Friday, May 8, 2015

How to get rid of Fordyce Spots on Lips

What is Fordyce spot?


Fordyce spot is a harmless medical condition caused by the presence of prominent sebaceous gland in an abnormal site in the body. It is also known as FORDYCE GRANULE or FOX FORDYCE DISEASE [1, 2]

Where does Fordyce spots appear?


Fordyce spot mostly occur in LIPS along the border where the smooth pink surface of the lip meets the oral skin. It may also present in the INNER ASPECT OF CHEEK and anywhere in the oral cavity. Other less common places are scrotum, shaft of penis, foreskin of penis in men where they are called as TYSON’S GLANDS and labia in women. [1, 2, 3]

Picture 1 – Fordyce spot on lip 

What causes Fordyce spots on lips?


Sebaceous glands are parts of the skin similar to the sweat gland. A sebaceous gland is situated in the deeper layer of skin called DERMIS and they produce a chalky white oily paste like substance called SEBUM.  Normally, a sebaceous gland opens into a hair follicle and releases the sebum into it. When the sebaceous gland lies in abnormal sites like the lip where there are no hair follicles it does not have an outlet to release the sebum. This causes building up of sebum inside the gland, making it to appear prominent. Hence they are called as SEBACEOUS PROMINENCE and this causes the Fordyce spot on lip.


Image 2 : – Normal sebaceous gland 

How does Fordyce spot appear? [3]

  •     Fordyce spot on the lip appear as a small elevation of size 1 – 3 mm.
  •     It is pale, white or red and looks like a miniature peanut.
  •     It is always painless
  •     It is not itchy
  •     It is not associated with any other systemic illness or symptoms like fever

Does Fordyce spot go away?


YES. In most cases, Fordyce spot in lip resolve spontaneously within couple of weeks. As it is a natural condition without any underlying disease, the chances are more for it to disappear automatically if it is left untouched without pinching or squeezing its content out.
Is Fordyce spot contagious?

NO. Fordyce spot is not contagious. It is not a disease or an infection that spreads from one person to another. So don’t get scared that you can catch Fordyce spot in lips by kissing someone. Also, Fordyce spot cannot get infected, as there is no inlet for the germs, same as there is no outlet for the sebum. It can get only infected if it’s broken up by biting into it accidentally or squeezing its contents out.[3,6]

Who gets Fordyce spots?


Fordyce spot can be present in anyone from a newborn to adult. But the chance of getting a Fordyce spot increases around the PUBERTAL AGE when there is increased activity of the sebaceous gland under the influence of the raging hormones. About 85 -90% people have Fordyce spot either in lip or in genitals and men are found to have Fordyce spot more than women. The cause for this male predilection is not known.[6,8]

Fordyce spot treatment and cure


        As said above, Fordyce spot is nothing to be worried about. Skin specialists advice against treatment to Fordyce spot because it does not cause any discomfort while some of the treatment options have undesirable side effects and some may form permanent scars. But most people approach a dermatologist for Fordyce spot only for cosmetic reasons.

So, how to get rid of Fordyce spot?


         Wait and watch: A Fordyce spot disappear or shrink in a small span of time. So wait and watch for couple of weeks.

        Vitamins: vitamins like B complex regulate the sebum secretion and reduce the prominence of the gland.

        Adding garlic to the diet can resolve the spots. The reason behind this is not known, probably because of the minerals like selenium in it and chemicals like allicin.

        Carbon dioxide laser: A laser is a cutting method that uses laser beam to vaporize the unwanted tissues. This laser is directed to the prominent gland which then destroys the tissue without bleeding. It causes complete cure to Fordyce spot and it doesn’t reappear. Sometimes it may cause minimal scarring. The epithelialisation of the spot occurs within 2 weeks time. The success of co2 laser technique has higher success rate when it is combined with topical application of tricloracetic acid.
 
        Pulse dye laser: In this technique the laser beam is directed as short repeated pulses. This is more expensive but causes lesser scarring. It is also a permanent cure for Fordyce spot.

        Cryosurgery:   This technique is similar to laser and the only difference is that, excessive cold is used to destroy the tissue by freezing it. This is done by using liquid nitrogen or carbon dioxide. This may cause some damage to some of the surrounding tissue. [9]

        Other techniques to remove Fordyce spot are Micro puncture, Electro desiccation, Photodynamic therapy and chemical cauterization.

       Topical isoteretinoin gel combined with alpha hydroxyacid agent gives relief in couple of weeks. But when used for a long period it cause unwanted side effects like dry skin, burning, itching, thinning of hair etc. [2, 3, 6, 7, 8]

So, if you are doubtful of having Fordyce spot and want to get it treated, check with your dermatologist and weigh your treatment options as some techniques work better than others due to individual variability.
   
   
References:   
  • http://en.wikipedia.org/wiki/Fordyce_spots
  • http://www.dermnetnz.org/acne/fordyce.html
  • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283840/
  • http://www.aocd.org/?page=FordyceSpots
  • http://www.ncbi.nlm.nih.gov/pubmed/12859392
  • http://www.ncbi.nlm.nih.gov/pubmed/7662086
  • Article on Treatment of Fordyce granules with a CO2 laser: report of two cases Tratamento dos gr├ónulos de Fordyce com laser de CO2 – Relato de dois casos
  • http://www.nhs.uk/medicine-guides/pages/MedicineSideEffects.aspx?condition=Acne&medicine=isotretinoin&preparation
  • http://en.wikipedia.org/wiki/Cryosurgery