Fordyce Spots (Ectopic Oral Sebaceous Glands)

Fordyce's Disease of Mouth

Fordyce Spots

Fordyce spots, also known as Fordyce granules, are sebaceous glands that can be seen in many adults. They are visible on the genital area, face, and mouth and manifest as small, painless, pale, red, or white spots or bumps with a diameter of 1 to 3 mm. These spots can appear on the scrotum, the outer part of the penis, the labia, as well as on the border of the lips and the inner surface of the lips (retromolar mucosa). Importantly, they are not linked to any disease or health issue and are not contagious; rather, they are natural occurrences in the body. As a result, unless an individual is concerned about their appearance, treatment is generally unnecessary. Some individuals who experience Fordyce spots may seek advice from a dermatologist due to concerns that they might have a sexually transmitted disease, particularly genital warts, or certain types of cancer. Fordyce spots are named after the American dermatologist, John Addison Fordyce, who first described them in 1896 (Fordyce spots - Wikipedia).

Causes of Fordyce Spots

The precise origin of Fordyce spots remains uncertain and is probably a result of a blend of biological and environmental elements. These spots often occur due to the excessive growth of sebaceous glands in atypical locations, which some research has connected to hormonal fluctuations and developmental factors during embryogenesis.

Typical risk factors that might be linked to the emergence of Fordyce spots encompass having oily skin, reaching post-pubertal age, being biologically male, experiencing dyslipidemia, having rheumatic disorders, and having colorectal cancers.

Understanding and Managing Sebaceous Gland Overgrowth

Fordyce spots, also known as Fordyce granules, are a relatively common dermatological phenomenon that affects many adults. These small, painless, and usually inconspicuous spots can appear on various parts of the body, often leading to concerns and misconceptions. In this comprehensive article, we will delve deep into Fordyce spots, exploring their causes, characteristics, locations, and the various treatment options available. By the end of this article, you will have a thorough understanding of Fordyce spots and how to manage them.

What Are Fordyce Spots?

Fordyce spots are essentially visible sebaceous glands. Sebaceous glands are tiny structures in the skin responsible for producing sebum, an oily substance that lubricates and protects the skin and hair. These glands are normally present in various areas of the body, and when they become visible, they are referred to as Fordyce spots.

Fordyce spots can manifest as small, pale, red, or white bumps or spots, typically measuring between 1 to 3 millimeters in diameter. While they can be found on both males and females, they appear more commonly on the male genitals and the face and mouth of both sexes. Specifically, you may find Fordyce spots on the scrotum, lateral surface of the penis, labia, as well as on the vermilion border and inner surface of the lips, known as the retromolar mucosa.

The Mystery of Fordyce Spots

The exact cause of Fordyce spots remains something of a mystery in the medical world. It is likely that a combination of biological and environmental factors is responsible for their development. One prevailing theory is that they result from the overgrowth of sebaceous glands in locations where they are not typically found.

Some research has linked the emergence of Fordyce spots to hormonal changes and factors related to embryonic development. However, no single, definitive cause has been established. What is clear, though, is that these spots are not associated with any disease or illness, nor are they contagious. Instead, they are considered natural and harmless formations in the body.

Characteristics of Fordyce Spots

Fordyce spots have several distinct characteristics:

Size: They are small, ranging from 1 to 3 millimeters in diameter.

Color: They can appear pale, red, or white.

Painless: Fordyce spots are typically painless and do not cause discomfort.

Surface: They often have a slightly raised or bumpy texture.

Location: As mentioned earlier, they can be found on the genitals, face, and mouth.

Harmlessness: They are benign and do not indicate any underlying health problems.

Risk Factors Associated with Fordyce Spots

While the exact cause remains uncertain, certain risk factors have been associated with the development of Fordyce spots. These factors can make individuals more prone to having visible Fordyce spots. Common risk factors include:

Oily Skin: People with naturally oily skin may be more likely to develop Fordyce spots.

Post-Pubertal Age: Fordyce spots are more commonly observed in adults, especially after puberty.

Biological Sex: These spots can appear in individuals of any gender, but they are more frequently observed on men.

Dyslipidemia: This is a condition characterized by abnormal levels of lipids (fats) in the blood and is sometimes associated with Fordyce spots.

Rheumatic Disorders: Certain rheumatic conditions may be linked to the occurrence of Fordyce spots.

Colorectal Cancers: Some studies suggest an association between Fordyce spots and colorectal cancers, although more research is needed to confirm this link.

It's important to note that while these factors may increase the likelihood of having Fordyce spots, they do not guarantee their presence, and the spots can still occur in individuals without these risk factors.

How are Fordyce spots identified?

Fordyce spots are typically diagnosed through a visual examination by a healthcare professional. Individuals who are troubled by the presence of their Fordyce spots, are exhibiting any associated symptoms like bleeding, or are grappling with emotional distress such as anxiety or depression, or who are concerned about the possibility of other medical conditions may choose to consult a healthcare provider for diagnosis and advice.

Accurate diagnosis of Fordyce spots is crucial because other conditions, including genital warts, epidermoid cysts, sebaceous hyperplasia, or milia, can mimic their appearance. For instance, certain sexually transmitted infections may initially resemble Fordyce spots on the genital area and could necessitate treatment with specific medications.

In some cases, swabs may be taken from the affected skin areas and tested to check for the presence of bacteria or viruses. If these tests return negative results, it is more likely that the diagnosis will be Fordyce spots. In instances where there is a suspicion of systemic involvement, blood and urine samples may also be collected. In rare circumstances, a skin biopsy might be necessary, involving the removal of a tissue sample for microscopic examination to rule out other conditions, including skin cancer.

Managing Fordyce Spots

Fordyce spots are generally considered harmless and do not require treatment unless they cause cosmetic concerns or psychological distress. If you are concerned about the appearance of Fordyce spots, there are several management options to consider:

Topical Retinoids: Dermatologists may recommend the use of topical retinoids, which can help reduce the appearance of Fordyce spots. These substances can affect sebaceous glands and decrease their size and visibility.

Laser Therapy: Laser therapy is another option for reducing the appearance of Fordyce spots. It works by targeting and minimizing the blood vessels that supply the sebaceous glands, leading to a reduction in their size.

Cryotherapy: Cryotherapy involves freezing the Fordyce spots, which can cause them to shrink or disappear. However, it may require multiple sessions.

Micro-punch Surgery: This surgical procedure involves removing individual Fordyce spots by making small incisions. It is typically done for cosmetic reasons and under local anesthesia.

Self-Care and Cosmetic Cover-Up: If the spots do not bother you significantly, you can choose to leave them untreated. Alternatively, you can use cosmetics to cover them up.

It's important to consult a dermatologist before deciding on any treatment option, as they can help determine the most appropriate approach based on your individual case and preferences. Keep in mind that some treatments may have potential side effects, and the visibility of Fordyce spots can vary from person to person.

Options for addressing Fordyce spots through topical treatments encompass bichloracetic acid, topical tretinoin (commonly known as Avita or Retin-A), and oral isotretinoin (sold as Sotret or Claravis).

When to Seek Medical Advice

While Fordyce spots are generally benign, there are situations in which you should seek medical advice or consultation from a dermatologist:

Uncertainty: If you are unsure whether the spots you are seeing are indeed Fordyce spots, consult a healthcare professional for a proper diagnosis.

Cosmetic Concerns: If the appearance of Fordyce spots on your face or genitals causes cosmetic concerns or distress, consult a dermatologist to discuss treatment options.

Anxiety About Other Conditions: If you suspect or are anxious that the spots might be a sign of a sexually transmitted disease or another health issue, consult a healthcare professional for evaluation and guidance. Fordyce spots are not related to these conditions, but it's essential to address any concerns you may have.

Unusual Changes: If you notice any unusual changes in the spots, such as sudden enlargement, discoloration, or pain, seek medical attention promptly.

In summary, Fordyce spots are common, benign, and natural occurrences in many adults. While their exact cause remains uncertain, they are not associated with disease and do not pose a health risk. Treatment is generally only considered when there are cosmetic concerns, and various options are available to manage their appearance. Consulting a dermatologist is advisable for a proper diagnosis and personalized guidance. Understanding Fordyce spots can help alleviate concerns and ensure that they are managed appropriately.

Similar links >> On this website, the link group where you can read the articles I have previously prepared about Fordyce spots >>

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47