Sebaceous Hyperplasia - Causes, Symptoms, Diagnosis, and Treatment

Introduction:

Sebaceous hyperplasia or sebaceous gland hyperplasia (SGH) is a benign condition and occurs mainly in the middle or older age groups. It is very uncommon in children and adolescents. It does not cause any problems, but it should be diagnosed for any other lesions or conditions as it looks similar to sebaceous adenoma, basal cell carcinoma, nevus sebaceous, etc.

What Are Sebaceous Glands?

These glands produce sebum or oil, and the ducts carry it into the skin surface. This sebum helps in lubrication, acts as a barrier against environmental factors, and maintains body temperature. These glands are small and are attached to the hair follicles of the skin. It is present all over the body and is more in number over the scalp, face, back, upper arms, and chest. The palm and sole lack these glands.

What Causes Sebaceous Hyperplasia?

The following factors cause the overgrowth of the sebaceous gland due to excess production of sebum or oil around the hair follicle, and this eventually looks like a big yellowish bump on the skin.

• Familial History: We are prone to certain diseases or conditions if our parents or grandparents have them. Likewise, sebaceous hyperplasia also occurs in traits.

• Hormones: Male sex hormones like testosterone trigger sebaceous glands to produce more sebum. These hormones are found in low amounts in females. During puberty, the testosterone level elevates, thereby increasing sebum production. However, male sex hormone levels decrease in aged people, but the sebaceous gland size increases because the dead cells within the gland are not replaced by new cells, and they tend to clog inside the gland.

• Certain Medications: Sebaceous hyperplasia may be a side effect of antiretroviral treatment in HIV (human immunodeficiency virus) patients. Long-term treatment with immunosuppressants like Cyclosporine is found to cause enlargement of sebaceous glands.

• Exposure to Sun: Chronic exposure to sunlight also is found to cause sebaceous gland overgrowth.

• Genetic Disorders: Rarely, a genetic condition known as Muir-Torre syndrome is found to cause hyperplasia of sebaceous glands. The syndrome is characterized by sebaceous gland tumors along with other tumors of the gastrointestinal and genitourinary tract.

What Are the Symptoms?

• One or more yellow or skin-colored bumps are seen mainly on the face's cheek, forehead, and nose.

• These bumps can occur in groups or a line. They are painless and non-itchy.

• They look soft and shiny and are 1 to 4 mm or larger.

• Tend to bleed if given pressure or contacted with a blade during shaving.

• A pitted area is seen at the center of the bump.

• Bumps stay for long, but it recedes in a shorter time when it occurs in babies.

How Is Sebaceous Hyperplasia Diagnosed?

• Clinical Inspection: Thorough physical examination of the patient is enough to diagnose sebaceous gland hyperplasia.

• Dermoscopy: Microscopic examination of the skin that helps analyze any skin lesions. Under microscopic examination, aggregated nodules are visualized in hyperplastic sebaceous glands.

• Skin Biopsy: Skin samples are taken from the lesion and sent for laboratory examination to rule out other conditions like basal cell carcinoma, sebaceous adenoma, etc.

How to Treat Sebaceous Hyperplasia?

Even if they do not pose any problems, they are mostly treated for cosmetic reasons.

Medicinal Management:

1) Topical treatment with face wash or facial peels containing Trichloroacetic acid is found to help. But these facial peels can cause irritation, sensitivity, and skin discoloration.

Topical creams containing Retinol or vitamin A as an active ingredient are used to prevent clogging. They can be applied for two to three weeks, but the facial bumps tend to recur once the treatment is stopped.

2) Oral medications like Accutane (Isotretinoin) are suggested for three to twelve months and are found to shrink the sebaceous glands. However, it is not indicated during pregnancy. Certain birth control pills and medications like Spironolactone can be used to reduce the increased testosterone levels.

Procedural Management:

Removal of bumps is considered as they tend to recur with medications.

• Electrocauterization: In this procedure, a sharp needle is electrically charged and used on the bumps so that it gets dried up.

• Laser Treatment: Laser waves are used to reduce the size and smoothen the surface of the bump. Mostly argon and carbon dioxide (CO2) lasers are used in this procedure.

• Cryotherapy: In this procedure, the bumps are allowed to freeze. Later, it gets dried up and falls quickly. Mostly liquid nitrogen spray is used in cryotherapy. But this technique can cause skin discoloration.

• Photodynamic Therapy: The specialist applies chemical substances or solutions sensitive to light over the skin. This light destroys the cells in the glands, thereby reducing their size. Light of wavelength of 1720 nm is used in this technique as it causes minimal damage to the surrounding surface of the skin. This treatment requires multiple sessions.

• Surgical Method: The bumps are excised or shaved by the skin specialist.

Can I Treat Sebaceous Hyperplasia at Home?

There are no such home remedies that can cure sebaceous hyperplasia. However, it can be prevented by following practices.

• Wearing sunscreen (sun protection factor- 30) before going out can prevent clogging due to increased oil secretion. It can also control the worsening of bumps once it has occurred.

• Regular cleansing of the face using a face wash that contains Salicylic acid or Retinol can help your glands from clogging.

• Giving warm compresses over the clogged glands can help open up the skin pores and release the oil from the skin.

What Are the Risk Factors After Treatment?

Various techniques and surgeries can cure sebaceous hyperplasia. But there are specific outcomes of the treatment that you should look for, and you can also consult the doctor if you face the following issues after treatment:

• Redness, pain, or swelling around the treated bump.

• Fever.

• Pus from the treated site indicating infection.

• Sensitivity or discoloration of the skin.

• Bumps may worsen even after treatment.

Conclusion:

Always consult a doctor for any bumps or lesions on your skin to rule out other skin conditions and for proper diagnosis. Even though the sebaceous hyperplasia is tiny and harmless, some prefer it to be removed. In addition, each one has a unique skin type; therefore, specialized dermatologists and cosmetologists can help with the perfect treatment.