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Lots of People Have It But Don't Know. 11 Signs of Sebaceous Hyperplasia

I get sebaceous hyperplasia – and I don’t like it. Makes me feel ugly. It appears as little flesh colored bumps on my forehead. Unfortunately, I am one of about 1% of the population that gets these lovelies (UGH!) No one knows for sure what causes them. They are more common in aging skin.

Possible Causes of Sebaceous Hyperplasia

Sebaceous glands are the same glands associated with acne. They are highly influenced by androgen levels. As we age, androgen levels decline and the turnover rate of sebaceous cells slows.

Let me explain. When our skin makes new cells, the cells travel from the bottom layer of skin to the top layer. Once they reach the top layer, they die and are shed to reveal the younger cells below. BUT, for people with sebaceous hyperplasia, the sebaceous cell turnover slows. There is a crowding of the cells within the gland that causes benign enlargement. The sebaceous glands grow – up to 10 x their normal size!  This is particularly noticeable on your face, where the glands are highly concentrated.

The funny thing is that, even though the glands are large, they secrete very little sebum when compared to a normal sebaceous gland.

Age and declining androgens could be a cause of sebaceous hyperplasia.

For some people, Sebaceous hyperplasia runs in their family. Young people in these families get multiple spots of sebaceous hyperplasia. It appears around puberty and progressively gets worse as they age.

We also know that 10 – 16% of organ transplant patients who take cyclosporin A for long-term immunosuppression get sebaceous hyperplasia. It seems to be specific for this drug, yet we still don’t understand why.

But you need a little background. What are sebaceous glands?

This is a disorder of the sebaceous glands. They are microscopic glands in your hair follicles / pores that secrete a waxy, oily substance called sebum. Sebum waterproofs and lubricates skin and hair. It is a mix of fats (triglycerides, wax esters, squalene, and cholesterol) and cell waste. Sebum protects your skin from drying out and becoming irritated. Most of the sebaceous glands are found on your scalp and face. However, they are found all over your skin – except for the soles of your feet and your palms.

To the right is a graphic of a hair follicle and sebaceous gland, courtesy of Wikipedia.com.

What does sebaceous hyperplasia look like? How do you know if you’ve got it?

  1. It usually occurs on the forehead, temples and cheeks where there are more sebaceous glands.
  2. They can occur on your chest, genitals, upper arms, and the areola of your nipples, but this is less common.
  3. The spots are raised and usually have a yellow tint. Others are flesh colored or have a white tint.
  4. They often have a central pore or follicle.
  5. They occur mostly in people who are middle aged or elderly; but they can occur in newborns.
  6. They can look like a pimple OR like a crater. Some are cauliflower shaped.
  7. They are usually 1 – 5 mm wide.
  8. The spots are soft with a smooth surface.
  9. There can be 1 or many
  10. They don’t hurt or itch.
  11. Sebaceous hyperplasia can look like an early form of basal cell carcinoma – but sebaceous hyperplasia is benign and won’t ever become cancer. If you have a spot, or any skin condition, that bleeds easily or grows over time, please have it checked by a dermatologist to rule out skin cancer.

What can I do about my sebaceous hyperplasia? How is it treated?

Sebaceous hyperplasia is benign. It doesn’t require treatment unless it becomes inflamed or infected (usually from repeated irritation like shaving or scratching). People – like me – have it treated because they don’t like the way it looks.

Things you can do at home:

Nightly application of a retinol cream may make your spots smaller. It works by regulating cell growth. Unfortunately, this treatment isn’t considered very effective. If the retinol does work, you should see results after about 3 months. Learn more in the Masterpiece Skin Restoration blog post, Use Retinol! It’s the Best Overall Age Fighter! Keep in mind that, if you stop using retinol, over time the spots will come back.

Office Treatments:

1. Photodynamic therapy

A chemical is applied to the SH to make it light sensitive. It is left to incubate and penetrate the skin. Then a light with a specific wavelength activates the chemical and destroys the abnormal cells. May cause scars and skin discoloration.

2. Cryotherapy

Liquid nitrogen is sprayed on the sebaceous hyperplasia. The lesion freezes then blisters or scabs and falls off. May cause scars and skin discoloration.

3. Topical Chemical Treatments – with bichloracetic acid or trichloroacetic acid. May cause scars and skin discoloration.

4. Cauterization 

Tissue is removed using electric current and a heated metal probe. May cause scars and skin discoloration.

Here's a video of Sebaceous Hyperplasia Treatment With the Skin Classic, a High Frequency / Radiofrequency Machine:

5. Electrodesiccation / Radiofrequency (Sometimes called High Frequency)

An unheated, very fine electrode contacts the skin. It heats the treated area and dehydrates the cells. After treatment, scabs develop on the treated areas and last about a week. Larger areas may require more than one treatment. This method is a time proven, highly effective method of treatment and can be offered for a fraction of the cost of laser treatments. There is little to no risk of scarring or hypopigmentation because radiofrequency causes minimal damage to the surrounding skin.

6. Lasers

Destroy the SH. Doctors may use an argon, carbon dioxide, or pulsed-dye laser. May cause scars and skin discoloration.

7. Shave Excision

Surgical removal by shaving with a blade. May cause scars and skin discoloration.

8. Excision

Surgical removal. May cause scars and skin discoloration.

9. Oral Vitamin A / Isotretinoin

Temporarily shrinks sebaceous glands. It works on some sebacous hyperplasia after 2 – 6 weeks. Unfortunately, the lesions return after you stop taking the medication. It should not be taken while pregnant or breastfeeding.

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As of now, we don’t know of a way to stop sebaceous hyperplasia or control it. We do know that it’s easier to treat the lesions as they occur. Dr. Baily, of DrBailySkincare.com likes electrocautery. Here’s what she has to say:

“I also treat the existing sebaceous hyperplasia papules as they arise. My treatment preference is electrocautery with a low current and fine epilating needle. I find it works beautifully, does not leave marks, and shrinks the charming and exuberant sebaceous lobules such that they are barely visible.”

Radiofrequency is also used to treat facial spider veins, skin tags, and cherry angiomas. Read more on our Spider Veins, Skin Tags, Cherry Angiomas page.

How about you? Do you struggle with sebaceous hyperplasia? Or, like many people, you didn’t even know you had it? Did you find a great way to treat it? Drop me an email. I’d love to hear from you!  – Amy

Masterpiece Skin Restoration is your online resource for all things medical aesthetics, skincare, beauty, and wellness. We keep you up to date on leading edge technology and the services available to help you restore your natural beauty.

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Disclaimer:

The Information provided on the MasterpieceSkinRestoration.com website is not medical advice and should not be viewed as such. By law, only a medical doctor can diagnose or give medical advice. As a registered nurse, my goal is to educate, so I provide information on skin care, skin care products, and skin care treatments. If you have any condition that concerns you, please see a medical doctor. While most skin conditions are benign, some – like melanoma – can be deadly. If there is any doubt, please, please consult your physician. Thank you!