What Are Oral Fordyce Spots?
The Fordyce spots are collections of sebaceous glands in our oral cavity. Still, its appearance can often be disturbing to a few patients despite these granules being a very common finding in many. It is a harmless condition that is visible on the lips or the oral tissues.
Common Sites of Oral Fordyce Spots:
It is a whitish or yellowish macule or papule that are commonly seen in -
- Buccal mucosa.
- Interior of the cheeks.
- Corners of the mouth.
- Lips.
Fordyce Spots Are Commonly Mistaken With:
Fordyce spots in the mouth may be occasionally found with serious ailments. The Fordyce spots themselves are harmless, and no evidence exists to prove that these spots can cause any ailments. However, in the genital regions, certain STD (sexually transmitted diseases) can be mistaken for Fordyce spots. If these spots are occurring elsewhere in any other region apart from the mouth, the physician needs to be consulted immediately. Your dentist will help you diagnose these papules as Fordyce spots only upon oral examination.
Sebaceous Hyperplasia:
The papules are nothing but scattered soft tissue variations in the oral cavity. They may even appear as common pimples or clusters of pimples (pimple-like formations) inside the oral cavity. In medical terminology, these spots are also referred to as Sebaceous hyperplasia of the lip or cheeks if they occur in these areas.
What Is the Etiology of Fordyce Spots?
Sebaceous glands are oil-producing glands that normally exist beneath the hair follicles of the skin to secrete an oil or waxy matter called sebum that lubricates our hair as well as skin. These sebaceous glands are found most commonly in the face and on the scalp except on the palm of the hands and the sole of the foot. When the cells of these glands divide or proliferate more, then they become visible macroscopically (Sebaceous hyperplasia).
Fordyce’s granules that appear on the lips or on the mouth most often are misnomers for other oral diseases like fibromas or other serious oral lesions (red and white lesions of the oral cavity), basal cell carcinomas, or epidermoid lesions and cysts. As there are no hair follicles in the oral cavity, the sebaceous glands in the oral cavity are not associated with any hairy structures. It forms an abnormal appearance like a lesion that may be found in the above-mentioned sites of the mouth and lips. The Fordyce’s spots are considered to be ectopic in origin, which may simply mean that these glands have been out of place in the oral cavity.
Who Are at Risk of Fordyce Spots?
1) Oily Skin People: Individuals with a more oily skin texture are definitely prone to Fordyce granules, according to researchers.
2) Gender: As per extensive research and cross-sectional studies conducted for tracing the cause of these granules, research shows that Fordyce spots exist twice as much in men as in women.
3) People With Hyperlipidemia: According to a few dental journals, a large number of Fordyce spots in the mouth are linked to increased levels of lipid or fat in the blood (hyperlipidemia) that can also be a risk factor for heart disease.
4) Hereditary: Some studies also link these granules to a familial or inherited form of colorectal cancer.
How Can We Diagnose Fordyce Spots?
1) Oral Examination: The dentist or the dental surgeon will diagnose this condition by the texture and appearance of the granules.
2) Biopsy: If it is suspected for an alternate lesion that may not be characteristic of these spots, then a portion of the affected tissue can be isolated, removed, and examined under a microscope by sending it to the pathology laboratory for further investigation.
What Are the Modalities for Managing Fordyce Spots?
Fordyce’s spots in the oral cavity may usually fade over a period of time themselves without any intervention by the surgeon. They are not only harmless but also do not require specific treatment unless they are a source of irritation or of cosmetic or aesthetic disturbances. No scientific evidence exists to prove any home remedies are useful in treating these granules. Your dental surgeon will advise you not to pick or prick these spots as a matter of habit as it can cause chronic irritation in that area. The most common modalities for managing Fordyce spots by the dental surgeon are-
1) CO2 Laser or Carbon Dioxide Laser:
These lasers are effective in removing the spots using varying wavelengths of concentrated light therapy. But, it may also result in scarring or scar tissue. Treatment by a specific pulsed dye laser will reduce scarring but is also expensive.
2) Topical Gel Applications:
Application of topical gels can be advised by your surgeon for shrinking these spots to a lesser size. Sometimes the combined use of topical gels and laser may together completely eliminate Fordyce spots as advised by the dentist. The most commonly used topical gels may include-
- Tretinoin (brand names - Retin A, Renova).
- Isotretinoin.
- Bichloracetic acid.
Tretinoin gels are usually used to treat acne and dark spots on the skin. Hence, your dentist may recommend this condition, but self-medication without consulting your dentist is strictly not advisable.
3) Scar-Avoiding Surgeries or Microsurgical Intervention:
This surgery does not leave behind any scar tissue and is also referred to as micro-punch surgery. A local anesthetic agent is sprayed to the affected area of the lips or the cheeks or the affected mouth area of Fordyce spots to relieve pain prior to surgery. Punch scalpels or micro punch needles are used to perform the surgery as it removes the unwanted sebaceous tissue preventing the recurrence of Fordyce spots once and for all. Though suturing may be required for this procedure, the area heals within a week, usually after surgery. As per research, this technique has proved to be very effective for achieving satisfactory functional and cosmetic results.
4) Cosmetic Elimination of Spots:
Other successful treatment modalities like
- Cauterization
- Electrodesiccation
are performed for cosmetic elimination of spots completely with good healing.
Conclusion:
Hence to conclude, it is important to realize that oral Fordyce spots, though linked to systemic ailments, are quite harmless. They do not require medications or treatments unless it proves to be a source of cosmetic or physical irritation to the patient. Visiting your dentist to crosscheck that it is indeed Fordyce spots and not any other lesion of the oral cavity will be useful in preventing serious oral lesions.
