You’re right SH girls ARE overlooked in a lot of skin care advice.  So glad you brought it up, and thank you for writing.

What is it?  Sebaceous hyperplasia (SH) is an overgrowth of the natural oil glands we have on our faces.  Most common in those with oily skin types.  The good news is that most people with SH don’t wrinkle much due to the abundance of natural oil secretions.  The bad news is that it causes texture problems like 1-4 mm whitish, or yellowish bumps, larger pores and texture problems.

What to watch out for….

Skin cancers can mimic SH so be sure you see your primary care doctor or a dermatologist.  And please don’t self diagnose (yes…even with the web)!  Many skin cancers, especially when they are early, don’t look like the photos you are seeing on the web.  We like to catch skin cancers early because less surgery is needed, and there is less risk of dying (melanomas especially).

What you can do to limit or improve SH

Oil production is largely genetic but there’s hope below:

  • Consider discussing with your derm taking spironolactone (prescription and only if female).  It lowers your male hormones that we all have a little, and usually decreases oil production.
  • Botox/dysport injected into an area of SH help control it.  This works best for areas where we might use Dysport/Botox already… like SH right in the area of the frown lines (11s), and the center area of the chin, for example.
  • Try an low glycemic index diet.  There have been recent studies showing that a high glycemic index diet contributes to acne, and possibly oil production.  Do this for at least 8 weeks before deciding if it helps.
  • Low dose Accutane works, but is not available usually in the U.S.
  • For skin care, try keeping your skin “just this side of dry”.  Try the MadisonMD glycolic cleanser for oily skin. Try using the hyaluronic acid gels instead of moisturizers, and retinol at night.  And try the powder based sunscreens like the Colorescience and the Shisheido oil blotting papers for day.
  • In our office, we flatten/shrink SH with a hyfercator (RF energy), small surgical currettes and comedone extractor.  It takes a week to heal, and looks awful for that week, but many of our patients can go a year or two between touch ups.  We also sometimes use a CO2 laser.

Hope this helps,

Dr. Brandith Irwin


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