What are Fordyce spots?
Fordyce spots are small (1–5mm), slightly elevated yellowish or white papules or spots that can appear on the glans or shaft of the penis, or the vulva of the female, the inside of the cheeks and on the vermilion border of the lips. They are also called Fordyce granules.
Fordyce spots are a variant of sebaceous glands (the glands that normally produce sebum and are usually found within hair follicles). Fordyce spots are visible sebaceous glands without hair follicles. They are present in 80–95% of adults. They are probably present at birth but become bigger and more visible from about puberty onwards. They may occur as a solitary lesion or more frequently in crops of about 50–100. They are easier to see when the skin is stretched.
Sometimes Fordyce spots cause anxiety but they are completely harmless whether on the lips or on the genitals. They are not a sexually transmitted disease and they are not infectious.
What work-up is required?
The importance of recognising these papules as Fordyce spots is in the differential diagnosis of other conditions that may appear similar. Some sexually transmitted diseases (STDs) may start off looking like Fordyce spots on the genitals so it is essential to get a proper diagnosis from your doctor. STDs need to be treated appropriately with medication.
What is the treatment for Fordyce spots?
Fordyce spots are generally harmless and do not require any treatment. Avoid picking or squeezing the spots.
Fordyce spots can be a cause of cosmetic concern for some patients. Electrosurgery and vaporising laser treatment (CO2 laser) have been used successfully to remove the spots. Other reported treatments for Fordyce spots include bichloracetic acid, photodynamic therapy, micro-punch excision surgery and oral isotretinoin.