Fordyce grains

An almost physiological phenomenon affecting a large part of the population, Fordyce granules have the appearance of spots or protuberances, yellowish white, red or the same color as the mucosa where they occur and between 1 and 3 millimeters in size.

The most common locations of Fordyce granules are the genitalia (penile shaft and scrotum in males and vulva in females), some parts of the face, such as the lips of the mouth, and the oral mucosa.

Unless they represent a certain aesthetic discomfort for some people, Fordyce pimples usually do not present symptoms: they are not painful, itchy, nor are they the manifestation of infections.

Diagnosis is immediate and requires only an objective examination.

According to physicians, their treatment is unnecessary; however, if they represent an aesthetic problem for the patient, there is no lack of therapeutic solutions.

What are Fordyce grains?

When we speak of Fordyce pimples (or Fordyce granules), we refer to a particular condition that mainly affects the mucous membranes, i.e. the genital organs and the mouth, but also the cheeks.

It is the formation of small sebaceous glands (precisely called Fordyce pimples) that are not associated with specific external causes or hair follicles.

As we shall see, it is rather a very common condition that, more precisely, affects the following parts of the body:

• Lips.
• Penis and scrotum.
• Vulva.
• Mouth.
• Cheeks.

The name Fordyce pimples is due to the fact that the dermatologist who first described them in the history of medicine was named John Addison Fordyce.

What causes Fordyce pimples?

As mentioned in the previous section, Fordyce pimples are a very common condition throughout the population. In fact, it has been estimated that 79% of people report having at least one Fordyce pimple, which is certainly a very high percentage.

Basically, we can say that there are no specific causes that give rise to Fordyce grains, nor are they associated with the presence of certain pathological conditions. In practice, they can be considered as physiological events.

In fact, anyone can have Fordyce's pimples, regardless of gender or age (although they are very rare in very young children under three years of age).

Symptoms

Thus, when we speak of Fordyce granules, also known as Fordyce pimples, sebaceous bumps or Fordyce spots, we refer to the presence of certain glands of a sebaceous nature.

Generally, these glands are whitish, reddish or the color of the mucosa where they occur and do not exceed 3 millimeters in size. In general they do not cause pain or itching, although they can be very annoying from an esthetic point of view.

The main characteristics of Fordyce grains for easy recognition should they appear are as follows:

• The granules that appear in the mouth or on the lips are white, almost yellow in color, very similar to small grains of rice.
• Fordyce pimples that form on the outside of the lips mainly affect the line that separates them from the normal skin of the face.
• In the oral mucosa, Fordyce grains tend to form mainly on the inside of the lips and in the tonsil area and may contain up to a hundred granules.
• Granules that are particularly close together may fuse, resulting in a larger gland that is often mistaken for symptoms of sebaceous hyperplasia of the skin.

Treatment

Most specialists in the field believe that resorting to therapeutic treatment is futile. However, if the problem is evident and esthetically uncomfortable, the patient may decide to undergo one of the following therapies:

• The Micro-Punch technique is undoubtedly the most innovative and, for the moment, seems to give optimal results. This procedure consists of extracting small portions of tissue by means of an instrument very similar to a pen that makes holes.
• Ablation with the help of a _CO2 laser (i.e. a carbon dioxide laser). This technique may leave scars on the skin.
• Pulsed dye laser therapy that gives good results.
• Photodynamic therapy that helps reduce the problem of Fordyce pimples through the use of light.
• Electro-drying which, like laser, removes papules, but may leave scars.
• Cryotherapy, which consists of freezing the papules with liquid nitrogen.
• The application of topical creams, such as those based on clindamycin.

However, it should be remembered that these granules are practically physiological manifestations of our organism, so doctors usually advise against the use of any therapy, also because some of them have not proved particularly effective in eliminating the problem.

Prevention of Fordyce pimples

Although Fordyce granules cannot be prevented, it is important to maintain healthy and correct eating habits and personal hygiene plays a fundamental role in the health of the mouth.

It is advisable to keep the facial skin clean by using good cleansers and exfoliating to remove the remains of dead cells, in order to prevent the accumulation of sebum. Similarly, it is advisable to use oral products (toothpastes, mouthwashes, toothbrushes, etc.) that meet the needs of your mouth, and your dentist or hygienist is the ideal professional to guide you in this selection.