The pimples or spots by Fordyce are ectopic sebaceous glands that appear as red, yellowish-white or skin-colored bumps or spots on the shaft of the penis, lips, scrotum or on the vermilion border of the lips of a person.
These spots are glands that normally produce sebum and are generally found within the scalp and face, where androgen secretion increases. It was the American dermatologist John Addison Fordyce (1858-1925), who first described them clinically in a medical journal. He also coined the terms Fox Fordyce disease and Fordyce tricuepithelioma lesion..
Although Fordyce spots are sebaceous glands that are in the "wrong place" and not in the hair follicles, they are not associated with any type of disease nor is it a sexually transmitted infection, although their appearance may be confusing..
Fordyce spots are also often mistaken for pearly penile papules, another dermatological condition that is not a sexually transmitted infection. Both Fordyce spots and pearly penile papules are not communicable and do not present any health problems..
Normally Fordyce pimples begin to appear during puberty and persist throughout life, although they tend to decrease with age.
Regarding prevalence, 80-95% of adults correspond to adults, although the reality is that they are present at birth, but they become larger and more visible around puberty and even more in adulthood..
People with high levels of blood lipids, such as cholesterol and triglycerides, also tend to have the highest number of Fordyce spots..
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Some of the symptoms that Fordyce spots can cause are irritation and itching, in addition to causing stress, anxiety and depression in those who suffer from it. This is because many people often mistake them for a sign of a sexually transmitted disease..
This may worry or embarrass you about what your sexual partners or friends might think about your spots. Sometimes the spots may bleed if injured during intercourse.
The symptoms of Fordyce spots on the lips usually develop along the edge, although it can also appear on the lip itself and on the inside of the cheeks..
In the genitals they usually appear on the shaft of the penis or scrotum and in women, on the vaginal lips. Generally, there are not many symptoms that Fordyce spots produce, except that they can sometimes be itchy..
Fordyce spots are believed to be caused by sebum (oil that secretes glands to lubricate and protect the skin).
The sebaceous glands produce sebum on a regular basis and these are found within the hair follicles, while in the case of Fordyce spots, there is no hair follicle so the sebum is blocked and forms small bumps or spots.
These spots or bumps occur naturally at birth, although they mostly appear at puberty. Evidence suggests that incidence increases with age.
On the other hand, people with high levels of blood lipids like cholesterol and triglycerides tend to have the highest number of Fordyce spots. For this reason, Dr. Angélica Girón recommends eating a healthy and balanced diet to have a good appearance of the skin.
As previously mentioned, the spots occur naturally and therefore it is not associated with any virus, or with any disease..
Most patients are usually asymptomatic, so the demand for treatment is not very high. However, some patients do receive treatment but for cosmetic reasons, since the lesions do not resolve spontaneously..
Fordyce spots are harmless and therefore do not require any treatment, as they tend to disappear on their own over time, although it can last for years.
Although many doctors advise against treatment, today there are methods that can help to reduce the spots or even reduce them, such as using the CO2 method or laser surgery..
The technique of electrosurgery and vaporize laser treatment (Co2 laser) has been used successfully to remove stains.
Other treatments include bichloroacetic acid, photodynamic therapy, micro-punch removal surgery and vaporization, and oral isotretinoin, although the latter should not be taken for long periods of time..
There is a report regarding photodynamic therapy with 5-aminolevulinic acid for blemishes, but due to its side effects such as burning sensation, vesiculation and post-inflammatory hyperpigmentation have been reported.
This method of photodynamic therapy uses a photosensitizing agent that is taken orally as a drug. Once in the body, the agent targets abnormal skin cells so that when the laser is applied, it can then burn the target cells..
One of the products known as tretinoin gel or cream, it is also a very popular Fordyce spot treatment. Many report that by using this product, the prominence of the spots was reduced.
Experts believe that this product can be even more effective when used in combination with an alpha hydroxy acid agent..
Another treatment is associated with a trichloroacetic acid chemical peel. This product helps to peel away blemishes, which in turn causes a significant improvement in the appearance of blemishes..
-Electro desiccation or CO2 laser have been used with a certain degree of success in those less visible spots, in the case that the patient's concern is purely cosmetic..
-Pulsed dye lasers, is a laser treatment generally used for hyperplasia of the sebaceous glands. Although it is expensive, it tends to leave less scars than other types of techniques.
-Micro-punch technique for treating Fordyce stains. Norbert Pallua, Professor in the Department of Plastic Surgery at RWTH Aachen University Hospital, Germany, published in the Journal of Plastic, Reconstructive and Aesthetic Surgery promising results with this technique for the treatment of Fordyce spots.
Some of the less invasive treatments are the following:
-Cryotherapy, commonly used to treat warts. It is a technique based on the use of liquid nitrogen to freeze the spots. The process is uncomfortable and it is normal that several sessions are needed.
-Biochloroacetic Acid BCA. Applied to the skin by a dermatologist, it is a quick and painless process, but it has the disadvantage that spots can reappear. Burning sensation is the most common.
-Isotretinoin is a drug that was developed to remedy severe acne. It is used on certain occasions and although its results have been favorable, there are a series of side effects to take into account, such as increased sensitivity to sunlight and psychological problems such as depression.
Generally isotretinoin is prescribed for a 12-16 week course which is when successful results are seen. However, once its use is stopped it appears that there is a strong probability that the stains will reappear..
The use of natural remedies can be effective in reducing blemishes, such as the use of healthy oils in the daily diet (cod liver oil) or through the use of omega-3 supplements..
Some of these natural remedies are:
Since research on the effectiveness of these methods or natural remedies is limited, it is always recommended to consult your doctor for the appropriate indications..
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