What Are Sebaceous Hyperplasias

Sebaceous gland hyperplasia is a disorder of the sebaceous glands (glands present in the skin's pores secrete sebum & oil onto the skin's surface).

Sebaceous glands are commonly associated with hair follicles, but they can also be found in hairless skin regions. Their secretion lubricates the skin, protecting it from drying out or becoming irritated.

In sebaceous hyperplasia, the glands become enlarged, producing yellow, shiny bumps or pimples on the face, mainly on the forehead, nose, around the eyes and cheeks. The bumps may be cauliflower-shaped or dome-shaped with a sunken area centrally.

Sebaceous hyperplasia is thought to be caused by a decrease in the circulating levels of androgens associated with ageing. Estrogens reduce sebaceous gland activity and the formation of the lesions related to sebaceous hyperplasia. There is, therefore, an increased incidence of sebaceous hyperplasia with menopause in women.

Many people who suffer from sebaceous gland hyperplasia do not seek medical advice. However, if the lesions become irritated (e.g. a result of shaving) or are multiple and cosmetically bothersome, it is advisable to see a doctor for advice about possible treatments.

Treatments

Skincare

Most lesions associated with sebaceous gland hyperplasia can be

improved and consequently eliminated over time by using appropriate skincare. A suggested skincare program should involve the following in the

following order:

Foaming Cleanser - should be used at least daily until any sensitivity, if present, has settled. This can then be used as a makeup remover as a more potent cleanser is introduced.

Vitamin C - topically applied to the skin is a potent antioxidant and will help to increase the oxygenation of the epidermis and dermis. If a powder is used, it can be mixed with a moisturizer or a retinol serum.

Vitamin A Derivatives (Retinoids) - shown to improve sebaceous gland hyperplasia and improve any coexistent acne lesions.

Moisturiser - use a light moisturizer in a lotion form (not a heavy cream) as often as required, usually twice daily.

Sunscreen - should be applied during the day, and this should preferably be in a lotion form, not a cream. Exposure to sunlight has been shown to stimulate the sebaceous glands and aggravate the incidence of sebaceous gland hyperplasia.

Things to avoid with sebaceous hyperplasia are:

Toners - these frequently contain alcohols that stimulate the sebaceous glands to produce more oil & sebum.

Masks - these create too much dryness and leave a residue on the skin, creating congestion associated with sebaceous hyperplasia.

Thick heavy creams - these are too occlusive for the skin.

Medical Treatments

Microdermabrasion and chemical peels - Microdermabrasion physically exfoliates the dead skin cells and gradually reduces the size of lesions associated with sebaceous hyperplasia. When combined or alternated with a chemical peel, the activity of the oil gland is reduced, and the formation of further hyperplastic bumps is avoided.

Electrocautery - Electrocautery, also referred to as thermal cautery, involves using an electrical cautery needle to burn the lesions. It is the most common treatment method for sebaceous hyperplasia among skin specialists. Electrocautery is quick, painless, effective, and has minimal risks. Following treatment, the skin scabs and falls away, leaving behind a smooth area of skin. However, in rare cases, electrocautery may cause changes to skin pigmentation in the affected area. This is why treatment should be performed only by licensed skin professionals.

Freezing (cryocautery) - Cryotherapy often involves liquid nitrogen or other chemicals, such as carbon dioxide and argon. During cryotherapy treatment, your doctor applies these chemicals to the affected area of the skin. The bumps fall away from the skin following application, leaving behind a smooth, bump-free surface. In some cases, cryotherapy treatment for sebaceous hyperplasia may result in discoloration to the treated area of the skin. Your skin specialist will discuss with you the most suitable treatment option for your skin's needs.

Radiofrequency shaving - the most effective way to remove larger lesions on the skin without leaving any residual scarring. The technique is the same as cosmetic removal of moles and skin tags.

Photodynamic therapy - Treatment of sebaceous gland hyperplasia can also be performed via ALA-PT with Blue Light Source Activation. Sebaceous gland hyperplasia (SGH) lesions often present as a sign of photoaging and have proven difficult to treat. However, Photodynamic therapy (PDT) is an effective treatment option. PDT should be administered once per month for four consecutive months. There is no risk of scarring with this treatment.

Laser treatment - Laser creates deep heating of the skin's dermis where the sebaceous glands are found and can reduce the oil gland activity and the visible effects of sebaceous hyperplasia. However, it is limited according to the area affected as it can't be used near the eyes.

Cutting out the lesion (excision) - This method has obvious issues with scarring.

Antiandrogen medications - As we think there may be a link between this condition and increased levels of naturally produced testosterone, some female patients benefit from taking antiandrogen medications to regulate their hormones

Isotretinoin - This effective acne medication also has uses in patients with sebaceous hyperplasia. It works by shrinking the size of the sebaceous gland and reducing the amount of oil production.