Sebaceous Hyperplasia: An Overview

Sebaceous hyperplasia is a harmless skin disorder in which the oil gland (sebaceous gland) that surrounds a hair follicle gets bigger, forming a bump. If these glands produce too much oil, skin issues like clogged pores, acne, and sebaceous hyperplasia can result.

Stress, age, certain medications, sun exposure, hormones, and/or genetics may all play a part in the over-production of oil. The exact cause is unknown.

Sebaceous hyperplasia typically doesn't go away without treatment, which many people elect to do for cosmetic reasons.

What Causes Sebaceous Hyperplasia?

Sebaceous hyperplasia bumps are not rashes, growths, or cancer. They are enlarged sebaceous glands that produce an oil called sebum. This oil keeps the skin lubricated and healthy.

Sebaceous hyperplasia is caused by an overabundance of sebocytes. These are special cells that make up the sebaceous glands. The excess cells enlarge the sebaceous gland, making it grow larger than normal.

Several factors are thought to contribute to sebaceous hyperplasia.

Hormones

Androgens are male sex hormones. These hormones, especially testosterone, stimulate sebaceous glands to produce more oil. Their role is very evident during puberty when a large increase in androgens leads many teens to have very oily skin.

With age, androgens decrease. This slows sebaceous gland activity and oil production. Cell turnover (the rate at which dead cells are replaced with fresh ones) also slows down. These dead cells back up within the sebaceous gland, causing it to enlarge.

Risk Factors

Sebaceous hyperplasia is more commonly seen in:

• Infants (due to hormones passed from mother to child)
• Those middle-aged and older
• Those with light or fair skin
• Those having had long-term sun exposure
• Those with a family history of the condition
• Those who are immunosuppressed (e.g., taking cyclosporine or prednisone)
  

Among healthy people, about 1% develop sebaceous hyperplasia.

Sebaceous Hyperplasia Symptoms

Sebaceous hyperplasia can appear as a single bump or multiple bumps in a cluster or line. The bumps range from 1 or 2 mm to several millimeters in size. They are often the same color as your skin but may also look white to slightly yellow.

The bumps don't hurt or itch. They may bleed if you knock them or shave over them, though.

Sebaceous hyperplasia most often develops on the face. The most common places to find them are the forehead, cheeks, and nose. Babies often have bumps on the upper lip.

Uncommonly, the bumps can appear in other places, such as:

• Back and chest
• Shoulders
• Areola, the darker skin surrounding the nipple
• Penis
• Scrotum
• Vulva

Sebaceous hyperplasia bumps don't usually go away on their own, except in newborns. Their bumps usually disappear within a few months.

Diagnosing Sebaceous Hyperplasia

Your healthcare provider can usually diagnose sebaceous hyperplasia with a simple visual inspection. If there's any question about the diagnosis, though, they may order a skin biopsy. This will help rule out other conditions, like skin cancer.

Sometimes it can be hard to tell the difference between sebaceous hyperplasia and a skin cancer called basal cell carcinoma. Basal cell carcinoma often appears on the head or neck. It looks like a shiny, raised, and round pimple, scar, or sore.

A biopsy can also help rule out sebaceous gland carcinoma. This rare, slow-growing cancer appears as a firm, yellowish lump. It often appears on the eyelid, and it may bleed and look like a pimple or sore that doesn't heal. It may also heal and then reappear.

Muir-Torre syndrome is a rare inherited disease. It is a variant of Lynch syndrome. Patients with this condition are at higher risk for developing sebaceous gland carcinoma.

How to Get Rid of Sebaceous Hyperplasia

There is no medical need to treat sebaceous hyperplasia. Adults may choose to treat the bumps for cosmetic reasons.

Squeezing sebaceous hyperplasia bumps is ineffective. This is because there isn't anything inside that can be extracted. However, squeezing can cause the bumps to become inflamed or bleed.

There are treatment options available. Treatment results will depend on factors such as:

• The number of bumps
• Your age
• Your skin type
• How your skin reacts to sun exposure
  

Prescription Medications

Prescription medications may help keep new bumps from forming. Options include:

• Topical retinoids
• Azelaic acid

These medicines speed up the skin's natural cell turnover rate. They may also make existing bumps appear smaller. These topical treatments probably won't get rid of all your bumps, though.

If you have a severe case, your healthcare provider may prescribe isotretinoin. This is an oral medication that shrinks sebaceous glands. This treatment is effective, but bumps may return after the medicine is stopped. Isotretinoin cannot be used during pregnancy.

Finally, women with sebaceous hyperplasia can try antiandrogen medications that block the effect of testosterone on the skin. These include:

• Certain birth control pills
• Aldactone (spironolactone)
  

Procedures

Several in-office procedures treat sebaceous hyperplasia. These treatments often provide faster and more obvious improvement. However, there is a risk of skin discoloration or scarring, and the condition may recur after the procedure. Options include:

• Laser resurfacing: A laser delivers a wavelength of light into your skin that targets, heats, and destroys enlarged sebaceous glands.
• Photodynamic therapy: A chemical substance that absorbs light is applied to your skin, and then light treatment is used to reduce the number and size of sebaceous glands.
• Cryotherapy: Liquid nitrogen is sprayed onto the affected area of the skin, freezing the bumps so they dry up and fall off.
• Cauterization or electrodesiccation: A sharp needle is heated with an electrical charge and inserted into each bump, rapidly drying them up.
• Excision: Bumps are shaved off or cut out.

OTC Medications

Over-the-counter (OTC) skin care products that contain the following may help:

• Salicylic acid
  
• Retinol

Products that contain retinol or salicylic acid are used to fight acne and unclog pores. They may help to shrink sebaceous glands, although there is no scientific evidence that these products work for sebaceous hyperplasia. When used as directed, though, there is no harm in trying.

Sun exposure is theorized to play a role in the development of sebaceous hyperplasia. Daily application of sunscreen with an SPF of a least 30 may help prevent the onset or worsening of the condition.

Home Remedies

Home remedies frequently touted to improve sebaceous hyperplasia include applying the following:

• Niacinamide (vitamin B3)
  
• Lemon juice
• Apple cider vinegar
• Peppermint oil
• Mint juice
• Turmeric powder
• Red clover extract
• Witch hazel

There is no research supporting anecdotal accounts of sebaceous hyperplasia benefiting from any of these remedies. If you want to try one of these options, discussing it with your healthcare provider first is best.

Summary

Sebaceous hyperplasia is characterized by the formation of small, painless bumps. While most often seen on the face, the bumps can appear on any part of the body where many oil glands are found.

This harmless skin condition can usually be diagnosed with a simple visual inspection. Sometimes a biopsy is performed to rule out skin cancer.

Treatment for sebaceous hyperplasia is for cosmetic purposes only.