Fordyce’s spots, also known as Fordyce granules, Fordyce’s condition, and “sebaceous prominence,” are small, painless, pale bumps or spots 1 to 3 millimeters in diameter that may appear on the shaft of the penis, the labia, and the border of the lips of the face. They are harmless, but are a great concern for cosmetic reasons. There is currently no standard treatment for Fordyce’s spots, and doctors don’t recommend treatment. It is possible however, to reduce the prominence of these spots, or even get rid of them completely.
What Causes Fordyce’s Spots?
When people first notice Fordyce’s spots, they usually think that they’re infected with a sexually transmitted disease or STD. On the contrary though, these spots, named after John Addison Fordyce, an American dermatologist, are not associated with any illness or disease, and are a natural occurrence on the body. In fact, they are estimated to be present in 70% to 80% of the population, which means they are very common.
The exact cause of Fordyce’s spots is unknown, although experts think that there is a genetic link. The condition isn’t caused by viruses or bacteria, and also not contagious. The spots are large ectopic sebaceous glands that develop on the moist tissue that lines some body cavities and organs. Usually, these spots are present at birth, but they don’t become prominent until the child reaches puberty.
Diagnosis of Fordyce’s Spots
There is no standard procedure to diagnose Fordyce’s spots. Your doctor will probably diagnose the condition through visual inspection. The yellow or white color of the spots and their location are typical indications that they are indeed just ectopic sebaceous glands, and not something more serious.
Consult your doctor immediately if you notice any abnormalities in your genitals. The spots or papules of Fordyce’s condition are sometimes similar to warts; and both appear at the genitals as well as the border of the lips of the face. Your doctor may also take a biopsy or a blood sample if the spots appear in your genitals to rule out other conditions.
Getting Rid of Fordyce’s Spots
Doctors don’t recommend treatment for Fordyce’s spots because the risk of complications outweigh the perceived advantages of not having the spots. Some people though, especially men, are very insecure of the spots when there are too many of them on the shaft of their penis. The following treatments can reduce or completely get rid of your spots:
- Tretinoin: Apply tretinoin cream or gel daily to the affected areas. This will reduce the prominence of the spots over time and prevent them from getting worse. Tretinoin cream works best when used in combination with alpha hydroxyacid agents. Tretinoin is a substance that’s normally used to treat acne and keratosis pilaris or “chicken skin.”
- Isotretinoin: The spots will likely reappear when you stop treatment, so keep on applying the medication. If the spots persist, try using Isotretinoin though, has a lot of side-effects, including: headache, urinary problems, rash, eye irritation, nosebleed, intestinal problems, dry skin, muscle and joint pains, chapped lips, temporary hair thinning, poor night vision, and depression. Do not take this drug if you’re pregnant because it may affect your unborn child, and may cause damage to your liver. Talk to your doctor before using this medication.
- Trichloroacetic Acid (TCA) chemical peels: TCA peels are sometimes prescribed to reduce Fordyce’s spots, but symptoms usually recur as soon as you stop treatment. TCA can peel deeper than other chemical peels that only cause mild skin flaking. It usually takes about a week for the skin to completely peel, and your doctor may recommend using a moisturizer during this time to hasten the peeling process. Also, make sure to use sun protection if you’re using TCA on other parts of your body aside from the genitals, because skin becomes more sensitive during the peeling process.
- Laser vaporization: The prominence of the spots can be reduced through vaporising laser treatments, such as CO2 laser or electro desiccation. Laser treatments though, may have side-effects such as burning or scarring, so talk to your doctor if this treatment is best for you.
- Cryosurgery or cryotherapy: Cryosurgery uses extreme cold temperatures to destroy the spots. It is a minimally invasive procedure that often comes with minimal pain and scarring. Risks involved in this procedure include damage to nearby healthy tissue and nerves. It’s normal to experience localized pain and redness after the procedure, but these can be alleviated by analgesics such as acetaminophen, ibuprofen, or aspirin. Blisters may also form, although these usually scab over and peel away after several days.
- Surgical diathermy or electrosurgery: Surgical diathermy involves the use of high frequency alternating current to cut or cauterize small blood vessels to stop bleeding. It causes localized tissue damage and burning, which are controlled by the frequency and power of a device called electrosurgical generator.
- Wait-and-see approach: Some people say that Fordyce’s spots sometimes go away on their own, so consider just observing the symptoms for a couple of months to a year. Take note if they seem to be getting less prominent or if their numbers are decreasing. If symptoms don’t go away after a long time, and if they are causing you real embarrassment, then consult your doctor for medical treatment. In addition, eat a balanced diet rich in folic acid, and vitamins A, C, D, E, K, and B complex, because these are good for your skin and promote normal metabolism.
Coping with Fordyce’s Spots Fordyce’s spots can sometimes appear so “ugly” or “abnormal” that people who have them get depressed and fear social rejection. As was mentioned however, the condition is very common, although people tend to not talk about it because they find it embarrassing. Some even get frustrated or mad when doctors tell them that treatment is not advisable because the condition is normal. The following are some tips to help you cope with Fordyce’s spots.
- Realize that many women/men are not bothered by them: The greatest fear of people with Fordyce’s spots is that their partners will refuse to have sex with them because they’ll think that they are ill; some even go so far as to think they’ll be called freaks. On the contrary though, many women and men don’t really care about the bumps.
Your partner may not even notice them if there are only a few of them on your genitals. Even if your genitals have many spots, you can always explain your condition to your partner. Assuming that you’re making love with someone who likes you very much, then the person should understand and believe you when you say that they are not symptoms of a disease.
- Talk to people about it: You may be surprised by how many people have this condition. Instead of getting depressed over the thought that you’re so different, which is probably not the case, try getting others to talk about it. You can start with your parents. Ask them if they know about such spots, and whether they know anyone else in the family or outside who has had them in the past. You’ll feel better once you open up about this topic to other people. Discussing it beforehand to your partner will also relieve anxiety and stress.
- Join online discussion groups: The biggest proof of the wide prevalence of Fordyce’s spots is the huge number of people who discuss them on the Internet. Lots of websites and message boards discuss this condition. Some forums even have archives of stories of people with Fordyce’s spots, where you can learn about how they cope with their condition, and new promising treatments. There are even people who have their own ways of getting rid of their spots, although these may be unsafe. Reach out to these people, and you’ll feel a lot more confident.
- Don’t be obsessed about it: The fact of the matter is, the spots will most likely remain on your genitals or other parts of your body if you don’t treat them. Since surgical procedure for removal of these spots can be expensive, you may not have a choice but to live with them. Try to get them out of your mind when you’re dealing with people of the opposite sex. Remember that when you get close to someone, you can always discuss them with the person later. Don’t let the spots ruin your social life and self-esteem, because these are only a small part of you, after all.
Talk to your doctor if you feel any pain or itch from your Fordyce’s spots. They can get irritated or infected, especially if you always scratch them. The best way to live with these spots is just to maintain a good personal hygiene, and leave them alone, so you’ll feel better.
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