Topical Corticosteroids (Steroids, Cortisone):

• Are moderately effective
• They are used twice daily on the affected areas until the spots become flat
  • At that point use should be stopped
• Topical corticosteroids must be used for at least a month to see if they are going to be effective
• The most common side effect would include, but not be limited to: thinning of the skin in the area to which they are being applied
  • Skin thinning may appear as bruising, stretch marks or dimpling

Intralesional Steroids (Cortisone Injections):

• Cortisone injections work much better than the creams, gels and lotions
• The cortisone is injected directly into the spot
• A lesion 5 cm (2 inches) in diameter would require about 8 injections
• The injections are repeated at monthly intervals
  • The main side effect from the injections includes, but is not limited to: thinning of the skin
  • Skin thinning may appear as bruising, stretch marks or dimpling

• • Skin thinning will usually resolve spontaneously once treatment is stopped

Phototherapy (Light Therapy):

• If granuloma annulare is extensive (more than 20 lesions) UVB or PUVA light treatments may be used
• They are helpful 50% of the time but carry the risk of sunburn and long term use increases the risk of skin cancer
• These treatments are usually done 2 to 3 times per week for a minimum of 6 to 12 weeks

Oral Medications (Pills):

• If there are many spots (several hundred) treatment is very disappointing
• A wide variety of oral medications (pills) have been tried but nothing has even been proven to be helpful
• Granuloma Annulare will eventually disappear on its own without treatment

• Sometimes it is best to leave the spots untreated especially in young children