Fordyce spots, also referred to as Fordyce granules or sebaceous prominence are clusters of ectopic sebaceous glands that are not associated with a hair follicle and appear as clusters on the surface of moist organs like body cavities and mucosal surfaces. They are manifested as small raised whitish yellow bumps that are 1-3 mm in diameter usually on the he shaft of the penis, vulva, testicles, and lips and become more visible with stretching of the skin.
Sebum or the natural oil of the skin which is produced by the sebaceous glands is believed to be the major cause of these spots. Under normal condition, this oil is secreted up the hair shaft to which the sebaceous gland is linked. However in case of Fordyce spots, as these glands are not linked to a hair follicle so the oil secretions are not discharged and they form bumps or pimples.
Bacteria living on the skin surface may increase in number by feeding on the sebum and cause the surrounding tissues to become inflamed. But Fordyce spots are not a skin infection and are actually natural occurrences on the surface of adult skin which should not demonstrate any symptoms of pus or pain.
Fordyce spots are asymptomatic and usually do not cause any pain. They are recognized as small bumps which may be yellowish, pinkish or skin coloured located commonly on the lips, penis, scrotum and vagina. They can be seen more easily on stretching the skin and may occur as single spots or in clusters. Although they are not painful but may cause itching occasionally.
Fordyce spots may be misdiagnosed because of the similarity of their appearance with many sexually transmitted diseases (STD’s). So the patients must consult with a physician for an accurate diagnosis.
Although these spots are benign, but they may cause anxiety in patients which leads them to seek treatment for cosmetic purposes. A variety of treatments are available for these spots with varying degrees of invasiveness and success rates. These include:
- Surgical Procedures: Commonly used surgical methods include punch excision and cauterisation. Punch excision makes use of a machine to create 1-2mm wide holes in the skin, followed by the manual removal of Fordyce granules from each hole and stitching them up. Although this method may be effective but it may cause scarring. The other method that can be applied for Fordyce spots is cauterisation which involves the use of a fine probe or Hyfrecator instrument, which is heated electrically then applied to the spots to burn them away. This treatment is also effective and has the additional advantage of being quick and comparatively less expensive than the other surgical options but it may also cause scarring.
- Laser Treatments: Carbon dioxide laser vaporization is commonly used because it is very precise and most suitable for small Fordyce spots around the mouth and lips. Although it is expensive and time consuming but it reduces the risk of scarring. Other methods include the use of pulsed dye lasers.
- Topical Treatments: These include the application of bichloracetic acid and isotretinoin. However these treatments have the disadvantage of causing recurrence of the spots after the culmination of treatment.
- Other Methods: Cryotherapy may be also be used which freezes the spots using liquid nitrogen.
Fordyce spots may be reduced through certain home remedies which include the use of garlic in diet, taking a healthy balanced diet, maintaining personal hygiene and drinking 8-10 glasses of water in a day.