process, persistent or excessive growth can be addressed through various treatment options. It is essential to consult with a healthcare provider to determine the best course of action for your specific situation. Remember, seeking medical advice is crucial, especially if you notice any changes in the area, such as increased redness, swelling, or discharge, which may indicate an infection or other complications.

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