How to Treat Sebaceous Hyperplasia, According to Derms
At this point—with our help—you might think that you know everything there is to know about facial bumps. After all, we’ve covered everything from whiteheads and blackheads to comedones and milia. (Pst: If you don’t feel brushed up, be sure to check out our guide to every single type of acne.)
But what about sebaceous hyperplasia? Recently, the common skin condition has been growing in popularity on social media, with the hashtag being viewed more than 45,000 times on TikTok alone.
Considering the seemingly newfound (and growing) interest in the topic, we decided it was time to cover the condition in depth. We asked board-certified dermatologists Dr. Melissa Kanchanapoomi Levin, MD, FAAD, Dr. Rachel E. Maiman, MD, and Dr. Marina Peredo, MD, FAAD, to tell us everything there is to know about sebaceous hyperplasia; read on for what they had to say.
What Is Sebaceous Hyperplasia?
According to board-certified dermatologist Dr. Melissa Kanchanapoomi Levin, MD, FAAD, sebaceous hyperplasia is a common, benign condition of the oily glands in our skin (aka sebaceous glands). Most often seen on the forehead and cheeks, Levin says that the condition appears as small yellow or skin-colored bumps usually 1-3 millimeters in diameter.1 “While the cause of sebaceous hyperplasia is unknown, it presents usually in middle age, and is seen more so in lighter-skinned individuals and those with sun exposure,” Levin explains, noting that there can be a family history as well.
Considering sebaceous hyperplasia is a condition that occurs within the oil glands of the skin, Dr. Rachel E. Maiman, MD, says that a common misconception is that the condition only affects those with oily skin, “though, this is not a strong correlation. Sebaceous glands are, however, highly sensitive to circulating androgens. So hormonal shifts that occur naturally in men and women during certain periods of life are thought to be responsible for why this condition tends to develop in adulthood. In women, for instance, the most common time for sebaceous hyperplasia to appear is post-menopause.”
While sebaceous hyperplasia breakouts are considered an overgrowth, it’s important to remember that they are, in fact, benign. “They are harmless and not cause for concern, but frequently present a cosmetic problem to patients who seek treatment for that reason,” Maiman says.
With that in mind, keep reading for the best treatments for sebaceous hyperplasia.
How to Treat Sebaceous Hyperplasia
Don’t Try It at Home
As tempting as it may be to attempt one of the Internet’s many DIY treatments, both Levin and Maiman strongly advise against doing so.
“Unfortunately, there are no effective treatments at home,” Levin says. “Treating sebaceous hyperplasia effectively requires in-office procedures in order for the results to be noticeable,” Maiman adds. “A brief Google search of my own did result in purported at-home remedies… but I can tell you that this is of little to (more accurately) no benefit.”
Prescription-Strength Retinoids Are the Only Exception
The one exception to the ineffective-at-home rule is prescription-strength retinoids like tazarotene, which Maiman says can potentially prove beneficial. “Prescription-strength retinoids are sometimes employed because they may help prevent the formation of new lesions by speeding cellular turnover, however, they are not generally capable of resolving existing lesions,” she says.
Prevention Is Key
Since sun exposure plays a major role in the formation of sebaceous hyperplasia, Levin says that daily sun protection is a must. (It ought to be mentioned, though, that that’s the case for everyone, as sun exposure can lead to a whole array of complexion concerns.)
Ask Your Dermatologist About Oral Isotretinoin
Visiting a dermatologist for your sebaceous hyperplasia concerns can prove beneficial for multiple reasons: They can either recommend an in-office treatment or prescribe medication. If the latter occurs, Levin says that oral isotretinoin (aka Accutane) can decrease the size of sebaceous hyperplasia. “But once discontinuing isotretinoin, the sebaceous hyperplasia can recur,” she warns.
Try Laser Therapy
Maiman says that many lasers have been used in the treatment of hyperplasia, ranging from vascular lasers such as PDL (pulsed dye laser) and the 1450-nm diode laser to fractionated ablative resurfacing lasers like Erbium: YAG and CO2 (carbon dioxide).
“Responses to these modalities range from complete elimination of lesions to flattening,” she says. Since there are so many lasers to choose from, she says that the best way to determine the right laser for your complexion concern is to sit down with your dermatologist to evaluate your skin.
Consider Chemical Peels
Maiman says that chemical peels, like trichloroacetic acid (TCA) in a concentration of 70 percent performed monthly for a period of four to five months, can prove to be effective in the treatment of sebaceous hyperplasia. However, it’s important that the concentrations are chosen with the utmost care. “To mitigate potential complications, lower concentrations, such as of 20 percent to 30 percent, can be used. However, this would be expected to produce less robust results and thus require more treatments,” she says.
While chemical peels can be effective at lessening the appearance of sebaceous hyperplasia, Maiman points out that they can also lead to side effects such as burning, itching, tingling, peeling, and redness.
Get Your Sebaceous Hyperplasia Removed With Electrocautery
Many dermatologists will recommend electrocautery—including Levin and Maiman. “I prefer to treat with electrocautery as this is well-tolerated, effective, quick, and [has] minimal risks,” Levin says, though she notes there can be a recurrence. Nevertheless, it’s a proven treatment (however short-lived) for sebaceous hyperplasia.
“This procedure involves the use of an electrical cautery needle to burn the lesions using thermal energy induced by the electrical charge it creates,” Maiman says. “In most cases, a small curette is then used to scrape away the lesions. In other cases, the practitioner may elect to leave the lesions alone. In either case, the patient walks out of the office with a small superficial burn at the treatment site.” Within a day or two of treatment, Maiman says that the burn will form into a scab which will then fall off within five to 10 days.
The only downside is that, depending on the size of the initial breakout, Maiman says that multiple treatments may be required to manage the sebaceous hyperplasia—potentially at monthly intervals. As far as pricing for this treatment goes, Maiman says that it’s highly variable based on the lesion site, the practitioner, and the area of the practice, but you can expect to pay as low as $50 and as much as $750.
Not into the idea of cauterizing your skin? Consider cryotherapy instead. According to Maiman, cryotherapy, which involves using liquid nitrogen to freeze the sebaceous glands to a point that they are killed, can be beneficial for the treatment of sebaceous hyperplasia.
“Much like electrocautery, the result is a small burn (although in this case from extremes of cold temperatures), that turns into a scab and flakes off over the ensuing days,” she says. “[Though] cryotherapy tends to be less efficacious to electrocautery, comparatively, and usually necessitates multiple treatments for complete removal.”
The Final Takeaway
While dermatologists will offer a variety of different treatment options for sebaceous hyperplasia, Dr. Marina Peredo, MD, FAAD, says that no treatment will completely cure the condition, only control it. “Even the best treatments I offer patients do not cure it,” she says, noting that cauterization is her method of choice.