Fordyce spots are harmless and tiny raised bumps that usually appear lips and reproductive organs. Read on to find out why and how you get these spots, symptoms and diagnosis, how to get rid of them at home and more other treatment options
Definition & Meaning- What are Fordyce Spots ?
This dermatologic condition’s name coined by John Addison Fordyce, an American dermatologist. It is a common skin condition that is seen in more than 70% of adults. Some people describe it as alike to granules, glands, spots or prominences and hence these terms can be used as adjuncts to the prefix name, Fordyce.
They are non-aesthetic regardless of the part of the body affected. They can appear in the mouth, along the wall of the inner cheeks, on the lips mostly the upper lip, face, and on the reproductive organs of both genders. You can already imagine how visible they are owing their appearance in such areas.
Fordyce spots occur as small bumps that are of varying sizes in diameter but are generally within the range of 1 to 3 mm. Like papules, they are raised bumps of sebaceous origin that may occur due to enlarged sebaceous glands and they are at times described by dermatologists as being heterotopic or ectopic.
Well, this is not totally convincing to some authors such as Baeder FM (2010) and Chern PL (2008), who stand by the fact that the lesions are not necessarily ectopic or heterotopic. This they add is due to there being, commonly, subtle sebaceous glands on the lips.
Elston and Meffert further investigated these spots and discovered that there were normal sebaceous glands on the vermillion border of the lips. This is the area above the lip mucosa.
One important note is that Fordyce spots are not linked to hair follicles but rather open directly onto the skin surface. You will notice as you read through the causes of Fordyce spots that hormonal change is part of the etiology.
Plotner and Brodell in their investigation of treatment of these spots, point out that enlarged sebaceous glands become visible in puberty in response to hormones especially the androgenic hormones such as testosterone.
Are fordyce spots normal, bad or contagious?
They are normal. Generally, Fordyce spots are asymptomatic and are not of clinical concern. They cause no harm and they do not hurt. As mentioned earlier, they occur in over 70% of adults.
However, if not taken care of, itching may be bad and hamper your normal day to day activities. This makes them bad even though they are normal
Pain or pruritus may be a symptom of Fordyce spots during its progression to acne. In the latter condition, there is colonization of Propionibacterium acnes which may lead to inflammation associated with pain.
Having said that, it should be straight forward that Fordyce glands are not contagious. The spots cannot be transmitted to other persons. This is because they not linked with infectious agents such as bacteria, virus or fungus.
Are Fordyce Spots itchy?
They are not itchy but can be. Intercourse also makes them itchy. When you are on therapy such as photodynamic therapy side effects may include itching, burning sensation that can last several weeks and small chance of infection.
Symptoms and Diagnosis
How do you know that what you are observing are indeed Fordyce spots?
Fordyce spots are harmless and associated with not systemic symptom. Signs are most prevalent with this condition and the time may span years without fading away. They are rarely painful in which case you should see a doctor.
They appear as small elevated bumps of 1-3 mm in diameter resembling a papule and may be of varying color. With regard to color, they may either by yellowish, white colored. When inflamed they are red. Some people say they have them in purple and brown colors.
Most are white. Note that they appear on sebaceous glands these mostly being on the lips of the mouth and the reproductive organs
Dermatologists may misdiagnose Fordyce spots as pearly penile papules, milia or sebaceous hyperplasia
However apart from diagnosis based on the appearance alone, your dermatologist may order a biopsy to rule out conclusively probabilities of STIs such as genital warts that may at times resemble Fordyce spots.
- Pearly penile papules: found on the male reproductive organs.
- Milia: these are small, white, benign and cysts with keratinous deposits and is not of sebaceous origin but rather, stratified squamous epithelium.
- Sebaceous hyperplasia: occur as multiple papule-like lesions that are discrete in appearance and not really in cluster form. They mostly have a central umbilication and are larger than Fordyce spots ranging from 2 to 5 mm.
Causes- Why and how do get Fordyce Spots-stress & cancer Links?
As of today, experts cannot tell the exact cause of Fordyce spots on the mouth area and other parts of your body. Research is still underway to identify the specific cause. However, it thought to be frequent in individuals with the following conditions
There is some evidence that some types of cancer can cause these harmless granules especially in the mouth area. A study published in the journal Gut discovered that 86.7 percent of patients with an inherited form of colorectal cancer had Fordyce spots in their mouth.
Some people believe that stress and anxiety can lead to the appearance fordyce granules. There is no prove at all. What is known is that the spots themselves can lead to stress and anxiety especially to those who do not know what they are.
People with skin issues such as oily skin (overproduction of sebum) tend suffer more from this
condition. It is thought that the excess sebum gets easily trapped, which lead to the appearance of these spots.
Other possible causes or conditions linked to fordyce granules include
- Rheumatoid disorders such as rheumatoid arthritis
- Hyperlipidemia (high levels of fats in your blood)
Fordyce Spots on Lips Top & Corner of Mouth pictures
The mouth, both the upper, lower lips and at the corners is where this spots appear most. Here are pictures.
Men Fordyce Spots
Fordyce spots also appear on reproductive organs of men. Following are the possible is how they look like and causes.
Entrapment of sebum
Sebum is produced onto the skin surface for its mild antimicrobial and humectant properties. However, when this fluid is trapped beneath the skin surface, then this may lead to Fordyce spots.
Enlarged sebaceous glands
This is analogous to entrapment of sebum and may also be a cause of it. When the glands enlarge, then there is a high amount of sebum being produced which may not be effectively released onto the skin surface hence causing Fordyce spots.
This is a malformation though rare that is characterised by presence of multiply divided hair matrices and papillae. Hence there occurs growth of more than one hair from one pore. This could lead to the entrapment of sebum and lead to Fordyce spots.
There seems to be a genetic reason to the occurrence of Fordyce spots. This is however still a speculation and still not yet vindicated.
Women Fordyce Spots Pictures
Fordyce spots occurring in females are confined to the pupenda. Causes may however not be far-fetched further than those that cause Fordyce spots in males.
Apart from the above causes, there is more to it to just what has been mentioned closely linked to hormonal imbalance in females. If there is excessive testosterone than estrogen, then the modulating function of estrogen on sebaceous glands is hampered.
Hence, sebum is produced in excess and leads to formation of Fordyce spots. There is a link between the formation of acne which is equally related to sebum as Fordyce spots and the decrease of estrogen as happens in the second half of the menstrual cycle and those with polycystic ovarian syndrome (PCOS). The two are associated with an imbalance of hormones leading to high androgen levels.
Infected, Irritated & Inflamed Fordyce Spots
If go through a couple of online health forums where this topic has been mentioned, there are many users reporting inflamed, irritated on infected fordyce spots. Can these spots be irritated or get inflamed?
If they are left alone chances of inflammation, irritation or infection are minimal. On the other hand, the granules can get inflamed or irritated but it this mostly occurs as a result of friction. A good example is scratch when the affected area. Rubbing can break the skin which will result to entry of bacteria that usual reside on the skin surface.
If the bacterium gets into your skin near a single Fordyce spot there is a possibility of an inflammation which can lead to an infection of the nearby skin tissues.
Popping Fordyce spots
Another possible cause of irritation and inflammation is when some individuals attempt to pop the spots with unsterilized sharp objects like a needle. This action can as well break the skin leading to irritation and infection.
Fordyce Spots or STD, Herpes, Genital Warts
Fordyce granules are not a sexually transmitted disease. As you’ve seen from the sections above, they are harmless and not a medical condition.
When compared to herpes they may appear to be somehow the same for some people. If you experience some pain and if they come and go then you see your doctor. These are some common symptoms of herpes.
Some people also confuse Fordyce granules with genital warts. Warts in the genital are come about as result of STD and they are only transmitted through open wounds on your body.
When compared to genital warts, Fordyce spots are tiny and uniform in appearance. Warts are usually larger and blend together to create a bubbly skin surface
Do Fordyce Spots go away? How long do Fordyce spots last?
How long do Fordyce spots last?
Fordyce spots may occur congenitally and mostly such cases become visible in puberty. There may be a cluster of these spots or in some appear singly. The most likely occurrence is about 50 to 100 of them stretching a small area of the skin.
Therefore, whether your spots last a certain period of time depends on the extent and whether it is congenitally acquired.
As you have learnt, the enlarged sebaceous glands occur though hidden underneath the skin at birth which means that they could last years.
Depending on the underlying condition such as PCOS or hormonal imbalances, the period they could last also varies.
Can Fordyce spots get bigger?
After appearing visually, normally during puberty, chances that will grow bigger are minimal. What can make them appear to be growing is an infection or inflammation.
Will or do Fordyce spots away naturally on their own
Fordyce spots may go naturally on their own without instituting any treatment. This is due to recuperation from an underlying condition through your body’s own efforts.
A good example is that which is caused by premenstrual changes in hormones in the blood or loss of weight unintentionally or with intent. The latter is mostly recommended for those with PCOS to balance off the hormones.
However, watch out for recurrence even if treatment has been instituted. The best advice would be not to diagnose yourself with Fordyce spots until satisfactory investigation by a specialist. This aside the vast platforms you can use to diagnose yourself on internet.
How to get Rid of Fordyce Spots at Home
Getting rid of Fordyce spots with toothpaste
Toothpaste in the removal of Fordyce spots may not be a really good option. This is due to the need to normalize the pH of the skin in treatment. Physiologically, the skin’s pH is about 5 units and this maintained is useful in the prevention of inflammation.
This pH changes when you use cosmetics and other chemicals that alter it. Though alkalinizers may help neutralize acidic chemicals, toothpaste might not be helpful if the pH is already high and hence need to reduce it.
Shower gels and soaps are aggressive alkaline chemicals and should be avoided but this does not necessarily justify the use of mild basic toothpaste. This is how you can use toothpaste if you really insist on trying it:
- Using your toothbrush, apply a stream of paste just as you do before brushing your teeth.
- Brush your teeth normally making sure that you have thoroughly cleansed your mouth.
- Then brush your lips gently without bruising your skin.
- Do this routinely.
Excess sebum may lead to the accumulation of excessive acid due to the fatty acids in sebum and without sweat, this is not well neutralized. Hence, limitedly, toothpaste might have a role to play.
Coconut oil for Fordyce spots cure
Coconut oil is particularly preferred in managing Fordyce spots as it forms a coat and avails its humectant property.
It also has the ability to aid in the replacement of damaged skin.
Coconut oil can be combined with garlic for its antibacterial properties in the prevention of acne.
This is how you use coconut oil for Fordyce spots:
Requirements: a clove of garlic, 50 mL of coconut oil, cooking pan, fire source.
- Pour the whole of the coconut oil in the pan.
- Heat it to warm then add the crushed garlic clove
- Continue heating on a low grade flame for about 15 minutes.
- You could choose to filter the cloves off
- Cool the mixture preferably in a refrigerator or by running tap water or dipping the container in cold water.
- Apply on the affected area once a day.
Fordyce spots on lips vinegar treatment
Apple cider vinegar is another popular remedy to cure Fordyce spots at home. The antibacterial and anti-inflammatory properties make it effective in dealing with the spots.
All you need is 2tbsp of ACV and a glass of water. Mix the two ingredients and then rub the mixture on the affected area using a cotton swab. Let the mixture stay for about 60 minutes and then rinse with lukewarm water. Repeat after every seven days.
Other home remedies for Fordyce spots on lips and parts of the body.
There are other home remedies that could be used other than the ones stated. These have been touched on briefly with the intent of informing. They include:
There are studies that show a relation between dehydration and formation of Fordyce spots. Dehydration of the mucous membranes may lead to their formation and thus the recommendation is that proper hydration by taking water or applying an oil could help treat it.
There is evidence of its gel working on Fordyce spots owing to its workability in inflammation conditions and providing protection against infections.
Lemon is an astringent and also a mild antiseptic. It may be helpful in the prevention of bacterial infections on impending attack. However, critically looking at this method would mean that it being an astringent would provide minimal opening of pores for sebum release.
There is a relation between conditions that affect the mucous membranes and vitamins. Vitamin B12 is particularly known for its manifestation as stomatitis and angular chelitis and thence more to it than just the two. Increase your intake of vitamins to reverse the formation of Fordyce spots.
Consider dark green leafy vegetables and other foods that will provide your body with vitamin A, B, C, D and E. Some of these such as vitamin C and E have astringent properties and mild antioxidant properties that could hasten the convalescence period.
Jojoba oil and tea tree oil are also good alternatives to coconut oil as they have the same properties though the latter is considered better. Honey has soothing effects on the spots and it mixing it with either of the oils may fortify beneficial effects.
Fordyce Spots Treatment & Medication
According to Rane and Read (2013), in their publication in the Australian FAM Physician Journal, mention that treatment is not necessary and reassurance is important especially about the benign nature of the condition.
However, treatment approach of Fordyce spots could either be a non-surgical or the otherwise as follows:
Bichloroacetic acid (BCA)
This is a topical treatment that is indicated for such spots. It is a caustic agent that destroys the spots as happens in warts. This it does by making the proteins coagulate.
Good thing it is highly viscous making it easily applicable. This drug can also be used for internal formation of Fordyce spots too (National Health Services).
Also indicated for genital warts, the use of nitrogen to freeze spots could be utilized in the treatment of Fordyce spots. This is done by a professional and cannot be self-administered on top of being uncomfortable and need to have multiple sessions.
Available under the brand Accutane or Roaccutane, is a medication that is indicated for the treatment of severe acne.
It can also be used for Fordyce spots though with serious side effects and a thorough patient care advice on how to use it.
Depression, sensitivity to light and the long duration of treatment before eliciting any therapeutic effect are some of the demerits.
Anti-Sebum topical cream-Does it work?
This cream has sesame extract, sage, Serenoa and Vitamin E. it reduces the formation of sebum from enlarged sebaceous glands and also absorbs the excess oils.
Blistex and Noxzema
A couple of online forums also mention use of blistex and Noxzema to get rid of fordyce spots especially on lips. These suggestions are based on personal accounts. They are not medically proved as a solution for the harmless spots.
- Cauterization/ Electrodessication/ Diathermy: this is a method in which a probe is heated electrically and then applied onto the spots. This burns them off.
- Laser vaporization: lasers could be focused at a high temperature onto the spots in a very accurate fashion about 0.1 mm.
- Photodynamic therapy: this method involves manual removal of the spots after the formation of holes by a machine that targets the spots. It is however linked to scarring.
- Punch excision: this method has been shown to be effective in the treatment of Fordyce spots. It does this by a photosensitizing agent that is ingested and accumulates in the abnormal skin cells as does in the treatment of various forms of cancer. This destroys the cells under the spots.
Tips & Ideas to Prevent Fordyce Spots
Fordyce spots can be prevented by various approaches that are simple to execute. These include:
- Proper hygiene: it is important to observe and maintain a clean skin. This may help prevent the accumulation of debris that may lead to the clogging of pores. Therefore, scrub your skin to remove the debris or even exfoliate it.
- Proper diet: you have learnt that insufficient vitamins in your diet could lead to Fordyce spots. Get advice from a nutritionist on the best foods to consume to replenish any voids.
- Treat or address underlying conditions: if you notice that you have a hormonal imbalance it is imperative that you seek medical attention as fast as possible to avoid any further adversities associated with it.
Fordyce spots before and after treatment
Below is a picture of before and after treatment of the lips on lips
Sources & References
 Rane V, Read T (2013) penile appearance, lumps and bumps. Aust Fam Physician 42: 270-274
 Baeder FM, Pelino JE, de Almeida ER, Duarte DA, Santos MT (2010) High-power diode laser use on Fordyce granule excision: a case report. J Cosmet Dermatol 9: 321- 324.
 Plotner AN, Brodell RT (2008) Treatment of Fordyce spots with bichloracetic acid. Dermatol Surg 34: 397-399.