Fordyce spots are common, harmless, and naturally occurring visible sebaceous glands that appear on the skin. Many individuals become concerned when they perceive these spots are “getting worse” or becoming more prominent. While typically benign, understanding the factors that can influence their appearance helps address these concerns. This article explores why Fordyce spots might seem more noticeable and provides guidance on when to seek professional medical advice.
Understanding Fordyce Spots
Fordyce spots are enlarged, slightly raised sebaceous (oil) glands that appear in areas of the skin lacking hair follicles. These ectopic glands are most commonly observed around the edges of the lips, inside the cheeks, and on the genital area, including the penis, scrotum, and labia. They are a normal anatomical variation, not a disease or an infection, and affect a large portion of the adult population, with estimates ranging from 70% to 80% of adults having them.
These spots typically appear as small, painless bumps, usually 1 to 3 millimeters in diameter, and can be white, yellow, pale red, or skin-colored. While present from birth, they often become more noticeable during puberty and into adulthood. This increased visibility is linked to hormonal changes that occur during these life stages.
Reasons for Increased Prominence
Several factors can contribute to Fordyce spots becoming more noticeable, leading individuals to feel they are “getting worse.” Hormonal fluctuations play a significant role. The increase in hormones, particularly androgens, during puberty and adulthood can enlarge these sebaceous glands, making them more prominent. This explains why they are often more visible after puberty and why males, who have higher levels of androgens, may experience them more frequently and prominently.
Changes in skin structure, such as stretching or thinning, can also make these spots more apparent. As skin ages, it naturally loses elasticity and thins, which can cause underlying Fordyce spots to become more visible. Similarly, stretching the skin, such as during an erection on the penis, can make the spots temporarily more obvious.
Irritation or trauma to the skin surface where Fordyce spots are located can also lead to increased visibility. Actions like rubbing, shaving, or even vigorous hygiene practices can cause inflammation, making the spots appear more red, swollen, or raised. Increased sebum production, whether due to hormonal changes, oily skin, or even dry skin prompting glands to overproduce oil, can also contribute to their prominence.
When to Consult a Healthcare Professional
While Fordyce spots are harmless and generally do not require medical intervention, there are circumstances when consulting a healthcare professional is advisable. If there is uncertainty about the diagnosis and concern that the spots might be another condition, such as herpes, genital warts, or molluscum contagiosum, a doctor can provide an accurate diagnosis. This is especially important for new spots in the genital area.
If the Fordyce spots are causing discomfort, such as itching, pain, or bleeding, a medical evaluation is recommended. Significant cosmetic distress that impacts an individual’s quality of life also warrants a discussion with a healthcare provider. Any rapid changes in the size, shape, or color of the spots should also prompt a medical consultation to rule out other conditions.
Management and Minimizing Their Appearance
Fordyce spots typically do not require treatment because they are benign and pose no health risks. Many healthcare providers recommend a conservative approach, often advising to leave them alone. However, for individuals bothered by their appearance, options exist to minimize their visibility, primarily for cosmetic reasons.
Avoiding irritation to the affected areas through gentle hygiene practices can help prevent inflammation that might make the spots more noticeable. Keeping the skin adequately moisturized, especially if dryness leads to increased oil production, may also be beneficial. It is important to avoid picking or squeezing the spots, as this can lead to irritation, inflammation, or even infection and scarring.
For those seeking cosmetic improvement, various procedures are available under medical supervision. Laser therapies, such as CO2 laser or pulsed dye laser treatments, can reduce the appearance of Fordyce spots by targeting and removing the enlarged glands. Other options include micro-punch excision, where individual spots are physically removed, or electrodessication, which uses an electric current to destroy the spots. Topical treatments, including retinoids like tretinoin, may also be considered, though results can vary and potential side effects like irritation should be discussed with a doctor. These treatments are not without risks, including potential scarring or discoloration, and are generally pursued for significant cosmetic concern rather than medical necessity.