The onset of Sebaceous Hyperplasia is usually after the age of 40 and the prevalence increases with aging. The most common sites of involvement are the forehead, infraorbital regions, and temples although I have seen them in all areas of the face to include the chin and nose. Rarely it may involve unusual sites such as the nipples, penis, neck, chest and vulva (To read about vulva and other areas of involvement click HERE). The lesions are small, cream-colored or yellowish, umbilicated papules 2-6 mm in diameter. They are tiny yellow donuts in the skin…and this makes sense since they are prominent sebaceous glands…
Histologically there is hyperplastic (enlarged) sebaceous glands. In the center is the hair follicle resulting in the central dot…or pore…giving it that yellow donut shape. The glands are multilobular, dividing into smaller lobules to produce a cluster resembling a bunch of grapes.
TREATMENT: Is solely cosmetic. I have had good results with electrocautery and I will have patients apply a topical anesthetic an hour before treatment so I can increase the energy applied. Alternative treatments include laser therapy, PDT (photodynamic therapy) and even shave biopsy. At times Sebaceous Hyperplasia may be difficult to distinguish from Basal Cell Carcinoma and a biopsy may be required. Isotretinoin (Accutane) has been used with some good results but once discontinued the lesions tend to grow back. It is not practical to keep patients on long term Accutane to treat this disorder. To read more about Sebaceous Hyperplasia click HERE and HERE.