What Are Fordyce Spots? What Causes Fordyce Spots?

Fordyce spots, also known as Fordyce's spots, Fordyce granules or Sebaceous Prominence, are small raised, pale red, yellow-white or skin-colored bumps or spots that appear on the shaft of the penis, the labia, scrotum, or the vermilion border of the lips of a person's face. They can also be found on the foreskin of the penis (called Tyson's glands).



The vermilion (vermillion) border of the lips is the normally sharp demarcation between the red colored part of the lip and the adjacent normal skin of the face.

Fordyce Spots are named after the American dermatologist John Addison Fordyce (1858-1925) who first described them clinically in a medical journal. He also coined the terms Fox Fordyce disease, Fordyce's disease, Fordyce's lesion, and Brooke-Fordyce trichoepithelioma.

Fordyce Spots are common in both males and females.

Fordyce spots are a type of ectopic sebaceous gland:

• Ectopic = in an abnormal location or position.
• Sebaceous - fatty, greasy, adipose, fat - relating to oil and fat
• Glands = organs or collection of cells that secrete things. Endocrine glands secrete things, such as hormones, into the body. Exocrine glands secrete things outside the body, such as sweat or mucus.
• Sebaceous gland = a small skin gland that secretes sebum (oily matter) into the hair follicles to lubricate the hair and skin
• Ectopic sebaceous gland = a sebaceous gland that is on the skin but not in the hair follicle.

According to Medilexicon's medical dictionary, Fordyce spots are:

"A condition marked by the presence of numerous small, yellowish-white bodies or granules on the inner surface and vermilion border of the lips; histologically the lesions are ectopic sebaceous glands."

Although Fordyce Spots are sebaceous glands which are in "the wrong place" (not in hair follicles), they are not associated with any disease or illness. Dermatologists say they are of cosmetic concern only - people who have them might not be happy with how they affect the way they look.

Experts say that Fordyce Spots are natural occurrences on the body and are not infectious. Some men may wonder whether they have some kind of STI (sexually transmitted infection) orcancer and see their doctor, only to be told that they are harmless.

What are the signs and symptoms of Fordyce Spots?

Small, pale (skin color, yellowish or pinkish) bumps or spots from 1 to 3 mm in diameter are visible on the:

• Shaft of the penis (in males)
• Scrotum (in males)
• Where the lips on the face meet the skin of the face (vermilion border)
• Labia (in females)

On the penis glans/shaft, scrotum and labia they may appear as bright red or purple papules, as a solitary lesion or in crops of 50 to 100. They are painless and do not itch. They are simply abnormally dilated blood vessels that are covered by thickened skin. In some cases they made bleed during/after intercourse.


30-year-old male patient, worried about herpes simplex, saw his doctor. Physical examination revealed several 1mm-wide smooth, white spots. He was diagnosed with Fordyce Spots (Hong Kong Medical Association)

What are the treatment options for Fordyce Spots?

Dermatologists and primary care physicians (general practitioners, family doctors) emphasize that Fordyce Spots are normal physiological occurrences and are not dangerous for human health. Many, in fact, advise against treatment.

Electro desiccation or CO₂ laser have been used with some degree of success in making the spots less visible, if the patient's concern is purely cosmetic.

Pulsed dye lasers have also been anecdotally reported to be effective in some cases. This is a laser treatment usually used for sebaceous gland hyperplasia (a skin disorder of the sebaceous glands, basically, an enlarged oil gland). Although expensive, pulsed dye lasers tend to leave fewer scars than other methods.

In the majority of cases, the treatment methods mentioned above are not effective enough for most patients. However, a recent article regarding a Micro-punch technique provides some hope.

Micro-punch technique for treatment of Fordyce spots - Professor Norbert Pallua, who works at the Department of Plastic Surgery, Hand Surgery, Burn Center, University Hospital RWTH Aachen, Germany, reported in the Journal of Plastic, Reconstructive & Aesthetic Surgery promising results with Micro-punch technique for the treatment of Fordyce spots.

In a retrospective study involving 23 patients from 2003 to 2011, Pallua and team say they achieved satisfactory functional and cosmetic results. They added that so far during post-operative observations, there have been no signs of recurrence from 12 up to 84 months (median = 51.3 months).

What are the possible complications of Fordyce Spots?

For patients with severe Fordyce Spots on the vermilion border of the lips of the face, there is a risk of anxiety and depression, because the eyes and lips are the first things people look at. The spots can affect people emotionally.

Those with severe symptoms in their genitalia may be embarrassed or concerned about what their sexual partners might think. In some cases, the spots may bleed if injured or during intercourse.

Many doctors fail to diagnose Fordyce Spots accurately

It is not uncommon for patients with Fordyce Spots on their lips to go to several dermatologists and plastic surgeons and find that only a minority are able to identify what they are and to provide information regarding their causes, nature and possible treatments.