What Are Fordyce Spots and What Causes Them?
Know what Fordyce spots are and how to spot them.
What are Fordyce spots?
Fordyce spots, also called as Fordyce glands or Fordyce granules, are enlarged sebaceous (oil) glands that are not associated with hair follicles. These spots are harmless and painless and are commonly seen inside the cheek's lining or on the edge of the lips. They are also seen in the genital areas of males (scrotum or penis) and females (labia). Fordyce spots can be seen in people of all ages, although the risk increases with age.
These spots appear as white-yellow bumps on the skin with no hair attached and are often seen in scattered or isolated bumps. In some cases, they tend to cluster in groups.
Identifying Fordyce Spots
Fordyce spots appear approximately 1-3 mm in diameter, which is around 0.04 to 0.12 inches. These spots are usually light-yellow and flesh-colored, but may also be reddish if they develop in genital areas. The spots also tend to become more visible if the surrounding skin is stretched.
Fordyce spots may also look similar to other skin conditions, such as:
- Epidermoid Cysts: These common cysts are small and hard lumps that develop under the skin. They are usually found on the neck, head, face, back, and genitals.
- Milia: These are hard, white-colored bumps that are often seen on the face.
- Sebaceous Hyperplasia: These harmless bumps appear flesh-colored or yellowish in color on the skin and are caused by the enlargement of sebaceous glands with trapped sebum.
- Basal Cell Carcinoma: Cancer that can appear as growths, red patches, or bumps on parts of the skin that are often exposed to the sun.
- Genital Warts: Fordyce spots may look similar to genital warts and can be mistaken as a symptom of a sexually transmitted disease (STD).
Causes and Risk Factors
Fordyce spots are a normal part of the body. Although these spots tend to be unnoticeable until they are enlarged due to hormonal changes, know that they are already present at birth.
People who have oily skin are also more prone to developing Fordyce spots. These spots are also more prevalent in men than women (1). According to research, the development of these spots around the eyes and mouth is associated with hyperlipidemia and other heart diseases (2).
There are also studies that have linked Fordyce spots that develop in the mouth to more serious medical conditions, such as colorectal cancer (3, 4).
When to See a Doctor
In most cases, Fordyce spots tend to be unnoticeable, benign, and are not caused by certain types of disease. Although they can be unsightly to some people, they are completely harmless. However, if the spots develop on your genital area, it is recommended to see a doctor to have an accurate diagnosis and proper treatment. Some symptoms of STDs may also look like Fordyce spots.
The spots can also be reduced or removed if they cause a certain level of discomfort and make you unhappy, especially when it comes to your physical appearance. Your healthcare provider may refer you to another doctor who specializes in the treatment or removal of these spots.
Diagnosis
The doctor can immediately diagnose Fordyce spots just by looking at them. However, in some cases, a biopsy may be required. A biopsy is a procedure in which a sample tissue from the affected part of the body is collected and further examined under the microscope.
Treatment
Generally, Fordyce spots are harmless and do not need treatment. However, for some people, the removal of these spots is a must for cosmetic reasons. The following treatment methods have been used for the removal of Fordyce spots:
- Laser Treatment: Doctors may utilize carbon dioxide laser for the removal of Fordyce spots. Unfortunately, this particular laser treatment may cause scarring unlike pulsed dye lasers, which leave fewer scars. Both of these lasers use concentrated light in different wavelengths. However, pulsed dye laser is a more expensive laser treatment.
- Topical Treatment: Fordyce spots can also be removed using topical treatments, such as topical tretinoin, oral isotretinoin, and bichloracetic acid. These topical treatments may be recommended by doctors along with laser treatments. The side effects of this treatment method include burning sensations and inflammation.
- Photodynamic Therapy (PDT): This technique is used for the treatment of Fordyce spots on the lips and involves the application of an oral photosensitizing agent or drug. This agent focuses on the different abnormal cells on the lips. Laser is then applied to the spots to burn targeted cells.
- Micro-Punch Excision Surgery: This type of surgery may effectively help remove multiple Fordyce spots on the face and genital areas. A local anesthetic is initially applied before the procedure to reduce any pain. Unwanted tissues are then removed by using a pen-like device that punctures the skin. The advantage of this procedure is that it does not cause scarring.
Chemical cauterization is another treatment method for the removal of the spots.
Complications
People who have severe Fordyce spots on the vermilion border are more prone to developing anxiety and depression due to the spot's unsightly appearance. The spots that are on the eyes and lips can greatly affect people's emotions because they are prominent areas of the face.
Those who have severe Fordyce spots on the genital areas may feel quite anxious about what their partners might think of them. The spots in these areas may also bleed if they are injured during intercourse.
Outlook
Majority of people have Fordyce spots. It is also important to remember that having spots does not mean that you have a disease. These spots are normal and generally go away after some time without any treatment.
If the occurrence of the spots causes you any discomfort, there are possible treatment options that can be discussed with your healthcare provider. Home remedies for the removal of the spots are not backed by scientific evidence. To avoid developing infections, do not squeeze or pick the spots.
References
Fordyce Spots. (n.d.). https://www.aocd.org/page/FordyceSpots
Understanding Fordyce Spots. (2017). https://www.healthline.com/health/fordyce-spots
(1) Leung, A. K. C., & Barankin, B. Fordyce Spots. Clin Case Rep Rev. (2015)
(2) Gaballah K. and Rahimi I. Can presence of oral Fordyce's granules serve as a marker for hyperlipidemia? Dent Res J (Isfahan). (2014)
(3) Almeida F., et al. Oral manifestations of hereditary nonpolyposis colorectal cancer syndrome: a family case series. BioMed Central Ltd. (2014)
(4) Felice C., et al. Fordyce granules and hereditary non-polyposis colorectal cancer syndrome. Gut. (2005)
