Fordyce spots treatment; at a glance
- Best Results1-2 sessions
- Treatment Recovery5-6 days
- Procedure Time15 minutes
- Skin SpecialistDr Sarath Bodapati at Cutis Dermatology
- Duration of ResultsVariable
- AnaestheticNumbing cream
- Back to Work1-2 days
- Cost$$
About Fordyce Spots
Fordyce spots are aggregates of oil glands known as sebaceous glands. They occur on the lips & genitalia of both men & women. In some individuals, these sebaceous glands are more prominent & group together. Though harmless, enlarged Fordyce spots can be unsightly. Ablative CO2 & erbium lasers are effective in treating these spots. One to two painless sessions can markedly remove the majority of Fordyce spots.
FactsFacts On Fordyce Spots
- Fordyce spots are enlarged oil glands
- Affected areas include the shaft of the penis
- Fordyce spots do not cause any symptoms
- These lesions are not sexually transmissible
- CO2 & erbium lasers can remove these spots
- Recovery from laser ranges between 5 to 6 days
What are Fordyce Spots?
Fordyce spots are harmless, skin-coloured bumps measuring 0.1 to 1.6 mm that occur on the penile shaft, unlike pearly penile papules that affect the head or glans penis.
They represent sebaceous glands.
What is the best Fordyce spots treatment?
Most cases do not require treatment, however a CO2 or erbium laser can provide good clearance in as little as one session. Compared with other ways of removing genital lesions, lasers offer less scarring & quicker recovery.
Outdated ways to treat Fordyce spots include hyfrecation & punch excision.
Disclaimer: I do not manage or diagnose genital disorders, including Fordyce spots. My colleague, Dr Sarath at Cutis Dermatology, Brisbane has an interest in male genital dermatology.
What is involved with treatment & is it painful?
Dr Sarath at Cutis Dermatology Brisbane performs this procedure in our accredited laser suites. Numbing cream is applied 1 hour before the procedure. The procedure is painless and takes approximately 10 to 20 minutes to complete.
For interstate or overseas patients, you can arrange a virtual consultation prior to laser surgery.
What is the recovery process like?
Treated areas of the penis will heal within 6 days to reveal new skin. Keep the area moist with an antibiotic ointment that prevents infection. As new skin is fragile, abstain from friction for 12 days after the fordyce spots treatment.
Recovery is painless & uneventful.
What are other conditions that may resemble Fordyce spots?
It can be confusing as there are numerous skin conditions that can affect the penile area. If in doubt, you can arrange a consultation with Dr Sarath at Cutis Dermatology.
Virtual consultations are a private way to obtain a diagnosis.
- Pearly penile papules: PPPs are dome shaped lesions that appear in a ring around the head of the penis. These lesions are more pointed & raised as compared to Fordyce. They may grow to 2-3 mm long.
- Angiokeratomas: are purple-red-blue & usually occur on the scrotum.
- Molluscum: are viral infections that can resemble Fordyce spots.
- Genital warts: are commonly seen on the shaft of the penis. Early wart virus can be challenging to diagnose.
Disclaimer: I do not manage or diagnose genital disorders, including Fordyce spots. My colleague, Dr Sarath at Cutis Dermatology, Brisbane has an interest in male genital dermatology.
How did I get Fordyce spots & are they transmissible?
Fordyce spots are not contagious & you can not transmit them. Other sexually transmissible conditions that look like Fordyce spots include molluscum & genital wart virus.
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What is isotretinoin & how does it work for Fordyce spots?
Accutane – Roaccutane or isotretinoin can be very effective in treating & preventing Fordyce spots as it shrinks down the oil gland. It is employed to prevent or treat residual Fordyce spots that are refractory to lasers.
The dose is much less than the acne treatment regime & ranges between 5 to 10 mg daily. Your dermatologist will guide you accordingly.
What creams are effective?
In theory, retinoid creams can be effective. They include retinol, tretinoin, adapalene & tazarotene. In practice, retinoids are highly irritating & will cause skin irritation, hence why oral retinoids are more effective.
Retinoid application is much safer on the lips compared to genital areas. You can give it a go (retinol 0.1%).
How to prevent Fordyce spots from recurring?
Accutane is the most powerful treatment for Fordyce spots. It works by reducing oil gland activity. The dose is much lower than that of acne dosages.
It takes 4-12 weeks before working however Fordyce spots recur after cessation of Accutane. You will have to negotiate with your dermatologist as to the use of this drug as it has common side effects. Tretinoin cream has been reported to reduce or prevent Fordyce spots from recurring, however in real life it is rarely effective.
Davin’s viewpoint: treating Fordyce spots
Fordyce spots, also known as Fordyce granules or sebaceous prominence, are benign ectopic sebaceous glands commonly found on the genitalia, including the penis. While Fordyce spots are harmless and do not require treatment, some individuals may seek medical intervention for cosmetic reasons or psychological distress. Here is summary of my experience in managing this common condition.
Topical Fordyce Spots Treatments:
- Tretinoin Cream: Topical tretinoin, a retinoid compound, has been reported as a potential treatment option for Fordyce spots. Tretinoin works by promoting cellular turnover and reducing sebaceous gland size. Though it can be effective in small studies, the actual chances of this working is slim.
- Cryotherapy: Cryotherapy involves freezing the Fordyce spots using liquid nitrogen. This method aims to destroy the affected tissue and stimulate the growth of healthy skin. Cryotherapy has shown variable results, with some reports indicating partial improvement, while others suggest minimal effect. It may be associated with side effects such as blistering, pain, or hypopigmentation. It is still performed by some GPs. Lasers offer more precise targeting of spots.
- Electrodessication: Electrodessication involves the use of an electric needle or probe to destroy the Fordyce spots. This method aims to remove or cauterize the affected tissue. This technique is done in third world countries who do not have access to lasers. Punch excision has been reported.
- CO2 Laser Ablation: Carbon dioxide (CO2) laser ablation is a procedure that utilizes laser energy to vaporize or remove the affected tissue. Studies have reported successful outcomes with CO2 laser treatment, demonstrating improvement in the appearance of Fordyce spots. It offers the best solution for Fordyce spots as it has minimal collateral damage & maximal precision. 1-2 sessions are required for best results.
Conclusion:
The treatment of Fordyce spots on the penis is primarily driven by cosmetic concerns or psychological distress experienced by individuals. Currently, there is no universally effective treatment for Fordyce spots, and the available options have variable success rates. Topical treatments like tretinoin may show some promise, but further research is needed. Surgical interventions such as CO2 laser ablation and electrodessication have demonstrated favorable outcomes in select cases, but their efficacy and safety should be considered on an individual basis. It is important for healthcare professionals to discuss the potential risks, benefits, and limitations of each treatment option with patients, considering their specific circumstances, preferences, and expectations.
Prevention is best achieved with oral isotretinoin therapy at a low dose of between 5 to 10 mg daily. The risk benefit ratio will be discussed by your treating dermatologist.
Disclaimer: I do not manage or diagnose genital disorders, including Fordyce spots. My colleague, Dr Sarath at Cutis Dermatology, Brisbane has an interest in male genital dermatology.
