Getting The Facts Straight
Right from the onset of this article we need to establish a few key points before going into an in-depth discussion of fordyce spots and cancer.
- Fordyce spots, correctly diagnosed as such, are not cancerous. If you consult your doctor they will be able to confirm whether your spots are fordyce spots should you be unsure.
- Having fordyce spots on your reproductive organs or elsewhere are not a sign of cancer.
- Fordyce spots are easily identifiable as such and are difficult to incorrectly diagnose.
- Fordyce spots are simply sebaceous glands (see the explanation below).
- Penile cancer and fordyce spots have a completely different appearance. The two are exceptionally unlikely to be confused.
- They are totally benign, harmless and doctors generally advise against treatment.
- Some treatments exist but are not advisable.
What are Sebaceous Glands?
In order to truly understand what fordyce spots are and why you should not be worried about them you need to understand what sebaceous glands are. Without this definition this article will not make much sense to you.
The short story is that sebaceous glands are the glands in your skin that produce oil (doctors call this sebum). They are found almost everywhere on the body (with the exception of the palms of your hand and the soles of your feet). Everyone has them and they are an essential part of the human body.
The Doctors Discuss Fordyce Spots
Understanding Fordyce Spots
The best way to reassure you about your fordyce spots is for you to actually understand what they are. Once you understand what they are you should feel much more reassured and less worried about them. With this understanding it should become clear to you that fordyce spots are a million miles away from cancer.
Fundamentally fordyce spots are simply sebaceous glands (see opposite). The only difference between fordyce spots and your other sebaceous glands is that you can see them. Other people have non-visible sebaceous glands where your fordyce spots are located. This is not to say that you are abnormal as fordyce spots are exceptionally common. Depending on which study you read the prevalence of fordyce spots somewhere on the body is between 70-80% of people with the most common site being the lips followed by the reproductive organs.
Typically fordyce spots present as white or slightly yellow bumps like those shown in the picture opposite. They should be painless and having them is totally harmless. They are also not sexually transmitted and are present in people prior to sexual maturity. They are not contagious at all (i.e. do not spread between people).
Fordyce spots are not a sign or symptom of cancer. The conditions mentioned below are related to sebaceous glands in general and completes the discussion of fordyce spots (which are sebaceous glands) and cancer.
The conclusion of this article is that fordyce spots are not cancerous which remains entirely correct. Fordyce spots are simply sebaceous glands.
However in the interests of a full and complete discussion of the subject it is proper to mention sebaceous carcinoma which is an extremely rare cancer that in incredibly rare cases has been known to affect the penis. As of 2009 only five cases of this have ever been reported in the medical literature. This type of cancer is usually associated with the head and neck. Furthermore there is no medical research currently published (as of the time of publication) providing evidence that fordyce spots can become cancerous outside of some indications for the oral cavity. To put it simply: everyone has sebaceous glands so everyone is, in theory, at risk for sebaceous carcinoma. Likewise everyone has a brain and is therefore at risk of a brain tumour. This is just part of being alive.
The problem here is that in exceptionally rare cases you can get tumours that resemble normal sebaceous glands which is why we call it sebaceous carcinoma. This cancer is thought to arise from sebaceous glands. However simply having fordyce spots is very unlikely to increase your chances of getting this very rare type of cancer as everyone has sebaceous glands all over their body. Additionally sebaceous carcinoma is typically much larger (usually around 10mm) than a fordyce spot (which is usually around 2-4mm) so the two are usually easy to tell apart.
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The bottom line is that fordyce spots should only ever be of concern if they stand out as exceptionally unusual. In this case it is highly advisable to consult a physician to examine them. Nonetheless cancer remains exceedingly improbable.
Lastly in extremely rare cases sebaceous lymphadenocarcinoma can occur in the salivary glands and can look mildly similar to fordyce spots.
Hereditary Non-Polyposis Colorectal Cancer Syndrome
This section is, like the previous section, is included only for completeness and should not be a cause for concern. Furthermore this section is only of interest in people with a very significant family history of colorectal cancer. To reiterate again, fordyce spots are not a sign of cancer.
However fordyce spots give doctors some clues which are useful in a very small percentage of the population because of their association with germline mutations in mismatch repair. There is preliminary evidence that the presence or absence of fordyce spots can be useful for cancer screening purposes.
Now that we have hopefully put your mind at rest with regards to cancer we can now look at the issue of appearance. This is really the only quasi-rational grounds for concern regarding fordyce spots.
The first thing to note is that most doctors consider fordyce spots to be perfectly normal human variation. Some people have glands you can see while others have glands you can't see. Doctors do not recommend treating these in the same way that they would not recommend surgery for big ears or slightly above average amounts of nose hair.
If you are insistent on treatment there are some treatment options however government programs such as Medicaid and the NHS will not cover the treatment which will be very expensive. However should you be willing to spend money for a fairly minor improvement your three options are:
- CO2 laser treatment
- Pulse dyed laser treatment
- Micro-punch technique
Let's start with the two laser treatments. Sadly both of these are likely to be unsatisfactory and provide only minor improvements in appearance. Treatment with a CO2 laser can be mildly effective in reducing the visibility of the spots. Pulse dyed lasers are used to treat sebaceous gland hyperplasia so may be mildly effective for treating fordyce spots. However laser treatments can leave some scarring which can undo the benefits of less visible fordyce spots.
The most effective treatment cosmetically is the micro-punch technique which is capable of substantially reducing the appearance of fordyce spots. A recent clinical trial on 23 patients showed very satisfactory results with no recurrence. However this procedure involves minor surgery. Given that fordyce spots are not dangerous, very common and harmless; surgery is not a rational reaction to these and is not recommended at all.
Sources and Further Reading
American Family Physician: Penile Appearance, Lumps and Bumps.
Urologia Internationis: Sebaceous Carcinoma of the Penis.
Medical News Today: Overview of Fordyce Spots.
British Association of Plastic, Reconstructive and Aesthetic Surgeons: Micro-Punch Technique for Treatment of Fordyce Spots
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.