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!!!
Hello Mary Jo,
This is a tough problem. There is actually no known way to stop or control the development of sebaceous hyperplasia papules from forming. 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 the otherwise normal oil glands. Every pore has an oil gland and 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, but the growths are more likely to occur in people prone to rosacea, especially those with oily skin and large pores. My approach to helping someone in my practice whose skin is a “sebaceous hyperplasia former” is to try to counter these characteristics. I do it with skin care, diet, and procedures.
I always recommend my Redness Relief Kits:
I try to find a tolerable deep pore cleaning product for their skin type. Options include:
- benzoyl peroxide,
- glycolic acid,
- glycolic acid with salicylic acid in an oil removing preparation, and
- tretinoin cream.
These are all potentially irritating products and it is an experiment to find the right one for an individual’s skin type and tolerance. My acne products contain the first 3 ingredients. Tretinoin is prescription.
I recommend a Clarisonic Skin Cleansing Brush System because it helps deeply clean oil and debris from the pores.
I consider using a permethrin cream to address demodex mites. Yes, really! Almost everybody has them in their pores and some actually live in the oil gland. Who knows, they may play a role. This treatment requires a prescription product that is very “off label” so it needs to be discussed with the treating dermatologist. Benzoyl peroxides may help with demodex and that is an OTC option.
I always recommend dietary changes because I see less sebaceous hyperplasia papules in people who eat a very healthy diet. That means less rich foods and more vegetables. A summary of my recommendations can be found in the post titled The Best Diet for Healthy Skin in 2012.
In fair-skinned patients, if appropriate, I recommend a series of IPL treatments because IPL helps with rosacea and, 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 fine epilating needle. I find it works beautifully, does not leave marks, and shrinks the charming and exuberant sebaceous lobules such that they are barely visible.
Great question about a frustrating condition. I hope my information helps.
Cynthia Bailey MD, Dermatologist
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