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[music] Hello, I’m Dr. Neal Schultz
[pause]
and welcome to DermTV.
Sebaceous hyperplasia is just a very fancy medical term for giant oil
gland. They usually occur on your face, they’re white or yellowish bumps,
about a sixteenth to an eighth of an inch, and sometimes they have a
little-bit of a hole in the center. They look like pimples or whiteheads,
but they’re not. If you use acne medications on them, they won’t get
better. If you try to pop them, the way you try to pop a pimple, it’s not
going to go away. If I try to pop it, the way I would open a whitehead or a
pimple in the office, it’s not going to go away, but there are things that
dermatologists can do to make these giant oil glands disappear, because
they really are a cosmetic eyesore. Let’s think about what a whitehead or a
blackhead is. First of all, this is a normal oil gland next to the hair
follicle, and from that normal oil gland there is a tiny little duct that
leads into the shaft. If you get a clog in this duct or a clog anywhere
along here, oil gland doesn’t know that. It keeps making oil, so you then
get a white enlargement, and that’s a whitehead, it’s just a big bag of
oil, but if instead of the oil gland being this size, the oil gland itself
is a giant oil gland, and is actually this size and actually pops up a
little bit through the top of the skin, and has this white or yellow color.
This is what sebaceous hyperplasia is, it’s just a giant oil gland. If this
is a normal size wine glass, this is a giant size wine glass. Alright, so
how do we treat these? If you just have a few, they are most easily treated
with a very special strong acid, called bichloroacetic acid. I touch the
acid, just to the oil gland, immediately it turns white, and then becomes
crusty in about a day or two. After about ten days, the crust goes away,
and the oil gland is gone. Now, that’s ok if you have just a few, but if
you have dozens, you don’t want to walk around with a dozen or two-dozen
little black crusts on your face, it’ll look like you got hit by a shot
gun. So instead, we use lasers, and it’s called photodynamic therapy,
because we use laser light to activate a chemical that we paint on the oil
glands, in the office. We leave the chemical there for about an hour, then
we shine the laser light on it, and it causes the oil gland to actually
dissolve. There’s no visual downtime, it takes two or three treatments, and
for people who don’t want to do that, oil glands that are enlarged,
sebaceous hyperplasia responds remarkably well to Accutane, the acne drug.
Now, it’s not FDA approved to treat sebaceous hyperplasia, but as an off-
label use, Accutane is very effective for reducing sebaceous hyperplasia
very quickly. So, if you have a bump on your face, which looks like a
pimple, but it just won’t go away, and it lasts more than a month, you may
want to see your dermatologist to have your sebaceous hyperplasia treated.