Is there a pimple on your face that won’t seem to pop? Well, it could be a cyst, a pimple that’s embedded too deeply within the skin, or it could be known as something called sebaceous hyperplasia. We will talk about the difference between the two, but above all else, you should remember the following as the most important thing: refrain from picking or popping anything on your face.

Picking and popping bumps on the skin can lead to:

• Deep scarring or hyperpigmentation that might only fade with professional treatments or extensive periods of time. 
• A damaged skin barrier and your skincare routine becoming less effective.
• Infection
• Increased and repetitive habits of skin-picking
• Increased inflammation and redness of the cyst or pimple.

However, it’s true that pimples and cysts can come to a head on their own and heal. But, if you’re noticing that the bump is not doing this, it could be sebaceous hyperplasia.

 

What is sebaceous hyperplasia?

Sebaceous hyperplasia is not the same thing as sebaceous filaments. Sebaceous filaments may come out of the skin like a thread, and they do not form bumps. They’re actually normal parts of the skin and sebaceous (oil glands). They help to move sebum from the glands to the surface of your skin to keep the surface glowing, hydrated, and shiny. However, when sebaceous glands overproduce sebum, it can make sebaceous filaments more noticeable.

On the other hand, sebaceous hyperplasia bumps are not super filled with oil. Actually, they’re not cysts or pimples at all. It’s a condition that may look like a bump, but in reality, it’s an enlarged oil gland. 

 

Photocred: Celibre Medical Center

With sebaceous hyperplasia, why are the sebaceous glands enlarged?

To begin with, sebaceous glands contain sebocytes. Sebocytes, like any other cell in the body, have to go through a process of maturation. Once sebocytes become fully mature, they accumulate lipids (fatty compounds). Eventually, though, the sebocytes disintegrate in the center of your oil glands. And these fatty compounds are released onto the surface of your skin. 

How do sebocytes grow?

Sebocyte growth is influenced by androgens, which are sex hormones. But, as we age, androgen levels go down, and the maturation process of sebocytes slows down. As it slows down though, some of the sebocytes get stuck and don’t reach the point of disintegrating and releasing fatty compounds onto the skin.

But, when you look at the bump of sebaceous hyperplasia under a microscope, you won’t see sebocytes filled with oil because they don’t have the normal androgen influence to help them accumulate lipids. When sebocytes become filled with oil, they normally disintegrate. But with sebaceous hyperplasia, you get enlarged sebaceous glands filled with half-grown sebocytes. 

The condition can happen to anyone, but it is most common in babies, middle-aged, and more mature skin. Ultraviolet radiation is also a known cause of sebaceous hyperplasia, and that’s why it’s important to wear a broad-spectrum SPF.  Immunosuppressant medications such as cyclosporine have also been known to cause sebaceous hyperplasia.  

What are treatments for sebaceous hyperplasia? 

Isotretinoin, vitamin A, is normally the first line of treatment for sebaceous hyperplasia. Vitamin A bonds to certain receptors in the skin to help it turn over quicker, resurface, and reveal a new layer of skin. They can help shed immature sebocytes. 

Photodynamic therapy 

Photodynamic therapy, a treatment that uses a light-activated drug, can help reduce the size of sebaceous glands. 

Cryotherapy

Cryotherapy is when liquid nitrogen is used to shrink or destroy the bumps. 

Electrodesiccation

Electrodesiccation uses heat from an electrical current to remove sebaceous hyperplasia.

With electrodesiccation, a fine needle is inserted into the bump, and it generates heat. Then, the heat destroys the tissue. Although the treated area develops a scab, it will usually heal in 1–3 weeks.

Laser

CO2 laser ablation is considered the gold standard and the quickest treatment for sebaceous hyperplasia. With laser ablation, a specific wavelength of light is absorbed by the water in your skin. During this process, heat is generated in the skin and around the sebaceous glands. This process will help to flatten the sebaceous hyperplasia bumps. 

The best treatment will depend on your skin and the customized treatment plan that your dermatologist prescribes you!

 

Cover photo cred: escholarship image of sebaceous hyperplasia