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 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. 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 skin and has large pores. To learn more about the types of rosacea you can download my free ebook on rosacea.
How do we 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 Redness Relief Kit
I also try to find another skin care product that will give us deep pore cleaning. This is tricky because a rosacea prone complexion can be very sensitive. Options include:
Benzoyl Peroxide Cream (best for oily rosacea prone complexions)
A retinoid such as prescription tretinoin cream or Retinol Night Cream. This is often the best choice. Most rosacea complexions can tolerate this option best and it also helps with antiaging skin concerns.
Know that both benzoyl peroxide and retinol are all potentially irritating products and it is an experiment to find out how often you can apply them to your skin.
Another great trick is to add a Clarisonic Skin Cleansing Brush to deep clean your pores. Pores contain an entire ecosystem of stuff and who knows what the stimulus for the sebaceous gland to grow in sebaceous hyperplasia. I like to keep the pores clean of odd interlopers such as demodex mites (yes, mites are common creatures living in our pores). A Clarisonic uses sonic oscillations to pump cleanser into the pores. I can tell a difference when someone starts using a Clarisonic. Normally pores that are clogged or have visible oily debris when I look with magnification are now clean and clear.
I follow the Clarisonic cleansing step that is used with the Calming Zinc Soap in my Redness Relief Kit with application of my Naturally Hydrating Pore Minimizing Toner. I then have patients apply the Green Tea Antioxidant Cream and complete the rest of their skin care with a moisturizer and sunscreen. (Hint, click those links to see the most popular options that my rosacea patients love.)
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. Now we have the new Soolantra Cream that has recently been approved for treating demodex mites in rosacea. Benzoyl peroxides may also help with demodex.
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 less rich foods and more vegetables. A summary of my recommendations can be found in my free ebook on Healthy Eating.
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. n 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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