A Chronic Skin Condition?

I have a skin condition called granuloma annulare. I’ve tried all the steroid creams without improvement. Do you know of any alternative treatments?

– July 26, 2005

Granuloma annulare is a chronic but harmless skin condition characterized by circular lesions composed of small, red bumps. The bumps are painless but can itch, and usually develop on the feet, legs, hands or fingers. This disorder occurs most often among children and tends to develop among girls more frequently than among boys. It can also occur in adults, sometimes in association with diabetes or thyroid disease.

Although the cause is unknown, granuloma annulare may be linked to sun exposure, trauma to the skin, insect bites and some viral infections.

Fortunately, the condition typically heals without any treatment at all, but it can linger for as long as two years before it finally resolves. And it may come back at a later date.

Conventional medicine treats it with steroid creams or ointments or the injection of steroids into the lesions. In severe cases, physicians may recommend treatment with ultraviolet light combined with drugs called psoralens that make the skin more sensitive to UVA light. This treatment is called PUVA (an abbreviation for psoralens plus UVA).

I would recommend hypnotherapy, which can be very effective in treating skin conditions. To find a hypnotherapist experienced in dealing with skin problems, log on to the web site of American Society of Clinical Hypnosis at www.asch.net/referrals.asp. You also might consider homeopathic treatment. In addition, try supplemental black currant oil or evening primrose oil. Both provide GLA (gamma-linolenic acid), an essential fatty acid hard to come by in the diet. GLA promotes healthy growth of skin, hair and nails. I usually suggest taking black currant oil in doses of 500 mg twice a day. You won’t see immediate results; it typically takes six to eight weeks for changes to appear. If your diet is not rich in essential fatty acids, you might also consider supplements of fish oil to improve skin health.

Andrew Weil, M.D.

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