Sebaceous hyperplasia is just a very fancy medical term for giant oil gland. They usually occur on your face, they’re white or yellowish bumps, about a sixteenth to an eighth of an inch, and sometimes they have a little-bit of a hole in the center. They look like pimples or whiteheads, but they’re not. If you use acne medications on them, they won’t get better. If you try to pop them, the way you try to pop a pimple, it’s not going to go away. If I try to pop it, the way I would open a whitehead or a pimple in the office, it’s not going to go away, but there are things that dermatologists can do to make these giant oil glands disappear, because they really are a cosmetic eyesore. Let’s think about what a whitehead or a blackhead is. First of all, this is a normal oil gland next to the hair follicle, and from that normal oil gland there is a tiny little duct that leads into the shaft. If you get a clog in this duct or a clog anywhere along here, oil gland doesn’t know that. It keeps making oil, so you then get a white enlargement, and that’s a whitehead, it’s just a big bag of oil, but if instead of the oil gland being this size, the oil gland itself is a giant oil gland, and is actually this size and actually pops up a little bit through the top of the skin, and has this white or yellow color. This is what sebaceous hyperplasia is, it’s just a giant oil gland. If this is a normal size wine glass, this is a giant size wine glass. Alright, so how do we treat these? If you just have a few, they are most easily treated with a very special strong acid, called bichloroacetic acid. I touch the acid, just to the oil gland, immediately it turns white, and then becomes crusty in about a day or two. After about ten days, the crust goes away, and the oil gland is gone. Now, that’s ok if you have just a few, but if you have dozens, you don’t want to walk around with a dozen or two-dozen little black crusts on your face, it’ll look like you got hit by a shot gun. So instead, we use lasers, and it’s called photodynamic therapy, because we use laser light to activate a chemical that we paint on the oil glands, in the office. We leave the chemical there for about an hour, then we shine the laser light on it, and it causes the oil gland to actually dissolve. There’s no visual downtime, it takes two or three treatments, and for people who don’t want to do that, oil glands that are enlarged, sebaceous hyperplasia responds remarkably well to Accutane, the acne drug. Now, it’s not FDA approved to treat sebaceous hyperplasia, but as an off-label use, Accutane is very effective for reducing sebaceous hyperplasia very quickly. So, if you have a bump on your face, which looks like a pimple, but it just won’t go away, and it lasts more than a month, you may want to see your dermatologist to have your sebaceous hyperplasia treated.
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