What Is Sebaceous Hyperplasia?

Sebaceous hyperplasia is a harmless skin condition that occurs more commonly in people over age 60. It refers to small bumps, usually on the face, that stem from overgrown sebaceous glands. Your sebaceous glands are under your skin and are connected to your hair follicles. The glands make sebum, an oily substance that protects your skin. When too much oil is produced, it can clog the glands and cause bumps on your skin.

The condition is common—approximately 1% of Americans have sebaceous hyperplasia. The bumps are not harmful, but they can be treated if you don’t like how they look. Treatments include medication, skin care, and outpatient procedures done in a dermatologist’s office.

Sebaceous Hyperplasia Symptoms

When you have sebaceous hyperplasia, small bumps or papules appear on your skin, most commonly on the face. It is typical to have many different bumps appearing around the same time in the same area of the body. The bumps can be flesh-colored or yellowish. They do not itch or leak fluid.

The bumps grow out of sebaceous glands, which are glands that produce oil to keep your skin moisturized and flexible. Sebaceous glands are on every part of the body except for the palms of your hands and soles of your feet. You can develop sebaceous hyperplasia anywhere you have glands, but it’s more common to develop it on the parts of the body with the most sebaceous glands, which is the face, back, chest, and upper arms.

What Causes Sebaceous Hyperplasia?

Sebaceous hyperplasia is linked to hormone levels, particularly androgens (male hormones), and it often develops as hormones change with age. Women tend to develop sebaceous hyperplasia soon after menopause and men experience it more often in their 80s, when their testosterone levels fall. There is also evidence that insulin resistance, a precursor to diabetes, plays a role in the development of sebaceous hyperplasia.

Sebaceous hyperplasia can also be caused by the long-term use of Sandimmune (cyclosporine), a drug prescribed for psoriasis, rheumatoid arthritis, and for immunosuppression after an organ transplant. The condition is also associated with HIV treatment side effects.

Scientists have found a genetic connection as well, and those with a family history of sebaceous hyperplasia tend to develop the condition at an earlier age. Sebaceous hyperplasia is also associated with certain genetic conditions, like Muir-Torre syndrome, which makes you more susceptible to certain cancers, including skin cancers. If you have been diagnosed with Muir-Torre syndrome and you have sebaceous hyperplasia, it’s important to speak with your healthcare provider.

Studies show that while children and adolescents rarely get sebaceous hyperplasia, it is common in infants. Newborn babies commonly have sebaceous hyperplasia on their faces as a result of being exposed to their mother’s hormones while in the womb.

How Is Sebaceous Hyperplasia Diagnosed?

Sebaceous hyperplasia is usually diagnosed by a visual examination from your healthcare provider. Dermatologists, doctors who specialize in skin conditions, may use a dermoscope to examine your skin closely. A dermoscope is a noninvasive tool that allows your healthcare provider to get a closer look at skin conditions like sebaceous hyperplasia. You may feel a little pressure on your skin, but the procedure is painless. 

If you have other risk factors, such as a family history of sebaceous hyperplasia or certain genetic conditions, then your healthcare provider may want to take a biopsy of the skin bumps. A skin biopsy is usually done by a dermatologist. They will clean and numb the spot and remove a few cells or a small piece of skin. This leaves a small wound behind, which your dermatologist will treat. The sample they removed will be looked at under a microscope by a doctor called a pathologist to learn what kinds of cells are growing.

Treatments for Sebaceous Hyperplasia

Sebaceous hyperplasia is not harmful and does not need to be treated, unless you’d like to have the bumps removed for cosmetic reasons. If the appearance of the bumps are bothersome, you can seek treatment from a dermatologist. Treatment involves stopping the buildup of oil sebum or removing the entire gland. The goal of treatment is to shrink existing bumps and stop new bumps from forming. Depending on the treatment, skin irritation, discoloration, or scarring can occur.

Treatment options for sebaceous hyperplasia include the following:

Medicine

Medications may only help improve the condition while you are taking it, and the condition may worsen after stopping the medication. The following can be used:

• Tri-Chlor (trichloroacetic acid): A topical treatment that goes directly on your skin
• Absorica (isotretinoin): A pill you swallow, but cannot be used during pregnancy
• Medicines that lower androgens: Aldactone (spironolactone), or birth control pills

In-office Procedures

Procedures done in a dermatologist's office can improve the condition dramatically. Sometimes procedures have to be redone if the condition returns. Procedures that can be done on an outpatient basis include:

• Cryotherapy: freezing the bumps with liquid nitrogen, which allows them to dry up and fall off your skin
• Electrodessication: a hot metal electrode is placed against the bump, causing it to dry up and shrink 
• Laser therapy: the light from the laser heats up and destroys the gland
• Excision: shaving or cutting the bumps to remove them
• Photodynamic therapy: light treatment shrinks the glands

How to Prevent Sebaceous Hyperplasia

Sebaceous hyperplasia cannot be prevented, but there are steps you can take to reduce your risk of developing the condition, or to keep the condition from worsening. It’s commonly known that sun damage can exacerbate any skin condition. While we all need some sunlight for vitamin D production, take steps to protect your skin from excessive sun exposure. Options include wearing a hat and long sleeves, or using sunblock.

Face washes that contain salicylic acid or retinoids can be helpful for treating sebaceous hyperplasia. Salicylic acid is a peeling agent that can be useful for many types of skin conditions, including sebaceous hyperplasia. Retinoid products can be helpful too, though they can irritate the skin if used too often or if the product has a high retinoid concentration.

Related Conditions

Occasionally, sebaceous hyperplasia bumps can look similar to a type of skin cancer called basal cell carcinoma. While anyone can get basal cell carcinoma, people who have Muir-Torre syndrome are at higher risk and need to be vigilant about getting sebaceous hyperplasia checked by a dermatologist. A biopsy can be useful in ruling out basal cell carcinoma.

A Quick Review

Sebaceous hyperplasia is a harmless condition characterized by small bumps on the face or other parts of the body. It does not need to be treated unless you wish to do so for cosmetic reasons. The condition is associated with getting older and with changing hormones. Many treatments are available that can be done quickly in a healthcare provider’s office and limiting your exposure to the sun can be helpful.