Why are Fordyce spots so difficult to get rid of?

But what is it that makes Fordyce spots so difficult to get rid of?

Here are 5 reasons why you should always be careful what products you choose when treating your Fordyce spots…

• Fordyce spots are a gland problem and not just a skin problem – Unlike acne where all you have to deal with under the skin bump is excess oil and some dead cell debris, at the root of every Fordyce spot is a sebaceous gland. Each gland constantly working with the endocrine system and being surveilled by the immune system for damage.
  
  These glands are very sensitive to injury.
  
  Damaging a sebaceous gland often causes them to become enlarged or blocked. This can leave your Fordyce spots bigger and harder than when you started.
  
  Remember, whatever treatment you choose, it should be gland-sparing. It should treat your Fordyce spots without triggering injury within the glandular tissue.
• Fordyce spots can be deep in the sub-dermis – Histological examinations have revealed that while some Fordyce spots are found in the epidermis (upper layers of the skin), many reside in the much deeper sub-dermis.
  
  To put this in perspective, if your skin was a standard asphalt street, getting to your sub-dermis would be the equivalent of digging a quarter mile deep. Keep in mind that most topical products barely cross the epidermal barrier. To treat a problem that resides in the sub-dermis requires a far more advanced therapeutic approach.
  
  This is why you should always look beyond just the ingredients on a product’s label and see how they address this crucial permeability issue.
• Treating them can cause hyperpigmentation and scarring – Where most active ingredients never pass the epidermal barrier, the few ingredients that do make it past the top layer of your skin can sometimes trigger something called post-inflammatory hyperpigmentation.
  
  This is because the deeper you go under the skin surface, the more aggressive the immune system’s response to a foreign substance. Think of it like barely pricking your finger with a pin vs poking it just a few millimeters deep. Your entire finger becomes red and painful.
  
  This is why getting deep to the sebaceous gland is a tricky process. The immune system’s response can cause cells called melanocytes to overproduce pigment, leaving your spots darker. The immune driven inflammation can also promote fibrogenesis within your Fordyce spots, leaving them scarred.
  
  Always make sure that any treatment you choose has been specifically tested on Fordyce spots – this way you won’t end up with hyperpigmentation or scarring.
• You are still left with the hypopigmentation issue after treatment – Note how your Fordyce spots look a bit palish or different in color than the nearby skin? That’s because at the surface of these bumps there are fewer pigment producing melanocytes.
  
  This is why the most common complaint by people that undergo laser Fordyce spots removal is that their tiny white bumps were replaced by tiny white dots. Their skin isn’t raised anymore but it still doesn’t look quite normal either.
  
  Why? Because their treatment ignored the pigmentation issue. The laser burned away the sebaceous gland deep under the Fordyce spot but left the discoloration issue as-is.
  
  To avoid this common problem, you want to make sure your therapy addresses the pigmentation imbalance on the Fordyce spot surface. What you want at the end of your treatment is not just perfectly smooth skin but also perfectly even-toned skin.
• Even if you were to smooth your Fordyce spots, they are likely to come back – One remarkable thing about sebaceous glands is that they constantly regenerate thanks to progenitor cells. However, this also means any improvements you see with your Fordyce spots treatment is likely to be temporary.
  
  Yes, that also includes laser treatments. Often laser treatments damage tiny sebaceous glands (10 times smaller than a grain of sand) with even tinier laser beams (100 times smaller than sebaceous glands).
  
  It’s like aiming to hit a pin head with the tip of a pin. It’s bound to be imperfect. This means over time, the slightly damaged gland will regenerate and many of your spots will reappear.
  
  The lesson to take from this is that the best way to treat Fordyce spots isn’t a brute force method like laser, electrodessication or micro-punch excision. You really want to reverse the problem on a biochemical level.