Sebaceous Hyperplasia - Causes, Symptoms, Diagnosis, and Treatment

Introduction:

Sebaceous hyperplasia or sebaceous gland hyperplasia (SGH) is a benign condition and occurs mainly in the middle or older age groups. It is very uncommon in children and adolescents. It does not cause any problems, but it should be diagnosed for any other lesions or conditions as it looks similar to sebaceous adenoma, basal cell carcinoma, nevus sebaceous, etc.

What Are Sebaceous Glands?

These glands produce sebum or oil, and the ducts carry it into the skin surface. This sebum helps in lubrication, acts as a barrier against environmental factors, and maintains body temperature. These small glands are attached to the hair follicles of the skin. It is present all over the body and is more in number over the scalp, face, back, upper arms, and chest. The palm and sole lack these glands.

What Causes Sebaceous Hyperplasia?

The following factors cause the overgrowth of the sebaceous gland due to excess production of sebum or oil around the hair follicle, and this eventually looks like a big yellowish bump on the skin.

• Familial History: Individuals are prone to certain diseases or conditions if their parents or grandparents have them. Likewise, sebaceous hyperplasia also occurs in traits.

• Hormones: Male sex hormones like testosterone trigger sebaceous glands to produce more sebum. These hormones are found in low amounts in females. During puberty, the testosterone level elevates, thereby increasing sebum production. However, male sex hormone levels decrease in aged people, but the sebaceous gland size increases because the dead cells within the gland are not replaced by new cells, and they tend to clog inside the gland.

• Certain Medications: Sebaceous hyperplasia may be a side effect of antiretroviral treatment in HIV (human immunodeficiency virus) patients. Long-term treatment with immunosuppressants like Cyclosporine is found to cause enlargement of sebaceous glands.

• Exposure to Sun: Chronic exposure to sunlight is also found to cause sebaceous gland overgrowth.

• Genetic Disorders: Rarely, a genetic condition known as Muir-Torre syndrome is found to cause hyperplasia of sebaceous glands. The syndrome is characterized by sebaceous gland tumors along with other tumors of the gastrointestinal and genitourinary tract.

What Are the Symptoms?

• One or more yellow or skin-colored bumps are seen mainly on the face's cheek, forehead, and nose.

• These bumps can occur in groups or a line. They are painless and non-itchy.

• They look soft and shiny and are 1 to 4 mm or larger.

• It tends to bleed if given pressure or if it is contacted with a blade during shaving.

• A pitted area is seen at the center of the bump.

• Bumps stay for long, but they recede in a shorter time when they occur in babies.

What Are the Risk Factors?

Males who are older adults are more likely to get sebaceous hyperplasia. Age and hormone levels have an impact on sebaceous gland activity. Therefore, this state can arise independently of external factors.

A person's genetic background and increased UV exposure may make them more susceptible to the illness. Scientists have not been able to demonstrate that these elements directly cause sebum hyperplasia, though.

Certain cases of sebaceous hyperplasia have been connected to long-term Cyclosporine medication after organ transplantation. Cyclosporine lowers immune system activity.

How Is Sebaceous Hyperplasia Diagnosed?

• Clinical Inspection: A thorough physical examination of the patient is enough to diagnose sebaceous gland hyperplasia.

• Dermoscopy: Microscopic examination of the skin that helps analyze any skin lesions. Under microscopic examination, aggregated nodules are visualized in hyperplastic sebaceous glands.

• Skin Biopsy: Skin samples are taken from the lesion and sent for laboratory examination to rule out other conditions like basal cell carcinoma, sebaceous adenoma, etc.

How to Treat Sebaceous Hyperplasia?

Even if they do not pose any problems, they are mostly treated for cosmetic reasons.

Medicinal Management:

• Topical treatment with face wash or facial peels containing Trichloroacetic acid is found to help. But these facial peels can cause irritation, sensitivity, and skin discoloration.

Topical creams containing Retinol or vitamin A as an active ingredient are used to prevent clogging. They can be applied for two to three weeks, but the facial bumps tend to recur once the treatment is stopped.

• Oral medications like Isotretinoin are suggested for three to twelve months and are found to shrink the sebaceous glands. However, it is not indicated during pregnancy. Certain birth control pills and medications like Spironolactone can be used to reduce the increased testosterone levels.

Procedural Management:

Removal of bumps is considered as they tend to recur with medications.

• Electrocauterization: In this procedure, a sharp needle is electrically charged and used on the bumps so that it gets dried up.

• Laser Treatment: Laser waves are used to reduce the size and smoothen the surface of the bump. Mostly argon and carbon dioxide (CO2) lasers are used in this procedure.

• Cryotherapy: In this procedure, the bumps are allowed to freeze. Later, it gets dried up and falls quickly. Mostly liquid nitrogen spray is used in cryotherapy. But this technique can cause skin discoloration.

• Photodynamic Therapy: The specialist applies chemical substances or solutions sensitive to light over the skin. This light destroys the cells in the glands, thereby reducing their size. Light of wavelength of 1720 nm is used in this technique as it causes minimal damage to the surrounding surface of the skin. This treatment requires multiple sessions.

• Surgical Method: The bumps are excised or shaved by the skin specialist.

Is It Possible to Treat Sebaceous Hyperplasia at Home?

There are no such home remedies that can cure sebaceous hyperplasia. However, it can be prevented by following practices.

• Wearing sunscreen (sun protection factor- 30) before going out can prevent clogging due to increased oil secretion. It can also control the worsening of bumps once it has occurred.

• Regular cleansing of the face using a face wash that contains Salicylic acid or Retinol can help prevent the glands from clogging.

• Giving warm compresses over the clogged glands can help open up the skin pores and release the oil from the skin.

What Are the Risk Factors After Treatment?

Various techniques and surgeries can cure sebaceous hyperplasia. But there are specific outcomes of the treatment that individuals should look for, and they can also consult the doctor if they face the following issues after treatment:

• Redness, pain, or swelling around the treated bump.

• Fever.

• Pus from the treated site indicates infection.

• Sensitivity or discoloration of the skin.

• Bumps may worsen even after treatment.

How Can Sebaceous Hyperplasia Be Prevented?

Although patients cannot prevent these bumps from growing, using specific skincare products can lower the likelihood of getting sebaceous hyperplasia. Among them are:

• Niacinamide: This vitamin B3 derivative may help restore the protective layer of the skin and regulate sebum production.

• Retinol: Both prescription and over-the-counter (OTC) forms of vitamin A are available. It may aid in keeping the glands that produce oils from clogging.

• Salicylic Acid: This substance aids in removing dead skin cells from the epidermis. Additionally, it lessens redness and swelling.

When Should One Visit a Healthcare Professional?

Consult a dermatologist or primary care physician if individuals experience any of the following symptoms in addition to skin problems. They could indicate a more significant issue:

• Stiff joints.

• The skin has lumps that are getting bigger.

• Trouble swallowing.

• High temperature.

• Muscle ache.

• Wounds that are open and not healing.

• Difficulty falling asleep.

Conclusion:

Always consult a doctor for any bumps or lesions on the skin to rule out other skin conditions and for proper diagnosis. Even though the sebaceous hyperplasia is tiny and harmless, some prefer it to be removed. In addition, each one has a unique skin type; therefore, specialized dermatologists and cosmetologists can help with the perfect treatment.