Effective Treatments for Fibromas: Managing Recurrence and Aesthetic Concerns

How to treat fibromas?

I have a fibroma on the middle phalanx of my left ring finger due to trauma.
I have undergone two surgeries, one at Kaohsiung Medical University and the other at E-Da Hospital, but there is still a noticeable protrusion.
The doctors at Kaohsiung mentioned that I have a keloid tendency, which is related to my internal condition, and they advised against further surgery due to the risk of recurrence.
I would like to know what other options are available to reduce the protrusion for aesthetic reasons.
Kaohsiung suggested that if it recurs, corticosteroid injections might help.
Can corticosteroids flatten the area?

Xiang, 20~29 year old female. Ask Date: 2016/03/15

Dr. Lu Daokuan reply Plastic Surgery

Scars from traumatic raised lesions near joints tend to have poorer treatment outcomes.
It is important to communicate frequently with your physician and be patient with the treatment process.

Reply Date: 2016/03/15

More Info

Fibromas, also known as fibromatosis or dermatofibromas, are benign tumors that can develop in the skin and subcutaneous tissue. They often arise from fibrous connective tissue and can be caused by trauma, genetics, or other factors. In your case, it seems that you have experienced recurrence after surgical interventions, which is not uncommon, especially in individuals with a predisposition to keloid formation or hypertrophic scarring.

When it comes to managing fibromas, particularly in aesthetic terms and to prevent recurrence, there are several options available:
1. Steroid Injections: As you mentioned, corticosteroid injections can be effective in flattening fibromas and reducing inflammation. These injections work by decreasing collagen production and can help in managing the size of the fibroma. However, the results can vary, and multiple sessions may be required. It's important to note that while steroid injections can help, they may not completely eliminate the fibroma, and there is a possibility of recurrence.

2. Laser Therapy: Laser treatments, such as pulsed dye laser or CO2 laser, can be used to reduce the appearance of fibromas. These treatments can help flatten the fibroma and improve skin texture. However, similar to steroid injections, results can vary, and multiple sessions may be necessary.

3. Cryotherapy: This involves freezing the fibroma with liquid nitrogen, which can lead to its destruction. Cryotherapy can be effective for some types of fibromas, but it may not be suitable for all cases, and there is a risk of skin discoloration or scarring.

4. Surgical Options: While you have already undergone surgery twice, it is essential to discuss with your dermatologist or plastic surgeon the possibility of a different surgical approach or technique that may minimize the risk of recurrence. Sometimes, a more extensive excision may be necessary, or a different closure technique may be employed to reduce tension on the wound.

5. Topical Treatments: Some topical treatments, including silicone gel sheets or ointments, can help flatten and improve the appearance of fibromas over time. These are particularly useful for managing scars and may help in conjunction with other treatments.

6. Observation: In some cases, if the fibroma is not causing discomfort or significant aesthetic concerns, a watchful waiting approach may be appropriate. Many fibromas do not pose any health risks and can be left untreated unless they become bothersome.

Regarding your concern about the aesthetic appearance of the fibroma on your left hand, it is crucial to have a thorough discussion with a dermatologist who specializes in skin lesions or a plastic surgeon. They can provide tailored advice based on your specific situation, including your history of keloid formation.

In summary, while steroid injections can help flatten fibromas, they may not completely eliminate them, and recurrence is a possibility. Exploring other treatment options, including laser therapy, cryotherapy, or even a different surgical approach, may provide additional benefits. Always consult with a qualified healthcare professional to determine the best course of action for your individual case.

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