Sebaceous hyperplasia papules are common. I often see them as an incidental finding on a facial skin exam. They are decorative proliferations of what was once a microscopic and invisible oil gland, now enlarged enough to be seen with the human eye. People often ask me why this happens and what can be done to get rid of sebaceous hyperplasia papules. I received this question from a reader and I wanted to share my answer.
Dear Dr. Bailey,
I am a 62-year-old woman with rosacea - I have had it for most of my life. My skin is still a mess, but I am hoping the products I purchased online from you will help me with that. My question is how to get rid of sebaceous hyperplasia papules (or at least STOP new ones from appearing). They are out of control, every time I look in the mirror I have more! I’ve had them removed by laser in the past but they return with a vengeance. My skin is very oily. HELP!!!
Thank you, Mary Jo
Hello Mary Jo,
This is a tough problem. There is actually no known way to stop or control the development of sebaceous hyperplasia papules. That said, I never give up. I agree, they are very annoying, and I can hear your frustration almost as though you were speaking to me in the same room.
Sebaceous hyperplasia papules are benign growths of otherwise normal oil glands.
Every pore has an oil gland. Most of the time these glands are microscopic and invisible to the naked eye. For some reason, in some people, oil glands start growing into little benign tumors called sebaceous hyperplasia papules.
We don't know why sebaceous hyperplasia happens. We do know that it is more likely to happen when a person is prone to rosacea, especially the type where the skin is oily and has large pores.
To learn more about the types of rosacea you can download my free eBook on rosacea. Find it on my free skin health eBook page here.
How do you prevent sebaceous hyperplasia papules from growing?
We really can't. There are no scientifically-proven ways to stop the process from happening. That said, I work hard to help my patients counter rosacea in the hopes that it will help reduce their skin's tendency to form sebaceous hyperplasia papules. I do it with skin care, diet, and procedures.
What is the best skin care routine for complexions prone to sebaceous hyperplasia?
The basis of my rosacea skin care routines is always to incorporate my Facial Redness Relief Kit. It includes a pyrithione zinc soap and a high concentration of green tea antioxidants. This product combination helps to control rosacea. I also try to add a product to the skin care routine that will give us deep pore cleaning. This is tricky because a rosacea-prone complexion can be very sensitive and pore cleaning products can be irritating.
Skin care solutions to deeply clean pores for rosacea prone skin include using my Naturally Hydrating Pore Minimizing Toner with witch hazel to help shrink pores. Apply the toner with a cotton pad after cleansing your skin. Another option is to use Retinol Night Cream at night if you complexion can tolerate it. Retinol has complex and beneficial action on pores and skin that provide wide reaching benefits to all complexions. The oral retinoid isotretinoin has been found beneficial in reducing sebaceous hyperplasia formation. That treatment has potential long-term systemic side effects. I prefer to approach this condition with a topical retinoid. It can be tricky to use for really sensitive skin but it is the one anti-aging and anti-clogged pore active that I am able to work into a rosacea complexion skin care routine.
A Complete Skin Care Routine to fight sebaceous hyperplasia in rosacea-prone skin may look like this:
CLEANSE: Calming Zinc Soap followed by my Naturally Hydrating Pore Minimizing Toner
CORRECT: Green Tea Antioxidant Skin Therapy in the morning and Retinol Night Cream at nightHYDRATE: Daily Moisturizing Face Cream for Normal to Oily Skin layered on top. If you have dry skin use my Daily Face Cream for Dry to Normal Skin.
PROTECT: Sheer Strength Pure Physical SPF 50+ Sunscreen during the day, either Matte Tinted or Invisible. Get both the Daily Face Cream and Matte Tinted Sheer Strength Sunscreen in my Fort Knox for Your Face Kit. I wear this product duo daily.
This is a comprehensive skin care routine that fights rosacea and helps keep pores clean.
What other skin care treatments are there for rosacea-prone complexions at risk for sebaceous hyperplasia?
I also consider using a prescription cream for demodex mites. I really think they are part of the process that stimulates sebaceous gland growth, though that is not proven scientifically.
In the past, I used permethrin cream applied nightly for a week every month to control demodex in place of Retinol. This is an off-label use and I discuss the topic for information only. Now, we have the new Soolantra Cream that has recently been approved for treating demodex mites in rosacea. Discuss prescription medicines with your treating physician.
What diet that may help fight inflammatory skin conditions like rosacea?
I always recommend dietary changes because I see less sebaceous hyperplasia papules in people who eat a very healthy diet. That means fewer rich foods and more vegetables. A summary of my recommendations can be found in my free eBook on Healthy Eating which can be found on my free skin health eBook page.
What are the best cosmetic procedures to treat sebaceous hyperplasia?
In fair-skinned patients, if appropriate, I recommend a series of IPL treatments because IPL helps with rosacea. It may reduce demodex mite populations. In my experience, it can even reduce the appearance of sebaceous hyperplasia papules. (This is my observation, though it's hard to understand why it works.)
I also treat the existing sebaceous hyperplasia papules as they arise. My treatment preference is electrocautery with a low current and a fine epilating needle attachment. I find it works beautifully, does not leave marks and shrinks the charming and exuberant sebaceous lobules such that they are barely visible.
Thank you for a great question about a frustrating condition. I hope my information helps.
Cynthia Bailey MD, Dermatologist
Tagliolatto S, Santos Neto Ode O, Alchorne MM, Enokihara MY. Sebaceous hyperplasia: systemic treatment with isotretinoin. An Bras Dermatol. 2015;90(2):211–215. doi:10.1590/abd1806-4841.20153192
Forton FMN, De Maertelaer V. Papulopustular rosacea and rosacea-like demodicosis: two phenotypes of the same disease?. J Eur Acad Dermatol Venereol. 2018;32(6):1011–1016. doi:10.1111/jdv.14885
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