Article

Fordyce Spots (Fordyce Granules or Sebaceous Prominence)
February 03, 201904,600

What are Fordyce spots?

Fordyce spots are small, white, yellow, or cream-colored bumps found just under the surface of the skin.2,4-6

They are commonly found on2,5,6:

  • the inside lining of the cheeks
  • the outer border of the lip
  • the foreskin and shaft of the penis
  • the labia majora
  • the labia

Fordyce spots are considered harmless and occur in approximately 70 to 80 percent of adults. They are more common among men and older adults.5,6

They are also referred to as Fordyce granules or sebaceous prominence.2,4-6

 

What do Fordyce spots look like?

Fordyce spots are white, yellowish, cream or skin-colored bumps. They are small, usually about the size of a pinhead, but they can range in size from 1 to 2.2 milimeters.6

They almost always appear on both sides of your mouth, lips or genitalia at the same time. In general, the number of Fordyce spots is roughly equal between sides of your body, as well.6

The spots may show up as individual bumps, or in little groups or clusters throughout the affected area.6

In some cases, you may not be able to see the Fordyce spot unless you stretch the skin in the area. This is commonly the case with Fordyce spots on the shaft of the penis.6

While not always possible, you can sometimes get a thick or chalky discharge to come out of a Fordyce granule if you squeeze it.6

 

Figure 1: Images of Fordyce Spots.

Left: Fordyce spots on the lips (Fospot by Perene is lisenced under CC 3.0).

Right: Close up of Fordyce spots on the penis. (Fordyces spot close up is in the public domain).

 

What causes Fordyce spots?

Fordyce spots are caused by a buildup of oil in a special kind of sebaceous gland. Sebaceous glands are a type of sweat gland that produce oil that helps keep the temperature of your skin and body steady.2,4-6

Sebaceous glands are found all over the body. Most of them are attached to a hair follicle, but a few are not. The sebaceous glands without hair follicles are responsible for causing Fordyce spots.2,4-6

Oil buildup in these glands is usually the result of skin cells blocking the opening to the sebaceous gland, preventing the oil from getting out onto your skin. Eventually, this fills up the gland, stretching it out and pushing it towards the surface of your skin, creating a visible bump.2,5,6

 

Figure 2:  Sebaceous gland diagrams

Left: Structure of the skin and location of sebaceous gland when it is associated with a hair follicle.

Right: Close-up of a sebaceous gland.

(iStockphoto/Timoninalryna)

 

Scientists and doctors do not know why some people’s sweat glands get covered with skin cells and other people’s do not. There is some evidence that your genes may play a role. Differences in hormone levels may also be important in developing Fordyce spots. This may be particularly true as you age.5,6

Some studies suggest that you might be more likely to get Fordyce spots on your lips or in your mouth if you have a lot of fat in your blood. Further studies, however, are needed to confirm this.6

There is no evidence that getting Fordyce spots has anything to do with your diet, your sexual history, or your personal hygiene.

 

What are the symptoms of Fordyce Spots?

For most people, the only symptom of a Fordyce spot is the visible white, yellow or skin-colored bump. They are not painful and often go completely unnoticed.

In the rare case that your Fordyce spots become irritated, they may cause other mild symptoms. Generally, the only symptom of an irritated Fordyce spot is itching. If they are located on your labia, foreskin or shaft of the penis, however, they may also cause discomfort during sex.6

 

How are Fordyce spots diagnosed?

It is important that you see a doctor to diagnose Fordyce spots.2

This is because the symptoms of Fordyce spots are so vague, you may easily mistake them for a different condition, such as a sexually transmitted infection (STI).2

You may also think you have Fordyce spots when you actually have something more serious.2

Your doctor will diagnose your Fordyce spots by asking about your medical history and examining the spots visually. Their diagnosis does not require any invasive tests.2,5,6

Your doctor will rule out several other common skin conditions that could be confused for Fordyce spots to make sure you are getting the proper diagnosis.

Common conditions that may be mistaken for Fordyce spots include2,5,6:

  • Milia

Milia are small, dome-like cysts. Though they look like Fordyce spots, they are made up of skin proteins, not oil. You may be born with milia, or they may be triggered by a disease or injury. They can also be a side effect of certain drugs. 6

Unlike Fordyce spots, milia are easily removed from the surface of your skin by exfoliation.6

  • Sebaceous hyperplasia

A sebaceous hyperplasia is caused by a sebaceous gland growing too large, but without any oil buildup. They usually look like small yellow bumps on your skin. They tend to be uneven and are rarely perfectly round.4

Unlike Fordyce spots, these skin bumps have a visible pore in the center. Sebaceous hyperplasia is typically found on the face, but like Fordyce spots, can appear on the groin area, as well.4

 

Other less common skin conditions mimicking Fordyce spots include6:

  • Syringomas
  • Closed comedones
  • Molluscum contagiosum
  • Cutaneous myxomas
  • Calcinosis cutis
  • Lichen nitidus

 

How are Fordyce spots treated?

Since Fordyce spots are in no way dangerous or contagious, there is no medical need to have your Fordyce spots treated.2,5,6 You can simply leave them be, if you want.

However, if your Fordyce spots are damaging your self-esteem or impairing your social or romantic life, you may decide you want to get rid of them.

There are many options for treating Fordyce spots. The most common include2,5,6:

  • 5-aminolevulinic acid-photodynamic therapy

In this treatment, your dermatologist will apply 5-aminolevulinic acid to the area of your skin with the Fordyce granules. This acid makes your skin sensitive to light.

After the skin cells have been sensitized, your dermatologist will aim pulses of laser light at the area. This kills the skin cells and allows the oil to escape from your sweat glands, eliminating the bump(s).9

  • Topical trichloroacetic acid or bichloroacetic acid

Trichloroacetic acid (TCA) and bichloroacetic acid (BCA) are two different chemicals that remove Fordyce spots the same way. They damage proteins in the skin cells blocking off your sweat glands. This causes the cells to die, allowing the oil to flow freely again.10

  • Cauterization with chemical agents:

This is a relatively new treatment for Fordyce spots. For this treatment, a chemical, rather than actual heat, is used to “burn” and seal the skin effected by Fordyce spots.5

  • Micro-punch surgery:

In a micro-punch surgery, your dermatologist makes tiny incisions and simply removes the Fordyce spot from your skin. Depending on the size of the incisions, she may add a couple of stitches afterwards, to aid in the healing process.12

  • Electrodessication

For this procedure, your dermatologist uses a special, electrified scraping tool to scratch your Fordyce granules off. The area is first numbed with a local anesthetic to prevent any pain during the treatment.13

  • Cryotherapy

Cryotherapy uses extreme cold to treat your Fordyce spots. Your doctor uses precise tools to freeze off the problem tissue, paving the way for the growth of new and healthy cells.14

  • CO2 laser ablation

CO2 laser treatment works by slowly removing thin layers of skin until only healthy tissue remains. In addition to Fordyce spots, this treatment is often used for wrinkles, scarring, and other harmless skin growths.15

All of these treatments come with the risk of potential side effects. Patients have reported scarring, burning sensations, and darkening or discoloration of the treated skin following these procedures.2,5,6

To decide which treatment is best for you, you should visit your dermatologist. She will be able to make an informed decision about which treatment will provide you with the greatest benefits based on the location and number of Fordyce spots you have.

 

Can you prevent Fordyce spots from forming?

Not much information is available on the prevention of Fordyce spots because we know little about what causes them.2,5,6

The best available information we have is that hormone balance is likely involved.

The inability to prevent Fordyce spots can be disheartening. They can, however, be treated, and they may go away on their own without treatment.

 

Other Important Information

Unsightly bumps on the skin can be demoralizing and difficult to deal with, but resist the urge to self-diagnose and self-treat at home, especially without a definitive diagnosis. Taking Fordyce spot treatment into your own hands is not recommended.

They are not pimples. Picking, squeezing, and irritating Fordyce spots will not get rid of them.6,8

Nor are they milia. Exfoliants and scratching are also not useful for removing them.6,8

It is best to seek advice from your dermatologist to avoid causing damage to your skin.

 

  1. American Osteopathic College of Dermatology. Fordyce Spots. http://www.aocd.org/?page=FordyceSpots. Accessed June 09, 2017.
  2. American Osteopathic College of Dermatology. Cysts. http://www.aocd.org/?page=Cysts. Accessed June 09, 2017.
  3. American Osteopathic College of Dermatology. Sebaceous Hyperplasia. http://www.aocd.org/?page=SebaceousHyperplasi. Accessed June 09, 2017.
  4. Gyong Moon Kim, M.D., et al. Clinicopathologic Manifestations of Patients with Fordyce’s Spots. Ann Dermatol. 2012 Feb; 24(1): 103–106.
  5. Leung AKC, Barankin B (2015). Fordyce Spots. Clin Case Rep Rev 1: doi: 10.15761/CCRR.1000140.
  6. American Academy of Dermatology. Evaluate before you exfoliate. https://www.aad.org/media/news-releases/evaluate-before-you-exfoliate. Accessed June 09, 2017.
  7. American Cancer Society. Photodynamic therapy. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/photodynamic-therapy.html. Accessed June 09, 2017.
  8. CDC. Sexually Transmitted Disease Treatment Guidelines, 2010. Genital Warts. https://www.cdc.gov/std/treatment/2010/genital-warts.htm. Accessed June 09, 2017.
  9. Pallua N, Stromps JP. Micro-punch technique for treatment of Fordyce spots: a surgical approach for an unpleasant condition of the male genital. J Plast Reconstr Aesthet Surg. 2013 Jan;66(1):e8-11.
  10. American Osteopathic College of Dermatology. Electrodesiccation and curettage (ED&C). http://www.aocd.org/page/EDC. Accessed June 09, 2017.
  11. American Family Physician. Cryosurgery for Common Skin Conditions. http://www.aafp.org/afp/2004/0515/p2365.html. Accessed June 09, 2017.
  12. Cleveland Clinic. Carbon Dioxide Laser Resurfacing. https://my.clevelandclinic.org/health/articles/carbon-dioxide-laser-resurfacing. Accessed June 09, 2017.

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