What are Fordyce spots and how do Fordyce spots form?

What are Fordyce spots?

In simplest terms, Fordyce spots are small bumps that form in clusters around the lips, labia, penile skin or scrotum.

These spots are usually around 1-3 mm in size (about the size of a ballpoint pen tip)
They tend to occur in groups of 50-100 spots
They are found in 70% of the population but some have it more visible than others
They can be whitish, yellowish or even reddish in color
Streching the skin around them makes them more visible
Though they don’t hurt or itch, they can bleed more easily from rubbing
They tend to be more common in men than women
They tend to arise around early adulthood but can become visible later as well

What causes Fordyce spots to form?

In short, it’s genetic. Studies have shown that Fordyce spots initially form when you’re an embryo. However, they usually remain invisible and need a hormonal trigger to make them visible. For most people this happens during puberty but for others it can happen during adulthood.

Once a fordyce spot forms, it tends to remain there for life.

What’s inside a Fordyce spot that makes it look like a bump?
Understanding this will ensure that you treat them effectively.

Believe it or not, even though Fordyce spots were officially named by Dr. John Addison Fordyce over 120 years ago, there is still a lot of disagreement on what exactly is happening below the surface.

Scientists usually give 4 explanations for what causes the skin bumps we call Fordyce Spots:

Some researchers claim they are ectopic glands with trapped oil under the skin surface – This means that your oil glands are misplaced and present where they shouldn’t be.

Normally sebaceous glands (oil glands) are found inside hair follicles in your skin, under your pores. This allows the oil they produce to escape through the open pore and onto the surface where it keeps your skin moist. In the case of fordyce spots, some of your oil glands are located at a part of your skin where there is no hair follicle or open pore above it.
In essence, these oil producing glands are trapped under the skin without any open channel to the surface. So when these misplaced sebaceous glands produce even a small amount of oil (sebum), that oil gets trapped under the surface, forming a small bump.

This small bump is what we call a fordyce spot.
Other researchers say Fordyce spots are actually acino tubular with cells that have lipid globules – This means that the oil glands under your Fordyce spots aren’t really misplaced and while they don’t have a proper follicle inside them, they do have a “tube” that goes to the surface.

So what causes the tiny bumps? The cells under your Fordyce spots have lipid droplets inside them. Imagine cells filled with a fatty, waxy substance instead of the typical liquidy cytoplasm. If you have enough of these lipid-filled cells under the skin surface, you’ll see it raised like a bump.
Still others say they are actually sebaceous hyperplasia – This simply means that the oil glands below your Fordyce spots are abnormally large. It just happens to be that the oil glands on your lips or genitals are larger than normal and that’s why they protrude more, looking like skin bumps.
Finally others claim they are simply a problem of sebaceous prominence – This explanation makes Fordyce spots seem almost similar to acne. The reasoning here is that the oil glands under your Fordyce spots produce too much oil and the escape duct for the oil gets clogged. This causes the excess oil being produced to be trapped and pile up below the surface leading to a small bump – the Fordyce spot.

So which of these 4 explanations is right?
They all are

It turns out that Fordyce spots are very variable. In other words, they come in many types:

Fordyce spots can have follicles and sometimes they don’t
Fordyce spots can be caused by lipid-filled cells under the surface
They can also be caused by oil trapped under the surface
They can also be caused by abnormally large oil glands
They can also be caused by normal sized oil glands that just produce too much oil (sebum)

This is the main reason why most Fordyce spot treatments fail. Most treatments only target 1 of the 4 primary causes.
If your goal is to get rid of your Fordyce spots, you should be treating all 4 of the suggested causes at the same time to leave nothing to chance.

However, just knowing what could be the cause of your Fordyce spots is just half the battle. Next let’s take a look at why Fordyce spots are so tricky to treat even if you know what caused them.

What are Fordyce Spots and why do they form?