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What Are Fibrous Papules?

By Misty Wiser
Updated Mar 06, 2024
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Fibrous papules, or angiofibromas, are small benign bumps on the skin that do not change in appearance throughout a person’s lifetime. These small spots are usually flesh-colored and may resemble a mole. The most common location for a fibrous papule to develop is on the face, especially on and around the nose. Most papules appear late in adolescence or during early adulthood, and bumps that suddenly appear later in life should be promptly evaluated by a medical professional. Treatment is not necessary unless removal is desired for cosmetic reasons.

The majority of fibrous papules develop as a singular lesion. When multiple papules form at the same time, it is often part of systemic condition such as tuberous sclerosis or multiple endocrine neoplasia type 1. Diagnosis usually occurs after a visual inspection and biopsy of the bump. Biopsy results will indicate an increase in blood vessels in the dermis of the skin and underlying fibrous stromal tissue.

Fibrous papules often resemble other, more serious lesions that require medical treatment. Reddish bumps may indicate the spots are caused by adenoma sebaceum, and their presence should lead to a screening test for tuberous sclerosis. Another form of lesions that are similar in appearance are called Koenen tumors, and any bumps of this type require medical treatment. Basal cell carcinomas may look similar as well, but grow much faster than the benign spot. A healthcare professional should assess any quickly growing or changing bump on the skin.

When these bumps are removed, it's usually an outpatient procedure. One hour before the appointment to remove the bump, an analgesic cream will be applied to the skin around the papule to numb it. After injecting a local anesthetic, a medical professional will quickly scrape away the small lesion with short horizontal strokes in a process called shave excision. He will then cauterize the site to prevent infection and promote a faster healing time.

Other methods of fibrous papule removal are curettage, elliptical excision, or laser removal. Laser treatment options include the pulsed dye laser, the CO2 laser, the KTP laser, or the argon laser. Each laser variation results in different after-care guidelines and healing times.

The fibrous papule will sometimes grow back in the same location after a few months. If the lesion returns, a follow-up appointment to remove the new growth will be scheduled. This procedure may need to be repeated several times if the fibrous papule may come back more than once.

Fibrous Papule of the Nose

A fibrous papule on the nose is a small spot that people tend to develop in early to mid-adult life. Typically, the papule will measure 1-5 millimeters. It is usually firm and can look like a small dome or like a skin tag or small wart. It may be the same color as your skin but can also have a red appearance. Fibrous papules occur due to aging. They are non-cancerous growths and typically only occur one at a time, although some people do develop more. The papule is made up of blood vessels and collagen. It does not typically carry any symptoms, so you'll only know it is there because you see it.

Fibrous Papule Removal

Before you can consider fibrous papule removal, it must be properly diagnosed. A doctor can do this by performing a skin biopsy. From there, he or she will find the distinctive properties of the papule, such as multinucleated cells, a fibrotic stroma, or dilated blood vessels. Once diagnosed, you will be able to decide whether you want treatment. Treatment is not a requirement because fibrous papules are harmless. However, some people prefer to have them removed for cosmetic reasons. This can be done in a number of ways, including a shave biopsy, laser therapy, cryotherapy, electrosurgery, or excision.

While the specifics of your removal depend on the type you choose, typically, they follow the same basic pattern. First, your doctor will inject you with a local anesthetic that numbs the area and prevents the removal from being painful. Then, he or she will remove the fibrous papule. Afterward, you'll have a superficial wound. The doctor will cover it in a bit of antibiotic ointment to prevent an infection. It will scab over and heal in about a week's time. Your doctor may also perform histological testing on the papule. After healing, a close-up examination may show a small scar, but it is typically not noticeable.

Aftercare and recovery for fibrous removal are quite easy. You'll need to avoid any heavy exercise for the rest of the day so that you don't sweat onto the area. It needs to be kept dry and clean while it heals. Use water and a cotton pad to cleanse the area as needed. You can go back to work the same day. If the wound is in an area that is prone to rubbing, such as where your glasses sit, then your doctor will provide you with a dressing for it.

Do Fibrous Papules Grow Back?

Once removed, fibrous papules rarely grow back. On the rare occasion that it does return, you can opt to have it removed again if you prefer. Keep in mind that because fibrous papule removal is considered a cosmetic procedure, most insurance companies will not cover it. However, removal is not very expensive. It typically costs between $150 and $500, depending on the size of the fibrous papule. You can talk to your dermatologist to learn about the specific cost for you.

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Discussion Comments

By anon941640 — On Mar 23, 2014

Fibrous papules on the nose / face can also be removed by DIY chemical peel solutions you can make at your own house. I have removed mine by holding apple cider vinegar pads over mine. The papule will turn white after the soaked pad being held in place for 10-15 min. I then follow it up with either benzoyl peroxide or lavender oil.

I will repeat for a number of days until it is gone. The area will become sensitive, so vitamin E and other forms of healing oils should be applied after you see the papule begin to recess.

Let it heal, and either it will be completely gone, or if there is a little left, let it completely heal for a couple of weeks and then go after it again with apple cider vinegar. I was self conscious for over a year about mine, and discovered this treatment by accident and it actually works. Good luck!

By bagley79 — On Nov 15, 2011

My uncle has several of these papules on his face. They don't seem to bother him at all, as he has never had anything done about them.

I think it would be hard to shave with all those bumps on his face, but every time I see him he always looks the same.

If this happened to me, I think I would have to seek out some kind of fibrous papule treatment. Even if they were benign and wouldn't cause any problems, I wouldn't like having these in places that were real noticeable.

Having bumps of the face is something that would bother me as well. I think it is hard for people not to stare at them even though they try not to.

By LisaLou — On Nov 14, 2011

When I was in my twenties, I had a fibrous papule on my nose. Even though this was a small bump, I was really self conscious about it and felt like it stuck out like a sore thumb.

Because it bothered me so much, I went to a dermatologist to see about having it removed. This didn't take very long and was pretty painless.

I was pretty frustrated though, when it returned after a year or so. The first time, my doctor removed it by curettage, but went with a laser treatment the second time.

It hasn't come back again, so don't know if it was the laser treatment that did it or not, but really hope I don't get any more of these unsightly bumps on my face.

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