Fordyce spots
Fordyce spots, also known as Fordyce granules, are ectopic sebaceous glands that are visible to the naked eye. They are a natural occurrence and present in a majority of individuals. Their presentation, although harmless, can sometimes cause cosmetic concerns or fear of sexually transmitted diseases.
Appearance and Location
Fordyce spots are characterized by small, painless, raised bumps that are pale, red or white in color. The spots typically measure between 1 to 3 mm in diameter. They most commonly appear on the genitals, including the scrotum and shaft of the penis in males and the labia in females. However, they can also be found on the face, specifically on the inner surface of the lips (retromolar mucosa) and along the vermilion border.
Pathophysiology
Sebaceous glands are typically associated with hair follicles, but in the case of Fordyce spots, these glands are found in a free-standing state directly in the mucosal surfaces. Despite their unusual location, they continue to secrete sebum, an oily substance that lubricates the skin and protects it from bacterial invasion.
Clinical Significance
Fordyce spots are not associated with any disease or illness, nor are they infectious. They represent a normal anatomical variant rather than a pathological condition. As such, no treatment is required unless individuals are concerned about their appearance.
Differential Diagnosis
Due to their appearance and location, individuals with Fordyce spots may initially fear that they have a sexually transmitted disease. However, a proper diagnosis from a dermatologist can quickly dispel such worries. It is important for healthcare providers to reassure patients about the benign nature of Fordyce spots to alleviate their anxiety.
Management and Treatment
While Fordyce spots do not require treatment, options are available for those who have cosmetic concerns. These include topical retinoids, oral isotretinoin, laser treatments, and surgical excision, among others. However, these treatments can have side effects and may not completely remove the spots or prevent them from reappearing.
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Contributors: Prab R. Tumpati, MD