What are Fordyce spots or grains

“Fordyce spots or Fordyce grains are asymptomatic, yellow or cream micrographer.They correspond to ectopic sebaceous glands (that is, they appear in places where they should not be) and are inconsequential lesions, although they usually worry patients, ”says CUIDATEPLUS José Carlos Moreno, honorary president of the Spanish Academy of Dermatology and Venereology (AEDV).

“Fordyce spots are small whitish lesions that can go on the lips, penis and genitals of people of any age and sex.They are usually young people who consult for their appearance, thinking that it can be other injuries, usually warts, ”adds Tomás Toledo Pastrana, from the Dermatology Service of the Quirónsalud Infanta Luisa Hospital, Luisa (Seville).In this regard, Moreno comments that, "generally, they become evident in the pubertal stage, since it is the time when the Sebaceous glands charge activity".

On the prevalence of Fordyce's grains, Moreno indicates that "there are no data in this regard, but they are possibly much more frequent than we apparently assume".To this, Toledano adds: “So frequent that it is nothing more than a variation of normality.They do not involve a worrying disease or finding ”.

Where Fordyce spots appear

“These small sebaceous glands become a little more visible than normal by two circumstances: on the one hand, the skin is irritated in more underwater areas and manipulation and that makes the most visible Fordyce spots.On the other, when located in mucous membranes or fine skin, Fordyce spots or grains become more prominent if compared to the skin around them, ”explains Toledano.

The Honor President of the AEDV describes that Fordyce's grains “usually appear on the lips, the mucosa of the mouth, the penis, the scrotum and the vulva.They are small elements, but they usually grouped into plates ".

In the words of Toledano, it is normal for them to go on lips and genitals, at any age and without this being a problem.Sometimes lesions that can simulate being Fordyce spots on the eyelids and nose, but that are not related to this type of structure.In those cases they are usually miliar cysts.

“There is no predilection for any sex when these injuries are manifested.However, women usually consult more when they are located on the lips and men, when they do it in the penis or scrotum, ”says the Dermatology specialist of Quirónsalud Infanta Luisa.

Is it possible to confuse them with another dermatological lesion?

"Yes," says Toledo, "both at the level of similar injuries (Milium cysts, retention cysts) that occur in other locations and with injuries that the patient confuses with other elements that, deep down, are Fordyce spots.Thus, many times patients come worried thinking that they are warts or other injuries of different nature.To get out of doubt, it must always be consulted with a dermatologist, who is the specialist in the assessment of the normal and/or pathological elements of the skin ”.

Moreno emphasizes that “for a specialist these spots imply doubt, but inexperienced people can confuse them with other yellow spots, such as Xantomas;Or, when they appear in genitals, with accumulated condylomas, which is an absolutely different pathology and is caused by an infection of the human papillomavirus (HPV) ”.

Do they cause itching?

Moreno explains that, “Generally, Fordyce spots are asymptomatic.The patient does not notice any type of discomfort, but there are patients referring to pruritus, especially in genital locations ”.

In this regard, Toledano states that “they are absolutely asymptomatic.It is true that certain accompanying conditions, such as itching or discomfort in the area where they are presented, triggered by other reasons, make these symptoms attribute to Fordyce spots, erroneously ”.

Is it necessary to treat them?

According to Moreno, “it is not necessary.Therapies that can eliminate them are aggressive, so they are not usually recommended ”.

Toledano points out that “it is not necessary to treat them, since they are absolutely asymptomatic, benign lesions and without any ability to suppose a medical problem.From the aesthetic point of view they also do not compromise patients, although that is absolutely subjective.The important thing is to convey its absolute present and future benignity ".

Even being a benign finding, the dermatologist of the Quirónsalud Infanta Luisa Hospital comments that “there are patients who want to eliminate them, especially when they appear on the lips.For this, creams with retinoids or skin abrasives can be used, such as trichloroacetic acid or salicylic acid, in the form of localized peeling.They can also be eliminated physically, with CO2 cryotherapy or laser.However, patients must.