Overview

Fordyce spots are small, raised, pale or white-yellowish bumps that commonly appear on the lips, inside the cheeks, and genital areas. They are a completely harmless and non-contagious dermatological feature, often considered a normal anatomical variation rather than a disease. These spots are visible sebaceous (oil) glands that are located close to the surface of the skin. While they do not cause any health risks, some individuals may feel self-conscious about their appearance.

Causes

Fordyce spots occur naturally in many people and are not caused by any external factor or underlying illness. The primary cause is the presence of ectopic sebaceous glands, meaning these oil glands are located in areas where they usually aren’t visible. Contributing factors include:

• Normal anatomy: Fordyce spots are a normal variant found in many healthy individuals.
• Hormonal changes: They often become more noticeable during puberty when oil glands become more active.
• Genetic factors: There may be a hereditary component, with some people more predisposed to having visible sebaceous glands.

Symptoms

Fordyce spots are usually asymptomatic and mainly of cosmetic concern. Typical features include:

• Appearance: Small (1–3 mm), raised, pale, white, or yellow bumps.
• Common locations: Found on the border of the lips (vermilion border), inside the cheeks, penis shaft, scrotum, labia, or vulva.
• Painless: They do not cause pain, itching, or discomfort.
• No secretion: While they are sebaceous glands, they typically do not produce any discharge.
• Stable over time: The spots tend to remain the same size or become slightly more prominent with age but do not spread aggressively.

Diagnosis

Diagnosing Fordyce spots is straightforward and usually does not require any special tests:

• Clinical examination: A healthcare provider can identify Fordyce spots based on their typical appearance and location.
• No biopsy needed: Since these spots are benign, biopsies or laboratory tests are rarely necessary.
• Differentiation from other conditions: It’s important to distinguish Fordyce spots from sexually transmitted infections (STIs), cysts, or other dermatological issues. A professional evaluation ensures correct identification.

Treatment

Treatment is generally not required because Fordyce spots are harmless. However, for cosmetic reasons, some individuals may seek treatment options:

• Reassurance: Most healthcare providers will advise no treatment, emphasizing the benign nature of the spots.
• Laser therapy: CO2 laser or pulsed dye laser treatments can reduce the appearance of spots.
• Micro-punch surgery: A minimally invasive surgical method to physically remove the spots.
• Topical treatments: Tretinoin creams or gels may slightly reduce the prominence of spots over time, though results vary.
• Electrosurgery: A controlled electrical current may be used to shrink or remove the spots in some cases.
• No home remedies: There are no scientifically proven home treatments for Fordyce spots.

Prognosis

The prognosis for Fordyce spots is excellent:

• Harmless condition: They do not pose any health risks and are not associated with infections or cancers.
• No treatment necessary: Most people live comfortably with Fordyce spots without any need for intervention.
• Good cosmetic outcomes: For those seeking removal, dermatological treatments can effectively reduce visibility, though recurrences are possible.
• No complications: Fordyce spots rarely cause any complications and do not impact sexual or general health.

In summary, Fordyce spots are a common, benign skin feature. While medically insignificant, treatment options are available for those concerned with cosmetic appearance.