Fordyce spots are enlarged oil glands. They are not contagious and do not necessarily require treatment but usually do not go away on their own. In contrast, herpes is a contagious viral infection that may heal in a few weeks; however, it can recur. Read on for detailed differences between them, including their appearance, treatment options, and more.
What are they?
Fordyce spots are small, white, or yellowish bumps that can appear on the lips, inner sides of the cheeks, and genitals. They are caused by enlarged oil or sebaceous glands and are considered an anatomical variation of the skin.
Herpes refers to infections caused by the herpes simplex virus (HSV), including oral herpes, typically resulting from HSV-1, and genital herpes, commonly due to HSV-2.
Causes
Fordyce spots
The exact cause of Fordyce spots is not known, but they are considered a natural occurrence. They are not caused by any virus or infection and are not sexually transmitted.
They often enlarge during puberty due to hormonal changes and possibly increased oil production. They are more frequently seen in men. There is some data suggesting that they are more common in people with oily skin.
Herpes
Herpes is caused by the herpes simplex virus types 1 and 2. The type varies depending on the location of the herpes lesions.
HSV-1 is the main cause behind cold sores, also known as herpes labialis. It can be transmitted by direct contact with the lesions, which includes kissing or sharing personal items like toothbrushes or eating utensils.
HSV-2 is almost exclusively transmitted sexually, causing genital herpes. It’s spread through direct skin-to-skin contact during vaginal, anal, or oral sex with an infected person.
Both viruses can remain dormant in the body and reactivate, leading to outbreaks. While HSV-1 mainly causes herpes labialis and HSV-2 primarily results in genital herpes, both viruses can uncommonly cause lesions in either location.
Contagiousness
Fordyce spots are not contagious, as they are simply enlarged oil glands and are not infectious in nature.
Herpes lesions are highly contagious, especially when sores are present. Direct contact with the lesions or oozing fluid can lead to the spread of the virus. Additionally, the virus can still be transmitted even when there are no visible symptoms.
Pictures
Appearance and location
Fordyce spots
These spots are small, measuring 1-3 mm in diameter, well-defined, and usually yellowish or white in color. They can sometimes appear reddish in the genital area. They may present as a single spot but are often found in clusters. The commonly involved areas are:
- Lips, especially the vermilion border (the line where lips meet the facial skin)
- Inside cheeks
- Penis
- Scrotum
- Labia
Herpes
Herpes sores often begin with tingling, burning, or itching sensations, followed by the appearance of small red bumps. These bumps then evolve into fluid-filled bumps called blisters. The blisters eventually rupture, leading to weeping areas that ooze fluid, followed by the formation of a crust. These sores eventually heal.
Cold sores, or herpes labialis, result in lesions on the lips, particularly along the lip line, corners of the mouth, under the nose, on the nose, and sometimes on the cheeks and near the eyes.
Genital herpes typically affects the genitalia, anus, thighs, and buttocks. Oral lesions may also be seen if there is direct contact with the lesions.
Related: Different stages of herpes on the lips
Associated symptoms
Fordyce spots
These are usually asymptomatic, causing no pain, discomfort, or itching. However, Fordyce spots on the genitals may become itchy, inflamed, or bleed during sexual activity.
Herpes
The symptoms of herpes labialis (cold sores) and genital herpes vary depending on whether it’s the first or a recurrent episode. The first outbreak is often the most severe and may include flu-like symptoms and swollen lymph nodes, lasting longer than recurrent outbreaks.
In the first outbreak of herpes labialis, sores may also appear inside the mouth. The herpes sores are often painful and are associated with itching or tingling sensations.
Do they go away?
Fordyce spots do not go away on their own. On the other hand, herpes sores usually heal within a few weeks, but the virus remains in the body. Triggers like stress, illness, or sunlight can reactivate the virus, leading to a herpes outbreak.
Related: How long do cold sores last?
Diagnosis
Fordyce spots are generally diagnosed based on their clinical appearance and are easily distinguished from other skin conditions by a dermatologist.
Herpes lesions can often be identified based on their appearance and location. In some cases, doctors may take a swab from the sores or perform blood tests to confirm the diagnosis.
Treatment
Fordyce spots
Fordyce spots are harmless. Treatment is not necessary unless for cosmetic reasons or if they cause symptoms. The treatment options include topical or oral retinoids, lasers, cryotherapy (freezing the spots), electrodessication, and micro-punch surgery.
Herpes
Herpes lesions usually heal on their own in healthy individuals. Antiviral medications, such as acyclovir, can be prescribed in some cases and may decrease the duration of symptoms.
The results are best when these medications are started within the first 48 hours of an outbreak. These medications can also reduce the frequency of outbreaks and the chances of spreading the virus.
Over-the-counter lip balms, like Carmex, can numb the area and reduce pain for oral herpes, but they do not affect the healing of sores. Abreva is an over-the-counter treatment with an antiviral that may help in the faster healing of herpes labialis or cold sores.
Prevention
Fordyce spots
These cannot be prevented as they are a part of normal skin variation.
Herpes
Once infected with herpes simplex virus 1 or 2, the virus remains dormant in the body and cannot be cured. However, certain measures can prevent recurrent outbreaks, including maintaining good health, reducing stress, and sun protection.
To prevent infection, avoid direct contact with sores of infected individuals, practice safe sex, and do not share items such as utensils, toothbrushes, or lip balms with those who have the infection.
Key differentiating features
| Fordyce Spots | Herpes |
|---|---|
| Part of normal skin variation. | Viral infection caused by HSV-1 or HSV-2. |
| Not contagious. | Very contagious. |
| White, yellow, or reddish bumps often in clusters. | Fluid-filled bumps, often in clusters. |
| Rarely cause symptoms. | Usually painful, may be associated with itching and burning sensations. |
| Do not require treatment. | Antiviral medications may reduce the severity of symptoms. |
| Do not go away on their own. | Lesions usually heal in 1-4 weeks but may recur. |
Summary
Although Fordyce spots and herpes can occur in the same locations, they can be easily differentiated based on their appearance and symptoms. Herpes lesions are highly contagious, making it important to differentiate them from Fordyce spots.
If you are unsure about spots on your lips or genitalia, it’s best to see a doctor for a definitive diagnosis and management.
Read more: Molluscum Contagiosum vs Herpes: Pictures and Differences
References
- Genital Herpes – CDC Basic Fact Sheet. CDC
- Sauerbrei A. Herpes Genitalis: Diagnosis, Treatment and Prevention. Geburtshilfe Frauenheilkd. 2016 Dec;76(12):1310-1317. doi: 10.1055/s-0042-116494. Epub 2016 Oct 18. PMID: 28017972; PMCID: PMC5177552.
- Lee JH, Lee JH, Kwon NH, Yu DS, Kim GM, Park CJ, Lee JD, Kim SY. Clinicopathologic Manifestations of Patients with Fordyce’s Spots. Ann Dermatol. 2012 Feb;24(1):103-6. doi: 10.5021/ad.2012.24.1.103. Epub 2012 Feb 2. PMID: 22363169; PMCID: PMC3283840.
Disclaimer: This article is for information purposes only and does not replace medical advice.