Problem: I recently went to the dermatologist and she told me the little whitish-yellowish bumps on various parts of my face are a disorder called sebaceous hyperplasia. She explained to me that the only way to permanently get rid of these bumps was to come in for laser treatments (probably three sessions) with the Smooth Beam laser. I just had my first treatment and my face looks awful to me. What can you tell me about sebaceous hyperplasia? No one seems to have an answer as to what causes it in certain people. Second, what do you know about the Smooth Beam laser treatment? Do you know what a person should expect in his/her results after a treatment?
Solution: Sebaceous hyperplasia is an extremely common, exceedingly stubborn, though completely benign condition of the oil gland. “Sebaceous” refers to the oil gland, and “hyperplasia” describes an abnormal but benign increase in cells (in this case sebaceous cells) that causes the oil gland to increase in size.
Sebaceous hyperplasia typically occurs in people 40 years of age or older and the effect looks exactly like what you described—white to yellowish soft bumps. You can have more than one, and they occur in areas where we have oil glands, mainly the nose, cheeks, and forehead. If you look close enough or with a magnifying mirror you can see a small depressed area in the center that looks like an open or clogged pore.
Oil glands in general are extremely sensitive to the status of hormone production, and although the number of oil glands you have never changes their activity and size does. As hormone levels change with age, cell production in the oil gland can become distorted and the result is these strange-looking facial blemishes. What is most frustrating is that no matter what you seem to do these types of blemishes never go away. Trying to squeeze them may release some sebum, but that rarely changes anything and usually just makes matters look worse.
Cosmetics companies have no solution for sebaceous hyperplasia. The bumps are not pimples or blackheads and therefore don’t respond to benzoyl peroxide or topical exfoli – ants. Unless the lesion is removed and the oil gland excised or destroyed, the condition won’t go away.
There are several medical treatments that can achieve this goal, including lasers, but your doctor could also have suggested far less-expensive options as well. Cryotherapy (liquid nitrogen—where the lesion is burned off), cauterization or electrodesiccation (these are other forms of burning off the lesion with heat), and topical chemical treatments (application of a deep peel such as trichloroacetic acid) all have research showing they work. Lasers, including the Smooth Beam, which is a nonablative, pulsed-dye laser, have research showing treatment can be effective, but there are risks, as there are with any medical option.
It should also be pointed out that retinoids, particularly tretinoin (as in Renova or Retin-A) can also help prevent the problem from happening in the first place, along with preventing recurrences from showing up. That would be an important maintenance consideration regardless of the treatment you decide to try.
(Sources: Clinical Dermatology, January-February 2006, pages 16-25; Journal of the American Academy of Dermatology, July 2000, pages 49-53; Journal of Investigative Dermatology, February 2000, pages 349-53; and Dermatology, January 1998, pages 21-31.)