Sebaceous hyperplasia is a skin condition that often goes unnoticed until it becomes a cosmetic concern. Although generally harmless, its presence can be worrisome, especially when it affects your appearance. As a dermatologist, I have seen how these small yellowish papules on the face can impact my patients’ confidence.
If you've noticed these persistent bumps, you might be dealing with sebaceous hyperplasia. Don’t worry, in this blog, I'll explain what they are, why they occur, and most importantly, how you can effectively treat them to restore the health of your skin.
What will I talk about in this article?
What is Sebaceous Hyperplasia?
Sebaceous hyperplasia occurs when the sebaceous glands, which are responsible for producing the oil (sebum) that keeps your skin hydrated, become enlarged. This enlargement leads to the formation of small, soft bumps that are often yellowish with a central depression, resembling tiny doughnuts on the skin. These bumps most commonly appear on the face, particularly on the forehead, cheeks, and nose. citation
Although these bumps are not harmful, their appearance can be concerning, especially since they can sometimes resemble more serious skin conditions, such as basal cell carcinoma. As a dermatologist, I emphasize the importance of getting a professional diagnosis to ensure that you are dealing with sebaceous hyperplasia and not something more serious.
Sebaceous hyperplasia can easily be mistaken for more serious conditions. A precise diagnosis is essential for successful treatment.
Contributed by Ronald Rapini, MD From: Sebaceous Hyperplasia
What do sebaceous hyperplasias look like on dermoscopy?
Dermatoscopy is a technique used by dermatologists to examine the skin in detail, using a special device called a dermatoscope. This device allows the skin to be viewed under magnification and polarized light, revealing structures that are not visible to the naked eye.
A sebaceous hyperplasia is a common lesion that appears as a small bump on the skin, usually on the face. It occurs when the sebaceous glands, which produce skin oil, become enlarged. Under dermoscopy, this condition looks like a yellowish lump with a small depression in the center, sometimes accompanied by small blood vessels on its surface.
What Causes Sebaceous Hyperplasia?
The exact causes of sebaceous hyperplasia are not entirely clear, but studies suggest that several factors contribute to its development: Quote
- Aging and Hormonal Changes: As we age, androgen levels decrease, which stimulates the proliferation of sebaceous glands, particularly on the face, typically beginning around the ages of 30-40.
- Androgen Sensitivity: Sebaceous glands respond to androgens, which increase their activity and size, contributing to the development of sebaceous hyperplasia.
- Sun exposure: Prolonged exposure to UV rays can accelerate the development of sebaceous hyperplasia, particularly on the face.
- Immunosuppressive Treatments: Medications such as cyclosporine A, used in transplant patients, can increase the risk of developing sebaceous hyperplasia.
- Genetic Factors and Syndromes: Some forms of sebaceous hyperplasia are associated with genetic predispositions and syndromes such as Muir-Torre syndrome, although they are much less common.
How to Treat Sebaceous Hyperplasia: My Recommendations
Although sebaceous hyperplasia is benign, many of my patients seek treatment to improve their appearance.
My Perspective as a Dermatologist
Throughout my years of practice and experience as a dermatologist, I have concluded that the most effective treatments for addressing this condition undoubtedly include the following approaches:
Preferred Method
- CO2 laser: In my opinion, the best treatment for eliminating sebaceous hyperplasia is CO2 laser therapy. This laser effectively removes the lesions, leaving the skin much more even. The results are exceptional.Quote
- Topical Retinoids: Once sebaceous hyperplasia has been removed, we recommend the use of topical retinol to prevent the appearance of new lesions. new sebaceous hyperplasia. This treatment not only helps to reduce sebum production and in some cases the appearance of new lesions. Although it is widely recommended by dermatologists, there are not so many studies that demonstrate its efficacy, which is why in more severe cases we can recommend an oral treatment.
- Oral Retinoids: In more severe cases or when there is a tendency for recurrence, we may offer the use of oral retinoids, always under the supervision of a dermatologist.
CO2 laser ablation is the fastest and most effective solution for treating sebaceous hyperplasia, with full recovery in less than a week.
Other Treatments
- Electrocautery and Curettage: In contexts where CO2 laser is not available, techniques such as electrocautery and curettage are excellent options that allow for the precise removal of sebaceous hyperplasia.
- Trichloroacetic Acid Peel: Another effective option isFocused chemical peels with TCA at 35-50%.Quote
- Cryotherapy It can be effective if done with caution and expertise. It is preferable to use a cotton applicator instead of the conventional spray method, as the latter can leave white spots or even cause scarring. However, in clinical practice, it may not make much sense given the availability of CO2 laser and other much more effective methods.
- Azelaic Acid and Other Alpha Hydroxy Acids: Known for their anti-inflammatory properties, these acids can help reduce the size and appearance of the lesions. However, retinoids are generally more effective.
Will They Reappear?
Sebaceous hyperplasia lesions generally tend to reappear over time, usually after a few years, although this can vary; in some cases, they may return sooner or later. Topical retinoids can help reduce the likelihood of recurrence, although in practice, oral retinoids tend to offer more consistent results.
Ready to Say Goodbye to Sebaceous Hyperplasia?
If you’ve noticed those small bumps on your face and they’re causing you concern, it’s completely understandable that you’d want to take action. Although sebaceous hyperplasia doesn’t pose a health risk, I know from experience that they can impact how you feel about yourself. Fortunately, there are effective treatments that can help improve the appearance of your skin.
Shall We Start your Transformation?
As a dermatologist with extensive experience in this condition, my goal is to offer you the best treatment options, tailored to your needs. Whether you're considering treatment or simply need guidance, I invite you to schedule a consultation. I’m here to help you find the solution that best suits your skin.
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