Sebaceous hyperplasia (SH) is a common, non-cancerous skin condition often mistaken for persistent acne or whiteheads. Because they superficially resemble pimples, many people feel the impulse to manually squeeze or “pop” these lesions. However, the underlying nature of SH makes any attempt at extraction ineffective and potentially damaging. Understanding what these bumps are is the first step in learning why professional treatment is the only safe path forward.
What Sebaceous Hyperplasia Is
Sebaceous hyperplasia is a benign enlargement of the skin’s sebaceous glands. These microscopic structures produce sebum, the natural oil that lubricates the skin and hair. SH is a structural overgrowth of these oil glands, not a clogged pore like a blackhead or a pus-filled infection like a typical pimple. This difference in composition explains why the lesions cannot be cleared by squeezing.
The lesions usually present as small, soft, yellowish or flesh-colored bumps, typically measuring between two and six millimeters. A characteristic feature is a central indentation or dimple, which represents the opening of the enlarged sebaceous duct. They are most commonly found on the forehead, cheeks, and nose, which are areas of the face with a high concentration of oil glands.
The development of SH is linked to hormonal changes, particularly a decrease in circulating androgen levels that occurs with aging. This decrease paradoxically stimulates the remaining sebaceous cells to multiply. Genetics and chronic sun exposure also play significant roles in their formation. This condition is most often seen in middle-aged or older adults, though it can occur earlier in those with naturally oily skin.
The Immediate Risk of Manual Extraction
The answer to whether you can pop sebaceous hyperplasia is no, and attempting to do so carries risks. The lesion’s core is composed of overgrown sebaceous gland tissue, not a liquid pocket of pus or easily extruded debris. Squeezing or picking at the bump does not remove the underlying enlarged gland structure, which is the source of the problem.
Trying to force out the contents results only in trauma to the surrounding healthy skin tissue. This manual pressure often causes bleeding, bruising, and inflammation. Breaking the skin barrier through aggressive squeezing increases the risk of a secondary bacterial infection.
The most concerning outcome of attempting manual extraction is the potential for permanent scarring. The resulting damage can lead to post-inflammatory hyperpigmentation, leaving a dark spot that lasts for months. It can also result in a raised, thickened keloid or hypertrophic scar. Since the sebaceous gland is deeper within the skin than a typical pimple, aggressive removal attempts will damage the dermis, resulting in an undesirable cosmetic outcome.
Safe and Effective Removal Methods
Because sebaceous hyperplasia is a structural issue, effective removal requires treatments that physically destroy or remove the enlarged gland tissue. These procedures must be performed by a licensed dermatologist to minimize the risk of scarring. A dermatologist also ensures an accurate diagnosis, as SH can resemble more serious conditions like basal cell carcinoma.
One common and effective in-office treatment is electrodessication. This procedure uses a fine needle to deliver a high-frequency electrical current or heat directly into the lesion. This process heats and cauterizes the overgrown gland, causing it to shrink, crust over, and fall off. Another option is cryotherapy, which involves freezing the lesion with liquid nitrogen. However, cryotherapy is less precise and carries a higher risk of leaving a pale or hypopigmented spot.
Laser treatments, such as the Carbon Dioxide (CO2) laser or pulsed dye laser, offer a targeted approach by vaporizing the abnormal tissue or heating the gland to shrink it. The CO2 laser is precise and minimizes damage to the surrounding skin, making it a preferred choice for many dermatologists. For managing smaller or widespread lesions, prescription topical retinoids, such as tretinoin, may be recommended to help reduce the size of the oil glands over time. Oral medications like isotretinoin are reserved for severe or widespread cases because of their potential side effects.