Fordyce spots
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Fordyce spots are benign, non-inflammatory skin-mucosal changes that represent a variant of anatomical norm, rather than a disease. They are visible manifestations of ectopic sebaceous glands, which are glands located atypically, outside of hair follicles. They most commonly occur on the vermilion border of the lips, the oral mucosa, the genital area, and less frequently on the nipples. The changes appear as small, whitish-yellow or light pearl-colored papules, usually asymptomatic. Their presence may cause aesthetic concern or be mistaken for sexually transmitted diseases, however, Fordyce spots are not contagious, do not turn malignant, and do not require treatment from a medical standpoint.
Fordyce spots – what are they
Fordyce spots are the result of visible activity of sebaceous glands which in a given area are not connected to hair follicles. Histologically, they correspond to normal glandular tissue producing sebum. These spots usually appear during puberty, which is related to the influence of androgen hormones on the activity of sebaceous glands, and they may become more pronounced in adulthood.
Most common locations:
- upper and lower lip (vermilion border),
- inner surface of the cheeks,
- penis and scrotum in men,
- labia in women,
- less commonly the areola of the nipple.
Clinical features:
- diameter usually 1–3 mm,
- white, yellowish, or pearly color,
- no pain, itching, or inflammation,
- stable course (no tendency to ulcerate).
Differential diagnosis includes, among others, milia, condyloma acuminata, pearly penile papules, or inflammatory changes in the sebaceous glands. Diagnosis is clinical in nature; additional tests are rarely needed.
Fordyce spots - how to prevent
Since Fordyce spots are anatomically and hormonally determined, there are no methods that can completely prevent their occurrence. However, it is possible to reduce their visibility and the risk of secondary irritation.
Preventive Recommendations:
- Gentle skin and mucous membrane hygiene, avoiding aggressive detergents,
- Avoiding irritating cosmetics, alcohol, and menthol around the mouth,
- Not squeezing or damaging the lesions, to prevent infections and scarring,
- Maintaining the proper hydrolipid barrier of the skin,
- For the intimate area – breathable fabric underwear.
Factors that contribute to greater visibility of lesions:
- Increased sebaceous gland activity,
- Hormonal fluctuations,
- Dryness and thinning of the epithelium,
- Mechanical irritation (rubbing, shaving).
Therefore, prevention is care-oriented and protective, rather than causal.
Fordyce spots - how to treat
From a medical standpoint, treatment is not necessary as the changes are benign. Intervention is considered solely for aesthetic or psychological reasons - after thoroughly explaining to the patient the nature of the changes and the possible limitations of the therapy.
Conservative management:
- education and reassurance of the patient,
- observation without intervention,
- supportive care for the skin barrier.
Methods of visibility reduction (selectively, after qualification):
- topical therapies affecting keratinization and the activity of the sebaceous glands,
- procedural methods leading to controlled removal or reduction of the glands.
It should be emphasized that no method guarantees permanent removal of all changes, and recurrences are possible. The choice of technique depends on the location, number of changes, skin phototype, and the patient's expectations.
Treatment of Fordyce spots
In procedural treatment, methods with precise and superficial action are used to minimize the risk of scarring and pigmentation disorders.
Most commonly described procedures:
- Laser therapy (e.g. ablative and non-ablative lasers) – allows selective targeting of sebaceous glands and epithelium,
- Electrocoagulation – spot removal of lesions using high-frequency current,
- Microdermabrasion or chemical peels – methods with limited efficacy, used rather as an adjunct,
- Minor surgical techniques – rarely, only in selected cases.
Potential side effects:
- Temporary erythema and swelling,
- Skin sensitivity,
- Risk of post-inflammatory hyperpigmentation,
- Very rarely, scarring.
Safety principles:
- Every intervention should be preceded by medical qualification,
- Procedures involving mucous membranes require special caution,
- It is necessary to inform the patient about realistic outcomes and the risk of recurrence.
In summary: Fordyce spots are a physiological phenomenon, and treatment is optional and aesthetic in nature. Proper diagnosis, honest patient education, and sensible qualification for potential procedures to reduce the visibility of the lesions are crucial.
