What To Know about Fordyce Spots

Fordyce spots are enlarged oil glands on the surface of your skin. They appear as white or yellow bumps and can form on the lips, vulva, penis, or scrotum. You may notice a few scattered spots or clusters.

While these bumps may seem alarming, they are normal and harmless. Researchers estimate that up to 90% of adults have Fordyce spots. These spots don't need to be removed, but cosmetic treatments are available if you don't like how Fordyce spots look.

What Do They Look Like?

Fordyce spots are pale, white, or yellow bumps 1-3 millimeters (0.04-0.12 inches) in diameter. You may have a few spots or a patch of multiple spots clustered together. Fordyce spots usually appear in the same pattern on both sides of the affected area. Stretching the skin surrounding Fordyce spots makes them even more visible. 

Fordyce spots are more common around the outer edges of your lips, inside your lips, and inside your cheeks. Fordyce spots can also appear on genital areas like the penis shaft, scrotum, labia, or clitoris. In rare cases, people can have Fordyce spots on the areolas (the pigmented area around the nipples) or esophagus (tube connecting the stomach and throat).

If you have Fordyce spots, you may not even notice them. However, some people have large patches that are very visible. These spots are not painful, itchy, or contagious. It is also rare for these spots to bleed during sex if they're on the genitals. 

Fordyce spots appear on people of all ages and are something you are born with. As you age, you can develop more Fordyce spots, and existing spots can become more noticeable. Fordyce spots usually don't go away without treatment. 

What Causes Fordyce Spots?

Fordyce spots are caused by enlarged oil glands on hairless areas, like the mucous membrane linings (moist inner linings) of the mouth and genitals. Oil glands, or sebaceous glands, are usually connected to hair follicles and secrete an oily substance called sebum that moisturizes your skin and hair. Fordyce spots are only found on oil glands directly on the skin, not those connected to hair follicles.

Researchers have found that the increase of hormones during puberty and adulthood enlarges oil glands, making Fordyce spots more noticeable. Males are twice as likely to develop Fordyce spots than females because androgenic hormones—known as the male sex hormones since they are more plentiful in males—increase them. Fordyce spots are the most common among males 17-67 years old. 

Can Fordyce Spots Be a Predictor of Other Conditions?

Research has found that Fordyce spots may indicate that you could be at risk for certain diseases. One study found people with hyperlipidemia (high cholesterol) typically have Fordyce spots. Other research has found an association between hereditary colorectal cancer and the presence of Fordyce spots in the mouth.

Since Fordyce spots are common in the general population, many people with health conditions likely have Fordyce spots. More research is needed to confirm whether Fordyce spots can predict the development of any disease. 

Diagnosis

A healthcare provider or dermatologist (a doctor specializing in skin conditions) can typically diagnose Fordyce spots by looking at your skin. They may also want to biopsy the spot to rule out other conditions. During a biopsy, a small amount of tissue is cut away and examined under a microscope.

IFordyce spots can sometimes look similar to other skin conditions, including:

• Epidermoid cysts: These tiny, hard lumps can form underneath the skin anywhere on the body. They are benign (non-cancerous) skin tumors that clogged hair follicles can cause.
• Milia: These benign small and firm white bumps appear on the face, usually around the eyes. They can also form on the penis or vulva. 
• Sebaceous hyperplasia: These benign, soft, skin-colored growths are caused by enlarged oil glands, usually on the face.
• Basal cell carcinoma: This skin cancer can look like a shiny and translucent skin-colored bump.
• Genital warts: Human papillomavirus (HPV) causes these rough, skin-colored bumps. The growths are sexually transmitted and can burn, itch, and bleed. They may look similar to Fordyce spots as they form.
• Pearly penile papules: These benign white bumps form around the head of the penis. 
• Molluscum contagiosum: These small, dimpled bumps appear white, pink, or skin-colored. They can appear anywhere on the body after skin-to-skin contact or unprotected sex with someone who has the virus that causes them. 

Treatment

Fordyce spots don't require treatment since they are not harmful. You can have Fordyce spots treated if you feel self-conscious or don't like the way they look. 

A healthcare provider can help remove or reduce the appearance of Fordyce spots with the following treatments:

• Carbon dioxide laser: A laser therapy removes the outer layer of the skin, helping to remove Fordyce spots.
• Cryoablation: This cryotherapy uses liquid nitrogen or argon gas to freeze off Fordyce spots. 
• Electrodesiccation and curettage: A topical anesthetic is applied to the skin, and a special tool scrapes or burns off Fordyce spots. 
• Micro-punching: A topical anesthetic is applied to the skin, and a sharp, pen-like tool "punches" part of the skin, cutting out Fordyce spots.
• Skin peels: Bichloracetic acid is applied to the skin to help remove or shrink Fordyce spots. 
• Photodynamic therapy: A light-sensitive medication (photosensitizer) is applied to the skin and targeted with light to destroy Fordyce spots. 
• Topical tretinoin: This prescription retinoid increases cell turnover to help the skin peel and unclog pores. 
• Oral isotretinoin: This prescription oral retinoid can help shrink oil glands that cause Fordyce spots. This medication is unsafe for people who are pregnant and can cause many side effects.
  

How To Prevent Fordyce Spots

Since researchers believe people are born with Fordyce spots, you likely can't prevent them from forming. Sticking to a skincare routine and caring for your skin may help you minimize their appearance. To potentially help reduce the look of Fordyce spots:

• Don't pick or squeeze your Fordyce spots
• Wash your face with a mild cleanser day and night
• Use a moisturizer after washing your face
• Avoid using douches, feminine washes, or scented products on your genitals

When To See a Healthcare Provider

You don't need to see your healthcare provider for treatment if you have Fordyce spots. They are not harmful and are considered benign skin lesions (non-cancerous bumps). They are not caused by a disease or sexually transmitted infection (STI).

You should see a healthcare provider if you're concerned about any bumps you have and are unsure if they are Fordyce spots or something else. People often confuse Fordyce spots on the genitals with STIs like genital warts, which can cause anxiety and emotional stress. If you notice any new spots on your genitals, see your healthcare provider to rule out an STI or other infection.

You can also visit a healthcare provider if you want to minimize or eliminate your Fordyce spots. They can talk to you about your treatment options.

A Quick Review

Fordyce spots are harmless pin-sized white or yellow bumps caused by enlarged oil glands on the skin's surface. You may find them inside your cheeks or on the lips, vulva, penis, or scrotum. Many people have Fordyce spots at birth but don't notice them until puberty starts to enlarge oil glands. You may have a few Fordyce spots on both sides of the affected area or clusters that look like patches. 

Fordyce spots can be confused for an STI symptom and can make people feel self-conscious. See your healthcare provider for a diagnosis if you're worried about a new bump. Your provider can help fade or remove Fordyce spots with laser treatments, cryoablation, skin peels, or retinoids.