Sebaceous Hyperplasia

Sebaceous hyperplasia is the term used for enlarged sebaceous glands seen on the forehead or cheeks of the middle-aged and elderly. Sebaceous hyperplasia appears as small yellow bumps up to 3 mm in diameter. Close inspection reveals a central hair follicle surrounded by yellowish lobules. There are often prominent blood vessels. The sebaceous hyperplasia lesions are sometimes confused with basal cell carcinoma.

Sebaceous hyperplasia generally affects middle-aged to elderly adults. The symptoms of this condition are 1-5 mm papules on the skin, mainly on the forehead, nose and cheeks, and sebarrhoeic facial skin. The papules may be cauliflower-shaped. Acne is also a symptom of this glandular disorder. It differs from the type of acne that affects adolescents and young adults, in that it is more of an abnormally discolored patch that is not cured by topical treatments alone.

Whatever causes Sebaceous Hyperplasia is unknown but it can tend to run in families that have a history of contracting Sebaceous Hyperplasia. However there is some relief from patients as they will find out from their doctor that this skin disorder is not contagious. It will be a welcome relief to hear that from their doctor. But the patient will mainly just want to know how to get rid of this skin disease. Of course seeing as though it does appear to run in the family maybe the patients parents would have told them all about what might happen if they get this skin disease.

Sebaceous hyperplasia lesions begin to appear in middle age (usually fifth or sixth decade) and continue to appear into later life. Tretinoin cream or gel used daily will reverse sebaceous hyperplasia slowly overtime and will also help keep the condition from worsening. TCA chemical peels will also reverse sebaceous hyperplasia, but new lesions will occur slowly after treatment. When the lesions are severe, extensive or disfiguring, oral isotretinoin or, in females, antiandrogens, may help improve the appearance. Applying a drug activated by light (photodynamic therapy). Oral isotretinoin has proven effective in clearing some lesions after 2-6 weeks of treatment. Light cautery, diathermy or laser vaporization are also helpful in removing skin lesions.

Sebaceous glands are found throughout the skin except on the palms and soles. They exist as a component of the pilosebaceous unit or, less frequently, open directly to the epithelial surface in areas of modified skin, including the lips and buccal mucosa (as Fordyce spots), glans penis or clitoris (as Tyson glands), areolae (as Montgomery glands), and eyelids (as meibomian glands). The largest sebaceous glands and the greatest number of sebaceous glands are found on the face, chest, back, and the upper outer arms.

Treatment:No treatment is necessary. Tretinoin cream or gel used daily will reverse sebaceous hyperplasia slowly overtime and will also help keep the condition from worsening.If the lesions are becoming unsightly and you really feel something needs to be done, a powerful, expensive drug named Accutane will reverse sebaceous hyperplasia, but you will develop new lesions after you stop the medication unless you also use tretinoin cream regularly.TCA chemical peels will also reverse sebaceous hyperplasia, but new lesions will occur slowly after treatment.Fordyce’s condition is usually left untreated.