These lesions appear as small (2-9 mm) white-to-yellow bumps, some of which have a small central depression or telangiectasia (dilated superficial capillaries). These characteristics can make them difficult to distinguish from basal cell carcinomas – a malignant tumor. They can appear anywhere on the skin except on the sole of the foot and palm of the hand, though most treatment is sought for those on cosmetically sensitive areas such as the face, chest, and arms.
Sebaceous glands and the cells within them (sebocytes) are very sensitive to androgen hormones and play an important role in androgen metabolism. Sebaceous hyperplasia is caused by low levels of androgen hormones brought on naturally immediately following birth and as a result of advancing age. Therefore, it is extremely common in newborns and common in middle-aged to elderly persons. Other factors that can contribute to the formation of these lesions include chronic sun exposure, immunosuppression, and genetics.
Sebaceous hyperplasia is completely benign and requires no treatment, though these lesions may become irritated or tender by trauma such as shaving. However, they can become cosmetically concerning and many different excellent treatment options exist if desired. They can be removed physically through many different methods such as curettage, electrodessication, phototherapy, cryotherapy, laser ablation, excision, or shave removal. It is important to note that most of these treatment options carry the risk of scarring or temporary pigmentation. Oral isotretinoin has been shown to successfully treat severe cases of sebaceous hyperplasia though recurrence is common once this medication is discontinued and is therefore rarely used, especially when considering its long list of potentially serious side effects. Contact your dermatologist if you think you may have sebaceous hyperplasia for evaluation and treatment.