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🩷 FORDYCE SPOTS OF THE LIPS
Benign • Common • Harmless

● Fordyce spots are ectopic sebaceous glands presenting as tiny yellowish-white or skin-colored papules, commonly seen on the vermilion border of the lips.

🔹 Clinical Features
Usually 1–3 mm in size.
Multiple, discrete, painless papules.
Become more prominent when the lips are stretched.
Usually asymptomatic and non-contagious.
They are not sexually transmitted and are not related to poor hygiene.

👥 WHO GETS FORDYCE SPOTS?
- Fordyce spots are very common and can occur in both males and females.
- They usually become more noticeable after puberty.
- Increased visibility is related to the development and enlargement of sebaceous glands under hormonal influence.
- They may become more prominent with age as the skin and lips change.
- They are not caused by infection or sexual activity.
- Most people have them without realizing it.

🔹 Diagnosis 🩺
Diagnosis is usually clinical.
Biopsy is rarely required unless the lesions are atypical or another diagnosis is suspected.

🔹 Differential Diagnosis
• Milia
• Mucous cysts
• Herpes simplex
• Viral warts
• Sebaceous gland hyperplasia

✨ MANAGEMENT & TREATMENT

🌸 1. Reassurance
Fordyce spots are benign and harmless, so treatment is not medically necessary.
For most patients, reassurance is the best approach.

💎 2. CO₂ Laser
One of the most commonly used procedural options for cosmetically bothersome lesions.
Fractional or ultrapulsed CO₂ laser can vaporize the superficial sebaceous glands.
Often provides good cosmetic improvement.
Multiple sessions may be required.
Possible adverse effects include erythema, crusting, post-inflammatory hyperpigmentation and scarring.

⚡ 3. Electrosurgery
Electrodesiccation/electrocautery can destroy individual lesions.
✔ Useful for discrete lesions.
⚠️ Requires careful depth control because excessive treatment may cause scarring or textural changes.

🔬 4. Micro-Punch Excision
A micro-punch technique can physically remove individual Fordyce spots.
✔ Particularly useful when there are few prominent lesions.
✔ Can produce durable cosmetic improvement.
⚠️ The main concern is the possibility of tiny scars.

❄️ 5. Cryotherapy
Cryotherapy has been used for Fordyce spots, but it is less predictable on the lips and may cause pigmentary changes or scarring.

🧴 6. Topical Retinoids
Tretinoin may reduce the visibility of some lesions by affecting sebaceous gland activity.
Start with a low concentration and gradual application.
Irritation and dryness are common.
Results are generally less predictable than procedural treatments.

⚠️ Avoid application on the mucosal surface and use carefully on the delicate lip area.

💡 7. Other Laser Options
Er:YAG laser and other ablative laser approaches have also been described and may provide good cosmetic results

⚠️ IMPORTANT
Because Fordyce spots are benign, the goal is cosmetic improvement—not complete eradication at any cost. Overtreatment can result in scarring, dyspigmentation, or textural changes that may be more noticeable than the original lesions.