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What Is Granuloma Annulare And How Can I Get Rid of It?

What happens when a condition like granuloma annulare is diagnosed? No one knows what causes it or how to cure it. Do home remedies work?

Don’t you love it when doctors characterize a condition as “idiopathic?” That is a fancy medical term for “we haven’t got a clue as to what causes this.” That’s the case with granuloma annulare. If you want to see what it looks like, here are some photographs on the www.skinsight.com website. Even if it is accurately diagnosed, there are no obvious cures. When there is no dermatologist-sanctioned treatment, people start looking for home remedies.

Help for Granuloma Annulare?

Q. Several years ago, I was diagnosed with a skin condition called granuloma annulare (GA). It manifests itself on the arms, legs, and back with round red or purplish circles that look like ringworm. There are no other symptoms. It’s just very unsightly.

I have been to several dermatologists who tell me that GA is idiopathic and that there really is no effective treatment for it. Light therapy sometimes helps; however, since I have had a melanoma, this is not recommended. Medicines and ointments are useless. Do you have a suggestion for a natural treatment that will help?

A. Doctors do not know what causes granuloma annulare, and there is no accepted medical cure (American Family Physician, Nov. 15, 2006).  Apparently, GA goes away on its own about half of the time.

For the other half, when GA becomes chronic, physicians may sometimes prescribe powerful immune-suppressing drugs known as biologics (International Journal of Dermatology, May 2019). Unfortunately, however, these drugs can carry some potentially serious side effects such as susceptibility to infection, nerve degeneration or rash. As a result, they probably don’t have enough potential benefit against this benign condition to warrant the potential risks. 

Doctors sometimes prescribe another medicine called pentoxyfilline (Journal of Dermatological Treatment, June 2021). Its approved use is for peripheral artery disease that causes pain while walking. However, it might also help against granuloma annulare.

Topical Treatments for Granuloma Annulare:

Another reader would like to find a treatment to make the marks go away. 

Q. I have granuloma annulare and was hoping that you might know of a topical remedy to rid me of the red circles and marks on both thighs.

A. Granuloma annulare (GA) is a benign, long-lasting skin condition. The cause is a mystery. This links to photos of the condition. 

Some readers have reported success applying vinegar to the spots. Others tell us that the antifungal cream Vagisil can help, even though GA is not supposed to be a fungal infection. No scientific studies have been done on either of these approaches for GA.

Could Selsun Blue Be Useful?

Q. Earlier this year you wrote about granuloma annulare (GA). I did not know what it was, but I have experienced many skin conditions over the years.

I find that using Selsun Blue shampoo with selenium sulfide 1% as a body wash is really helpful. It alleviates itching immediately and dries out rashes. Eventually the skin problem goes away.

The skin is our largest organ. It sweats out, expels and reflects what goes into the body, so eating right is also important.

A. We have not found any research indicating that granuloma annulare would respond to Selsun Blue. The ingredient in this dandruff shampoo (selenium sulfide) may help ease the itching and scaling of seborrheic dermatitis. Other readers have used it to treat rosacea, eczema and jock itch.

Doctors don’t know what causes GA. However, these round raised reddish areas are not contagious. No pathogen has been identified as the cause.

As mentioned above, some people find that Vagisil with resorcinol for vaginal yeast infections is also helpful for GA. Dermatologists don’t have a standard treatment, but pentoxifylline, a drug for peripheral artery disease, shows some promise (Journal of Dermatological Treatment, June 2021).

You are right that diet may play a role. Sometimes GA is associated with diabetes. In addition, Japanese doctors reported success in a patient who followed a strict lipid-lowering diet (Dermatology Practical & Conceptual, Jan. 31, 2014). 

Home Remedies for Granuloma Annulare:

There is no research on home remedies for GA that we are aware of. In fact, dermatologists have complained that most of the articles on potential prescription treatments are based on case reports rather than randomized controlled trials. Without research, we must also base our recommendations solely on other readers’ testimonials.

Some have reported that applying white or apple cider vinegar to the rash daily speeds healing. Others have used the antifungal cream Vagisil for the same purpose. Since GA is not a fungal infection (unlike ringworm), we don’t know why or how this would help.

Linda in Issaquah, Washington offered a turmeric remedy:

“In response to the comments on granuloma annulare, I have my own experience to add. I too, had the rash on my hands, but also on my arms and back. it would get worse in the cooler months of the year, and much better in the summer-I’m guessing from the sunlight.

“I saw a dermatologist and got a topical cream and got cortisone injections in the worst spots, neither of which did anything to reduce all the large bumps.

“It wasn’t until I started taking turmeric supplements that I noticed a difference. All of the spots disappeared fairly quickly and have not returned. I have been taking Turmeric (with pepper extract) for over two years now, and haven’t had any flare ups at all. I hope this helps someone.”

Diane relied on tincture of time:

“I have had granuloma annulare for over 2 years. You name it and I have tried it, but I drew the line at injections. I finally decided to ignore it.

“The bumps on my hands have gotten much smaller and the inside of my thighs is almost completely clear and my elbows have lightened up considerably. I just tell people that I have a skin condition and it is not infectious to others.”

Many times granuloma annulare goes away by itself, just as mysteriously as it arrived. Diane’s experience is not unique.

Jacqueline got corticosteroid injections:

“I had several on my legs and 1 on my ankle. Also one on my middle finger.

“My dermatologist 1st tried cortisone creams and occlusive dressings……no improvement whatsoever. Then intra dermal cortisone injections. After 6 treatments they were completely vanished. Just a smallish white indentation remains.

“This was back in 1986. New one has now appeared on my ring finger 22 years later. I am going straight to the dermal injections…painful though it was.”

C.C. has had some success with a home remedy:

“I read your column recently about the raised spots on your arms, legs etc. I tried using the vinegar (white and apple) and low and behold the spots are flat and very smooth. They have not disappeared as yet but i will keep trying. I am elated to find out about this process in your articles. Thank you so much.

“A dedicated reader.”

H.H. shared his experience but didn’t name the antibiotic:

“I must tell you about my granulola annulare that appeared on my legs and back 17 years ago. I doctored with a skin specialist for over a year, just using a topical ointment, but to no avail… nothing.

“One day he came in with a big smile on his face and when I asked him why he was so happy, he told me he had heard the cure was antibiotics.

“He gave me a shot of some kind of antibiotic. I can’t remember if it was just the one shot of not, but my spots disappeared completely.”

Anonymous offered this:

“I am writing in response to your reader with the condition of granuloma annulare.

“After visiting numerous doctors and trying many treatments, I have found that taking two apple cider vinegar tablets each day works to keep this rash at bay. The vinegar also keeps my skin soft, and the tablets are inexpensive.”

The People’s Pharmacy Perspective:

Why vinegar would be helpful is mysterious, but several people insist that it is. We wish some enterprising dermatologist would test some of these remedies and let us know which might be most effective. 

Let us know what has worked for you in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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Citations
  • Cyr PR, "Diagnosis and management of granuloma annulare." American Family Physician, Nov. 15, 2006.
  • Chen A et al, "The role of biologics in the treatment of chronic granuloma annulare." International Journal of Dermatology, May 2019. DOI: 10.1111/ijd.14350
  • Visconti MJ et al, "Granuloma annulare: strengthening potential associations and pentoxifylline as a therapeutic option." Journal of Dermatological Treatment, June 2021. DOI: 10.1080/09546634.2019.1662366
  • Watanabe S et al, "Remission of generalized erythematous granuloma annulare after improvement of hyperlipidemia and review of the Japanese literature." Dermatology Practical & Conceptual, Jan. 31, 2014. DOI: 10.5826/dpc.0401a17
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