Fibrous Papule on Nose

Question

I have a fibrous papule on the tip of my nose. I use a razor almost daily to lessen it. Is laser treatment the best way to remove this permanently? What laser type is recommended? Thank You, Any help is very appreciated. Steve

William Ting, MD · Answer

Fibrous papule is a benign growth that is often found on the nose in individuals with history of sun damage. Shave excision by an experienced dermatologist typically offers the best cosmetic outcome. Ablative laser should not be used as a first line unless pathology has been determined and skin cancer ruled out.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Hooman Khorasani, MD · Answer

Excellent question.  Before making the diagnosis of fibrous papule it would be good to know how this diagnosis was reached?  The best diagnosis would be made by a dermatologist with the assistance of dermoscopy and sometimes a biopsy.  Fibrous papule is also known as an angiofibroma and is a benign entity that does not need to be removed for medical reasons.  However you should have a full medical history and examination by a dermatologist because occasionally angiofibromas are associated with syndromes such as tuberous sclerosis complex.  You should not be alarmed but should have complete medical history and examination performed as a precaution. There are many ways to remove a fibrous papule for cosmetic purposes - commonly used methods include shave, electrosurgery, cryotherapy and ablative laser such as CO2 or erbium laser.  I hope this helps.

Vivek Bansal, MD · Answer

I like the CO2 if you have a small spot size, a Vbeam, or 532 laser.  All of these lasers can help. Thank you for your question and good luck.

Susan Fox, DO, RPVI · Answer

I would see a dermatologist to look at this.  They can make sure it is just a fibrous papule and shave  this off if need be or remove it as they see appropriate.  They usually are treated easily and I would not be shaving this or treating this at home.  Why risk infection or scarring.  Go to your Dermatologist

Stanley Kovak, MD · Answer

A fibrous papule is considered a benign lesion and as such, can be removed simply in a variety of ways. Prior to removal, the lesion should be evaluated by a dermatologist to assure that it is benign. If there is any question or concern, the lesion should be removed by a shave excision and the piece be sent off for evaluation. If it is truly benign, I have found the erbium laser to be most helpful and give the best aesthetic result. The erbium is very precise in its depth of treatment and, unlike the CO2, there is no excess heat left in the tissue which minimizes the risk for hypopigmentation.

Martie Gidon, MD, FRCPC, FAAD · Answer

Since you do not mention bleeding when you shave your papule, it is probably a white angiofibroma. It could be removed with a CO2 laser; however, it would be very simple to do a shave excision and send the tissue to the lab for analysis. Please see a dermatologist for removal.

Anatoli Freiman, MD · Answer

Nose angiofibroma can be removed with electrocautery, or laser therapy such as e.g. CO2 resurfacing or BBL to decrease redness.  Best is to get assessed by a dermatologist.

Steven Bernstein, MD · Answer

In order to get a better understanding of what you and your doctor are dealing with you need to have a biopsy for your Fibrous Papule. It is considered a naevus and should not be treated without more information.
	When you are ready to undergo any esthetic procedure, it is best to have a consultation with a board certified cosmetic doctor or dermatologist who you trust, in your case a dermatologist. They will give you the honest answers for your unique situation (your starting point, your objectives and your budget). It is at this consultation that you will really find out if this is a good procedure for you. Any esthetic tool needs to be in the right hands, to achieve the best possible results.

Benjamin Barankin, MD, FRCPC · Answer

A fibrous papule of the nose is also often called an angiofibroma. It can be nicely reduced in size and appearance with a hyfrecator/electrosurgery. Liquid nitrogen can also be helpful, as can a gentle shave excision. See you dermatologist for the best option in your case.

Fibrous Papule on Nose

Answers (14)

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