Fordyce Spots · What Are They, Causes, Treatment, and More

Fordyce spots, also known as Fordyce granules or Fordyce glands, are a skin condition characterized by large, ectopic sebaceous glands (i.e., oil glands) frequently found on the oral mucosa and genitalia. Fordyce spots are very common, occurring in up to 70-80% of adults. They are considered normal variants of the skin that are likely present at birth, however they often go unnoticed. After puberty or with increased age they may grow and become more visible as a result of increased oil production in the skin and hormonal influences.  

Fordyce spots typically appear as painless, pinpoint (<1 mm), whitish-yellow bumps that most commonly appear in areas of the skin without hair follicles (e.g., inside lining of the cheeks, inferior eyelids, vermilion border of the lips). They appear either individually or in scattered patterns, often clustering in groups of 50 to 100 spots that form patches on the skin. Fordyce spots may also appear on genitalia including the shaft of the penis, scrotum, labia majora, and/or labia minora.  Lesions are typically purple or red in color in these locations.  

The exact cause of Fordyce spots remains unknown and is likely due to a combination of biological and environmental factors. Fordyce spots are commonly caused by the overgrowth of ectopic sebaceous glands, which some studies have linked to hormonal changes and/or factors in embryo development.   

Common risk factors that may be associated with the development of Fordyce spots include oily skin, post-pubertal age, and male sex at birth. Individuals with certain conditions are also at increased risk, including those with dyslipidemia, rheumatic disorders, Muir-Torre syndrome, and colorectal cancers. 

Fordyce spots are commonly diagnosed by a healthcare professional upon physical examination. Individuals who find their Fordyce spots bothersome; are experiencing any signs or symptoms related to them, such as bleeding, depression or anxiety; or are concerned about other diseases may seek diagnosis or treatment and medical advice from a healthcare professional.  

It is important that Fordyce spots are accurately diagnosed as the differential diagnosis for Fordyce spots include other conditions, such as genital warts, epidermoid cysts, sebaceous hyperplasia, or milia. Additionally, sexually transmitted infections may initially resemble Fordyce spots on the genitals and may require treatment with medications. To diagnose infections, swabs of the affected skin areas may also be taken and tested for the presence of bacteria or viruses. Blood and urine samples may be taken to rule out other conditions. A skin biopsy may be required in rare circumstances, where a sample of tissue is removed and examined under a microscope to rule out other conditions, like skin cancer.