The presence of small, raised bumps on the skin is often of concern to many. But they may all not be harmful. Fordyce Spots is one such benign skin condition.
What are Fordyce Spots?
Fordyce spots refer to a skin condition where small bumps or spots appear on the border of the lips of the person’s face or inside the cheeks. For males, they also occur on the penis shaft, the foreskin or the scrotum. For females, they may appear on the labia or sometimes near the entrance to the vagina. This condition is also called Sebaceous Prominence or Fordyce Granules.
Fordyce spots were named after the American dermatologist John Addison Fordyce. They can appear as isolated bumps but are more commonly found in clusters.
How do Fordyce Spots occur?
Fordyce Spots are basically sebaceous glands found in the moist linings of organs and mucosal surfaces. Sebaceous glands are enlarged oil glands that produce sebum and are usually located in hair follicles. But Fordyce Spots are not associated with hair follicles and appear on skin surfaces where there is no hair.
In normal sebaceous glands, the secreted oil goes up into the hair shaft via the follicle. Since Fordyce Spots do not have follicles, the secreted sebum finds no outlet to get discharged. This then results in the formation of raised bumps.
Are Fordyce Spots a Cause for Concern?
Fordyce Spots are not painful or harmful in any way. They are not symptoms of a disease. As they are not caused due to a virus, they are not contagious either.
Fordyce spots may be a cosmetic concern for many people. The presence of too many spots may appear unlikely to the person and he or she may want them removed. This could cause emotional problems of anxiety and depression for people who have these spots.
Their presence of the genitals may cause embarrassment during intimacy and this way may affect their sexual life in a psychological way. Sometimes the appearance of the granules may be mistaken for the presence of genital warts, pearly penile papules or STDs.
Symptoms of Fordyce Spots
It is important to know the symptoms of Fordyce Spots as they can be mistaken for many other skin conditions. Their symptoms are:
- The appearance of small and raised bumps or spots on the skin which are around 1-3mm in diameter.
- The color of the spots may be skin color, yellow or pink.
- They may appear bright red or purple on the genitalia.
- They can appear as a solitary spot or in clusters. They appear more commonly as clusters in the scrotum, penis shaft and labia regions of the body.
- They are generally painless. Sometimes, as a result of sexual intercourse, they may bleed.
- The bumps do not cause any itching sensation.
- The granules appear more prominent when the skin is stretched.
When do Fordyce Spots appear?
- Fordyce Spots are usually present at birth. But they only enlarge during puberty because of hormonal changes.
- They are more associated with people with oily skin.
- It is also noted that a high level of lipids, cholesterol, and triglycerides in the blood are also associated with Fordyce Spots as they trigger the sebum output in the body.
- The risk of developing these spots is also seen in people with weaker immune systems.
Diagnosis of Fordyce Spots
Even though this is a harmless condition, it is advisable to get it checked by a dermatologist. The doctor will physically assess the affected areas using a dermatoscope. Sometimes a biopsy may be done and a small segment of the affected area is taken for analysis.
Diagnosis becomes important as Fordyce Spots can resemble other skin or genital conditions which may be harmful. Therefore, the biopsy will rule out the possibility of other skin conditions and will confirm the condition of Fordyce Spots. This is very important if the person is already suffering from or is at risk of contracting a sexually transmitted disease.
Differential Diagnosis for Fordyce Spots
The below list contains a few skin conditions that Fordyce Spots could be mistaken for. It is imperative that the dermatologist should rule out the following disorders while making the diagnosis for Fordyce Spots:
- Milium cysts
- Sebaceous hyperplasia
- Basal cell carcinoma
- Sebaceous carcinoma
- Muir Torre Syndrome and many more.
Fordyce Spots Treatment
As mentioned above, it is important to get a professional diagnosis to rule out misdiagnosis.
Many dermatologists will view Fordyce Spots as a normal bodily condition and may advise against treatment. In most cases, the spots go away on their own, but may also reappear.
There are different options for treatment. They are:
- Laser treatment – This is a method that is commonly used to treat Fordyce Spots. One treatment involves the use of CO2 lasers to make the spots less visible. This may cause scarring though. Another treatment is by using pulsed dye lasers. This treatment focuses light on spots to destroy the supply of blood and oxygen to the bumps. This is less scarring but may be expensive.
- Micropunch technique – This is a new surgical technique. Local anesthesia will be administered to reduce pain. A small device will then punch holes of 1-2mm width into the skin and the unwanted tissues will be removed manually. This procedure does not cause scarring.
- Chemical cauterization – This technique involves heating a fire probe and applying it to the spots and burning them away. It is a quick process, is less expensive but may cause scarring.
- Cryotherapy – This is a similar technique but liquid nitrogen is used here to freeze out the spots. This may be an uncomfortable process and may need multiple sessions.
- Photodynamic therapy (PDT) – This involves taking a photosensitizing agent orally as a drug. This agent then builds up in concentration in the affected skin. When the laser is applied, it reacts with the oxygen and the agent and burns away the abnormal cells. This method has side effects of burning and itching sensations.
- Topical treatments – The doctor may recommend topical treatments such as tretinoin and oral isotretinoin along with laser treatment. Application of these treatments may cause inflammation and burning if exposed to the sun.
- Home remedies – The application of jojoba and coconut oil has been known to improve the symptoms of Fordyce Spots for those who don’t want medical treatment.
- Balance skin Ph levels – Avoid harsh alkaline soaps and shower gels and use only natural cosmetics.
- Nutrition – Following a proper diet, taking supplements and staying hydrated will also aid in the above treatments as they help in skin repair.
Fordyce Spots Pictures
Fordyce Spots on Lips
Fordyce Spots on Shaft on the Penis
Fordyce Spots on Scrotum
Fordyce Spots are small bumps seen in many areas such as the penis shaft, scrotum, labia, and border of the lips on the face. They are harmless, painless and are not contagious. These spots usually go away without treatment but may reappear. It is important to get a proper diagnosis to avoid misdiagnosis. However, doctors may not suggest treatment as it is not a harmful condition. Most people opt for treatment as they feel it is a cosmetic concern.