Sebaceous Prominence Information
Fordyce’s spots, also known as angiokeratoma of the scrotum and vulva, or sebaceous prominence, are small, painless, raised white or red spots or bumps that occur on the scrotum or the shaft of the penis in men, and on the labia in women. They may also occur on the inner surface, also known as the retromolar mucosa of the inner lips of the face.
They are common in men and women of all ages, but commonly appear during puberty. The cause of Fordyce’s spots like is not entirely known or understood, but they are harmless and are not known to cause any cancers or other health complications. Same as pearly penile papules, Fordyce’s spots are not sexually-transmitted.
The condition is named after an American dermatologist, Dr. John Addison Fordyce.
Despite its benign nature, patients seek dermatologic consult regarding this condition because they are worried that they may have a sexually-transmitted infection or some form of disease, but this is not the case. Likewise, it is also aesthetically displeasing, and can also cause anxiety to their partners as well.
No standard treatment is currently available for this condition. However, the appearance of these spots might be reduced. Likewise, surgical management is another possible option in removing Fordyce’s spots.
Fordyce’s spots are believed to be caused by sebum, otherwise known as the natural oil of the skin. This sebum gets trapped in what is medically known as ectopic sebaceous glands: normally, sebaceous glands are oil-secreting glands that are found associated with a hair follicle. Ectopic sebaceous glands, on the other hand, are abnormally dilated blood vessels, covered by thickened skin. They appear as small lumps arising on the skin, or little swellings on the skin surface, and are normally yellow in color. Ectopic sebaceous glands are commonly seen in moist tissues without hair follicles, such as the mouth, penis, labia, and even in the esophagus, if found on the penile foreskin, these spots are referred to as Tyson’s glands.
In Fordyce’s spots, the sebum gets trapped in an ectopic sebaceous gland. The latter, not being associated with hair follicles, have no means of getting discharged or secreted by the body, thus the small, bumpy appearance. They are not, by any means, similar to pimples or acne. Pimples develop in sebaceous glands with a blocked opening, where they lack the normal route of escape, which is through the hair follicles.
It should also be remembered that bacteria are abundant on the skin, and the sebaceous oil in hair follicles provide them nourishment to thrive. As bacteria feasts on sebum, they also grow and cause the surrounding tissue to become inflamed and painful – producing a pimple. In Fordyce’s spots, however, they do not cause pain, nor they have any symptoms of pus – thus they are not classified as a type of skin infection. They cannot be spread around or transmitted in any form. Instead, they are natural occurrences on the adult skin. However, since patients and their partners find them unattractive, they almost always seek whatever treatment that is available.
Fordyce spots are painless, small, pale bumps that measure about 1-3 mm in diameter. Their appearance is somewhat similar to pimples, however, unlike pimples, they are usually found on moist tissues of the body without hair, such as the penis, labia, and lips of the face.
Fordyce’s spots are not known to be associated with any disease or illness. It is non-itchy and not transmitted sexually.However, they are of great cosmetic concern, which is the main reason why patients seek treatment.
Currently, there are no indications for laboratory and imaging studies recommended in diagnosing Fordyce’s spots. It is often diagnosed based on history, clinical presentation, and a high index of suspicion.
Given the non-cancerous nature of Fordyce’s spots, it is not necessary to undergo specimen biopsy for confirmation. Likewise, there are no staging systems that exist, nor it is necessary for work-up, diagnosis, and treatment of Fordyce’s spots.
Medical and Surgical Treatment
Since Fordyce’s spots do not have any other associated signs and symptoms, and do not pose any life-threatening conditions, they do not require any oral antibiotic, antiviral, or anti-parasitic therapy or medication. Likewise, there is no known standard of oral or topical medical treatment for F spots. However, their appearance can cause anxiety to patients and their partners, which are the main reasons for seeking medical or surgical treatment in order to eliminate F spots. Given their benign nature, healthcare professionals do not normally advise treatment.
There are, however, some products that can be used in treating Fordyce’s spots, which can be readily purchased in drug stores. One such product is Tretinoin gel or cream. Reports have shown a decrease in the prominence of sebaceous prominence upon use of this product. Some experts also believe that Tretinoin gel or cream can be more effective when used in combination with an alpha hydroxyacid agent.
Another topical treatment that can be used is Trichloroacetic Acid chemical peel. This product helps peel off the skin on the spots, resulting in significant improvement in the appearance of F spots. Patients, however, should keep in mind that there is a chance of the spots returning when treatment is stopped.
Some modes of surgical treatment have been used to reduce or eliminate Fordyce’s spots. Available treatments include vaporizing laser treatment, such as Carbon dioxidelaser or electrodessication. These methods may be expensive and can also cause scarring over sensitive areas.
Home Remedies and Removal
Not a lot of home remedies are available for Fordyce’s spots. However, there are some tips which can be used to make the spots fade away.Same as pearly penile papules we are going to use natural home remedies
One known home remedy is garlic. Some patients have reported that including garlic in their diet have produced significant improvement in the appearance of Fordyce’s spots.
Good personal hygiene is strongly advised to avoid these spots from getting aggravated.
Any diet which is rich in Vitamins B Complex, A, C, D, E and K, helps in reducing these spots and causes them to resolve faster.