Sebaceous Hyperplasias - Patients ask, Dr. Ringpfeil answers
Please feel free to use the blog below to share information about Sebaceous Hyperplasias or to ask Dr. Franziska Ringpfeil a question that might be of interest to others.
Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Sebaceous Hyperplasias
Treatments: Smoothbeam laser, photodynamic therapy, CO2 laser ablation, electrofulguration, curettage.
These benign yellowish growths occur on the face anytime after the age of 30. They tend to run in families. Occasionally, they can resemble basal cell cancers of the skin and should be evaluated before treatment. Destruction of the underlying enlarged oil gland is the aim of all treatments.
The only treatments that provide results without scarring is Smoothbeam laser or photodynamic therapy because they selectively target sebaceous (oil) glands. Other modalities include ablation by CO2 laser, slow melting of the oil gland with an electric needle (electrofulguration), and scraping of the oil gland (curettage).
Depending on the size of the enlarged oil gland, one or treatments are necessary to achieve complete destruction with any of the above treatment modalities. Treatment of the existing glands cannot prevent development of new sebaceous hyperplasias at other sites.
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I have some sebaceous glands on my penis shaft. Can those be treated with the smoothbeam laser?
Smoothbeam laser treatment for Fordyce spots (ectopic sebaceous glands) is possible in fair skinned individuals. Similar to treating sebacous gland hyperplasia on the face, it can take several treatments to reduce these on the penis. Later this year nanopulse technology will be available, which will likely take fewer treatments. CO2 laser treatments can be performed in all skin colors but has a high failure rate.
Is there down time after treatment with the diode laser for numerous sebacious hyperplasia leisions. Would I be able to go to work or does it create redness or scabbing that may cause someone to not want to appear in public?
Laser treatment of sebaceous gland hyperplasia is effective but there is downtime. It takes between 1 and 3 treatments 4-6 weeks apart to remove the enlarged sebaceous glands. Treatments must be kept in sequence to be effective. After the treatment, each of the treated glands looks red and blistered for 4-7 days. Make up coverage will conceal redness but not the blistered look. If you are very self-conscious or if you have many sebaceous gland hyperplasias, you would want to take a a few days off from public appearance.
Also, must a skin brightened always be used
Before smooth beam treatment and for how long in advance?
Thank you
The laser is safe on fair skinned individuals. However, a skin brightening agents should be used for 4 weeks prior to Smoothbeam treatment in everybody who has a Mediterranean or light Asian complexion to avoid lasting post inflammatory hyperpigmentation. Some of these individuals might even have to use a fading agent after treatment
Hello.
Does the amount of smoothbeam treatments depend on the size of the sebaceous hyperplasia? Also, does the laser have any effect on nearby hair?
Thanks
The Smoothbeam laser has a very small spot size, yet large enough to treat an enlarged oil gland. The number of treatments is most often related to the size of the enlarged oil gland, not the number of oil glands. The wavelength of the laser selectively targets oil but in the process of destruction of the oil gland, there is a rare chance that the associated hair follicle might become affected.
I was told that in your office, the esthetician performs the procedure using the 1450 diose laser for sebaceous hyperplasia. The research I’ve done says that the patient should only trust the doctor to use this laser on one’s face. I have these bumps over my entire face., with new ones coming up about every few months. With this consideration, my apprehension is that the esthetician does not have the skill level or experience to ensure that the procedure will go as well as it would were the doctor herself performing the procedure. It’s just that I have sooo many on my face-would photodynamic therapy be a more suitable treatment for me? I greatly appreciate your reply, as I am very self conscious about all these ugly bumps on my face-I don’t even want to be seen in public.
The most effective treatment for sebaceous gland hyperplasia is the 1450 nm diode laser. It can safely be used on fair skin and is not suitable in darker skinned individuals; e.g. Mediterranean or darker. Photodynamic therapy is an option in all skin colors but is not as effective as the laser. It might help, however, to reduce the rate in which new sebaceous hyperplasia occur. Our laser technicians are indeed the ones that operate this laser. They are extremely well trained and do not only have the skill it takes to succeed but have certainly much more experience with this treatment than some of our dermatologists. As you said, experience is very important when you seek treatment.
My gynecologist thinks I might have vulva lichen planas and took a discharge sample for culture or examination. Should I have a biopsy done for confirmation?
A small skin biopsy can confirm the diagnosis of lichen planus so that appropriate treatment can be started. Swabs can rule out infection.
my doctor has recommended KTP laser for my sebaceous hyperplasia. I have many bumps all over my face. Is KTP laser the same as the one that you speak of called the diode Lazer?
The 1450 nm diose laser is specific for destruction of oil glands, including sebaceous gland hyperplasia. This laser treats only oil glands and removes the sebaceous gland hyperplasia after 1-3 treatments depending on size. Its efficacy is close to 100%. Electrofulguration, electrocautery KTP laser, CO2 laser and cryosurgery are used to treat sebaceous gland hyperlasia when the 1450 nm diode laser is not at the physician’s disposal. The efficacy of these treatments ranges around 50%. If you do not have access to an office that operates the Smoothbeam 1450 nm diode laser, KTP is a good option to try because it is not associated with scarring.
Now will the photodynamic therapy be used on my entire face or just the area with the sebaceous hyperplasia. Also, do they have to be treated individually? I have so many on my nose, so close together, it has kind of changed the shape of my nose. Lastly, what can I expect all of these treatments and visits to cost me?
Photodynamic therapy is a full face treatment, so it is perfect for many growths close to each other like you describe. It reduces the number of oil glands and shrinks sebacous gland hyperplasias. This will improve the look on you skin and will reduce your tendency to develop new ones during your lifetime. As you have noticed on the blog there is only one known cure – the diode 1450 laser, which is not suitable for your skin color. The exact number of treatments to your satisfaction is difficult to judge but most most people will notice significant improvement in their overgrown oil glands in as little as 3 treatments. There is no specific unsafe limit to photodynamic therapy. Current cost is $450 per treatment. Initial medical consultation is submitted to your insurance, or incurs $115 should you not have insurance.
Hi. I recently got diagnosed with sebaceous hyperplasia on my nose. I was told accutane was my only option at this time. I’m African-American with medium brown skin and have very active acne in combination with the S.H. on my nose. Are my dermatologist right?
Sebaceous gland hyperplasia can be shrunk with photodynamic therapy, which is safe for your skin color. It usually takes several gentle treatments. Accutane is another option. In our practice, it is not prescribed for the treatment of sebaceous gland hyperplasia.
I have bumps on my face that I was told are enlarged oil glands. I was told by 2 dermatologists that they can be removed and told by another dermotologist that they can remove them but they come right back. I have alot of them on my forehead and would love to be able to have them removed if possible. What is your advice/opinion?
Conventional treatment (curettage, electrofulguration, radiofrequency treatment, CO2 laser ablation) removes sebaceous gland hyperplasia only temporarily and some of these treatments could even leave a scar. The only known cure for sebaceous gland hyperplasia is the diode laser 1450 nm. This is called the Smoothbeam laser. It is non-scarring and eradicates these glands in 1-3 treatments. Sebaceous gland hyperplasia is a genetic trait. It is possible to develop others over your lifetime but the ones that have gone after Smoothbeam treatment do not return.