A dermatofibroma is a harmless bump in the skin, and most people never need to treat one. When one hurts, itches, or bothers you, there are ways to remove it or make it less noticeable.1RV Plastic Surgery. Dermatofibroma Excision: When Removal is Recommended
Do You Need to Treat a Dermatofibroma
Dermatofibromas are firm, often brownish raised bumps, most often found on the legs.2PubMed Central. Multiple Dermatofibromas: Dermoscopic Patterns Pinching the skin on either side usually makes the bump sink inward.3PubMed Central. Multiple Dermatofibromas: Dermoscopic Patterns The look and the dimple test are enough for a doctor to recognize most of them.4PubMed Central. Multiple Dermatofibromas: Dermoscopic Patterns Many appear after a minor skin injury such as an insect bite, scratching or an ingrown hair.5PubMed Central. Dermatofibroma: Reappraisal and Updated Review
Dermatofibromas do not need removing for health reasons.6RV Plastic Surgery. Dermatofibroma Excision: When Removal is Recommended They are benign and are not considered a skin cancer risk.7RV Plastic Surgery. Dermatofibroma Excision: When Removal is Recommended
Most stay about the same size for years and cause no symptoms. Some flatten or fade a little over time, though many persist.
When Removal Makes Sense
Doctors usually consider removal when a dermatofibroma becomes painful, tender or itches persistently.8Dermpro. Dermatofibroma Removal: When It’s Needed and What to Expect Bumps where a waistband rubs or a razor catches on the lower leg are more likely to get irritated.9RV Plastic Surgery. Dermatofibroma Excision: When Removal is Recommended One that bleeds after being bumped or scratched is another common reason.10Dermpro. Dermatofibroma Removal: When It’s Needed and What to Expect Removal in these cases can bring real relief.11RV Plastic Surgery. Dermatofibroma Excision: When Removal is Recommended
Shaving the lower leg is the classic trigger. A razor repeatedly catches the raised bump, causing nicks, bleeding and scabs. Some people solve the problem by shaving around it or switching methods before considering removal.
Appearance is the other reason. Some people want one removed because it sits somewhere visible, such as the face.12Dermpro. Dermatofibroma Removal: When It’s Needed and What to Expect A doctor may also recommend removal when the diagnosis is uncertain and the tissue needs to be examined.13Dermpro. Dermatofibroma Removal: When It’s Needed and What to Expect
Surgical Removal and Its Scar
Cutting the bump out completely, called excision, is the most definitive treatment.14Thomas Clinic. Dermatofibroma: Removal Options & Creams The surgeon removes the bump down into the fat beneath it along with a margin of 1 to 3 mm of normal skin.15PubMed. Dermatofibroma surgery Taking that margin and depth lowers the chance it grows back.16Dubai Skin Clinic. Surgical Dermatofibroma Excision: Process, Recovery, Results
The procedure is done in a clinic under local numbing. The doctor injects numbing medicine around the bump, which stings briefly and then the area goes numb.
The cut is usually shaped as a narrow oval so it closes flat. On areas under tension, such as the leg, the doctor may place deeper stitches that dissolve under the skin plus surface stitches that are removed. Surface stitches stay for one to two weeks depending on body site, and the removed tissue is usually sent to a lab to confirm what it was.
Excision always leaves a scar.17Thomas Clinic. Dermatofibroma: Removal Options & Creams In some cases the scar ends up more noticeable than the original bump.18News-Medical. Dermatofibroma Management and Prognosis The oval cut is roughly three times as long as it is wide, and leg skin heals more slowly, so scars there tend to spread.
Laser Treatment to Flatten and Fade
A pulsed dye laser, which targets blood vessels in the skin, can shrink a dermatofibroma.19PubMed. Treatment of dermatofibroma with a 600 nm pulsed dye laser In one small group, three quarters of bumps flattened completely and about 6 in 10 lost their color.20PubMed. Treatment of dermatofibroma with a 600 nm pulsed dye laser In another group, about half the bumps improved by more than half, and nearly 3 in 4 people were satisfied.21PubMed. Dermatofibromas treated with pulsed dye laser: Clinical and dermoscopic outcomes Combining this laser with a pigment laser faded the brown color fully in most treated people and softened the bump.22Actas Dermo-Sifiliográficas. Prospective Study of Q Switched Alexandrite Laser 755 nm and V Beam Pulsed Dye Laser 595 nm in Dermatofibroma
Lasers are considered a gentler, palliative treatment that tends to look better afterwards than surgery.23PubMed. Dermatofibromas treated with pulsed dye laser: Clinical and dermoscopic outcomes The evidence comes from small groups of patients, though, so results vary.
A course usually means several sessions spaced weeks apart, with results building gradually. It is generally a cosmetic cost not covered by insurance.
The laser suits people mainly bothered by color or a raised profile, and those who want to avoid a surgical scar. It is not a good fit if your diagnosis is uncertain, since no tissue is examined.
Steroid Injections and Freezing
Injecting a corticosteroid into the bump can soften and flatten it.24RV Plastic Surgery. Dermatofibroma Excision: When Removal is Recommended This tends to suit smaller or flatter dermatofibromas.25Aspen Dermatology. Dermatofibromas – Aspen Dermatology It does not remove the bump and isn’t treated as a definitive removal method.26Thomas Clinic. Dermatofibroma: Removal Options & Creams
The doctor injects a small amount of steroid directly into the bump with a fine needle, which stings briefly. If the first dose is not enough, repeat visits are sometimes spaced weeks apart. The skin around the spot can thin or dimple, and the area may lighten in color, which is more noticeable on darker skin.
Some dermatofibromas have been treated successfully by freezing with liquid nitrogen.27Romanian Journal of Military Medicine. Atypical Fibroxanthoma versus Hemosiderotic Dermatofibroma: Challenges in Differential Diagnosis – Literature Review and Case Report Still, surgical excision remains the most common approach.28Romanian Journal of Military Medicine. Atypical Fibroxanthoma versus Hemosiderotic Dermatofibroma: Challenges in Differential Diagnosis – Literature Review and Case Report
Creams and home removal don’t work. The bump sits in the deeper skin layer, out of reach of creams. Cutting or burning it at home risks infection and a worse scar, and over-the-counter wart or mole removers are not designed for it.
Will It Come Back After Removal
Cellular, atypical and aneurysmal types of dermatofibroma are more likely to grow back after removal.29Connolly Dermatology. How to Treat a Dermatofibroma: Removal Options Cellular, atypical and aneurysmal are names the lab gives when the tissue looks different under the microscope from the usual type. These types need complete removal with clean edges.30Connolly Dermatology. How to Treat a Dermatofibroma: Removal Options For the cellular type, when some of the bump was left at the edges of the first removal, about 1 in 10 grew back.31PubMed. Cellular Dermatofibroma: Clinicopathologic Review of 218 Cases of Cellular Dermatofibroma to Determine the Clinical Recurrence Rate Lasers and injections leave the growth in place, so the bump can remain.
Your lab report names the type and says whether the edges, or margins, are clear. If they aren’t, ask whether a second, wider removal is advised. Ordinary types with clear margins rarely need follow-up.
Regrowth looks like a firm bump returning within the scar over months. Report it rather than waiting, since it may need to be cut out again.
When a Bump Should Be Checked
Telling a dermatofibroma from atypical moles or melanoma can sometimes be difficult.32PubMed Central. Multiple Dermatofibromas: Dermoscopic Patterns Doctors often look with a dermatoscope, a lighted magnifier, where some show a pale center with a fine brown network around it.33PubMed Central. Multiple Dermatofibromas: Dermoscopic Patterns That classic picture appears in only about 1 in 5 dermatofibromas.34PubMed Central. Beyond classic dermoscopic patterns of dermatofibromas: a prospective research study When the look isn’t clear, a small biopsy settles the diagnosis.35PubMed Central. Skin Biopsy Techniques A rare slow-growing skin cancer can also resemble a dermatofibroma, and lab staining of tissue tells them apart.36PubMed. The pathological distinction between “deep penetrating” dermatofibroma and dermatofibrosarcoma protuberans
Get a bump checked if it keeps growing after the first few months, doesn’t dimple when pinched, has uneven color, or bleeds without injury. The same goes for one that is larger than a typical pea-sized dermatofibroma or is not on a limb.
A biopsy takes a small numbed sample or the whole bump. Results usually return within one to two weeks. If the whole bump is taken, the biopsy is also the treatment.