Fordyce spots or granules are a normal variant and affect many people. They are not infectious and are not caused by HPV or the herpes virus. In fact, they are enlarged oil glands.
However, Fordyce spots can resemble other conditions, some of which are contagious, such as genital warts (caused by the human papillomavirus – HPV), herpes (caused by the herpes simplex virus – HSV), and molluscum contagiosum. Therefore, it becomes important to see a doctor if you are not sure about spots or lesions on your skin.
What are Fordyce spots?
Fordyce spots are small white bumps or dots that can appear on the lips, inside the mouth, and on genital mucosa. They are considered a normal anatomical variant and occur due to prominent sebaceous or oil glands. These oil glands are not attached to hair follicles and open directly onto the skin surface.
These bumps are named ‘Fordyce spots’ after John Addison Fordyce, the dermatologist who first described them in 1896.
Fordyce spots are harmless and are not bad for your health. About 80 to 90% of adults have them.
Other names
Fordyce spots are also known by several other names which include:
- Fordyce granules
- Fordyce bumps
- Fordyce glands
Cause
Fordyce spots are part of our normal anatomy and are present at birth. They enlarge at puberty due to hormonal changes and probably due to increased oil production.
There are no clear reasons as to why they enlarge in some people and not in others. However, they are more often seen in men and there is some data suggesting they are more common in people with oily skin.
Pictures
Identification
Fordyce spots appear as small, raised dots that are white, yellowish, or skin-colored, sometimes appearing as reddish or reddish-brown in the genital area. They are usually 1-3 mm in size and can be present as single spots or in clusters.
When a large number are close together, they may indeed resemble a plaque. These spots usually do not change in appearance over time and are often found on the lips, inside the mouth on the cheeks, and on the genitals.
Below, we will discuss their specific characteristics based on their location.
1. Lips
Fordyce spots on the lips often appear as white dots along the edges of the lips, particularly on the vermilion border, which is the line separating the lips from the facial skin. These spots are more commonly seen on the upper lip.
They become more prominent when you slightly stretch the skin of the lips. Additionally, they can often be observed in the corners of the mouth. They are usually present symmetrically on both sides of the lips.
2. Penis
Fordyce spots on the penis are usually present on the foreskin, head, or shaft, or they may be found on the scrotum. They may become more prominent during an erection. Although usually asymptomatic, Fordyce spots may cause discomfort or may bleed during sexual activity.
3. Labia
In women, Fordyce spots can be seen on the vulva, predominantly on the labia, which are the skin folds surrounding the vaginal opening. The labia minora are located on the inner side, while the labia majora are the outer set of lips or folds. The labia minora are a more common site for Fordyce spots.
Fordyce spots on the genitals can often be confused with other conditions such as genital warts or herpes, making it important to differentiate them from these conditions.
Associated symptoms
Generally, Fordyce spots are asymptomatic and do not cause itching or pain. However, sometimes Fordyce spots on the genitals may become itchy, inflamed, or bleed during sexual activity.
Are Fordyce spots contagious?
Fordyce spots are not contagious and are not a sexually transmitted infection. They are not caused by any infectious agent but are, in fact, just prominent oil glands. One cannot spread them through skin-to-skin contact or any other form of contact.
Are they cancerous?
Fordyce spots are not cancerous and do not develop into cancer. However, if you have any spots and are unsure what they are, it is important to get them checked by a healthcare professional.
Look-alikes
Below are the skin conditions which can look like Fordyce spots.
1. Fordyce spots vs. Herpes
In the early stages, herpes can resemble Fordyce spots. However, as herpes progresses, the spots usually form blisters and then eventually scab over.
Herpetic lesions are often painful. In contrast, Fordyce spots are usually not painful, tend to stay the same, and do not change in appearance. Additionally, herpes is a contagious viral infection caused by herpes virus, while Fordyce spots are not contagious.
Read the detailed comparison between Fordyce spots and herpes.
2. Fordyce spots vs. Warts
Early warts and Fordyce spots can be confused with each other. Warts, caused by the human papillomavirus (HPV), usually have a rough texture and can occur anywhere on the body, including on the genitals.
In contrast, Fordyce spots are commonly located on the lips, inner cheeks, and genital area. Warts are contagious and can be transmitted through direct skin contact, including sexual contact in the case of genital warts. Fordyce spots, however, are not contagious.
3. Fordyce spots vs. Molluscum contagiosum
Molluscum contagiosum is a viral infection caused by the molluscum contagiosum virus, a member of the poxvirus family. It is characterized by small, firm, skin-colored, white or pink bumps (or papules) with a dimple or pit in the center. These lesions can appear anywhere on the body.
Molluscum contagiosum is contagious, spreading through direct skin-to-skin contact or contact with contaminated objects. This condition is more common in children but can also affect adults, particularly those with weakened immune systems or through sexual contact.
In contrast, Fordyce spots are not contagious. They often become visible at puberty and commonly appear as yellowish or white bumps on the lips, inner cheeks, and genital area.
Diagnosis
Fordyce spots are usually diagnosed based on their location and appearance. A skin biopsy or additional testing is rarely required.
Do Fordyce spots go away?
Fordyce spots do not go away by themselves. However, they are harmless. If they cause any discomfort or for cosmetic reasons, they can be removed. One should not try to pop them as that can lead to infection and scarring.
Are there any home treatments that are effective?
There are no effective or proven home remedies to get rid of Fordyce spots. Also, their site of occurrence, like lips and genitalia, are areas with sensitive skin. So, one should avoid using harsh home remedies, which are unlikely to treat them but can lead to complications.
Treatment options
While treatment is usually not necessary, if one needs to remove Fordyce spots for cosmetic reasons or if they cause any discomfort, the following treatment options are available:
- Topical retinoids: These include Vitamin A derivatives such as Retin-A, which can improve the appearance of Fordyce spots by increasing cell turnover.
- Oral retinoids: In some cases, oral retinoids may be recommended, which can reduce the appearance of Fordyce spots. These may be combined with laser treatments.
- Trichloroacetic acid (TCA): Topical TCA can be used to shrink or remove the Fordyce spots.
- Lasers: Fordyce spots can be effectively treated with lasers, such as CO2 lasers or pulse-dyed lasers (these are less likely to cause scarring).
- Photodynamic therapy with 5-aminolevulinic acid. This involves the application of 5-aminolevulinic acid to the affected area, followed by light treatment.
- Cryotherapy: This procedure involves the use of liquid nitrogen to freeze and destroy the spots.
- Electrodesiccation: This involves the use of an electric current to burn and destroy the bumps.
- Micro-punch surgery: This is a minor procedure in which Fordyce spots are removed by a pen-like device. The area to be treated is numbed with an anesthetic before treatment.
For multiple lesions, often one has to combine treatment options and undergo multiple sessions.
Prevention
There is no known way to prevent Fordyce spots, as they are a normal anatomical variation of the skin.
Key points
Fordyce spots are not contagious and non-cancerous; they are generally not harmful and, in most cases, more of a cosmetic nuisance. These spots occur due to enlarged oil glands. Treatment is usually not necessary unless it is for cosmetic reasons or if there is any discomfort.
If you have any concerns about these spots, it’s best to see a doctor for advice and reassurance.
References
- 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.
- Pietkiewicz P, Navarrete-Dechent C, Goldust M, Korecka K, Todorovska V, Errichetti E. Differentiating Fordyce Spots from Their Common Simulators Using Ultraviolet-Induced Fluorescence Dermatoscopy-Retrospective Study. Diagnostics (Basel). 2023 Mar 4;13(5):985. doi: 10.3390/diagnostics13050985. PMID: 36900129; PMCID: PMC10000991.
- Kim SK, Do JE, Kang HY, Lee ES, Kim YC. Combination of topical 5-aminolevulinic acid-photodynamic therapy with carbon dioxide laser for sebaceous hyperplasia. J Am Acad Dermatol. 2007 Mar;56(3):523-4. doi: 10.1016/j.jaad.2006.10.044. PMID: 17317498.
- Handiani F, Sadati MS. Isotretinoin-induced regression of Fordyce spots in a patient with acne: the first report. G Ital Dermatol Venereol. 2015 Jun;150(3):343-4. PMID: 25946679.
Disclaimer: This article is for information purposes only and does not replace medical advice.