I am 52, female, and have developed sebaceous hyperplasia on my forehead. My current dermatologist says there is nothing she can do for me that won't cause scarring. They are getting larger and very noticeable. I was diagnosed with Graves Disease 2 years ago and am on 5 mg of methimazole a day. Do you think this could have anything to do with it? I have read that electrocautery is successful in treating this condition. What treatment do you recommend? Please help!
Graves Disease Preventing Scarless Sebaceous Hyperplasia Treatment?
Doctor Answers 2
Sebaceous hyperplasia treatment
Sebaceous hyperplasia is an overgrowth of the oil glands around a hair follicle that creates a bump which typically has a slightly indented center, and the skin is somewhat yellowish in color in the bump. Many people have these. There is no cure as the hyperplasia continue to grow in new areas and the old ones continue to grow slowly over many years. They may be shaved off or treated with cauterization, or planed down by the careful application of a very strong acid. All of these treatments are maintenance and do not remove the growth entirely. Excision, or punch excision will leave a scar, but for a large one or irregular one, especially if this is the only one you have, such a removal is preferred so a biopsy can be sent to the laboratory for confirmation that it is benign.
Grave's Disease is associated with many dermatologic changes such as warm, moist, and smooth skin. The hair can become fine, and there is a characteristic nail change called Plummer's nails ( a distal upturning of the nail plate). However, as far as I am aware there is no association between Grave's Disease and sebaceous gland hyperplasia.
Fortunately, there are many excellent treatments for this condition. As you mention electrocautery is a simple, effective and inexpensive method. Another method is to place a tiny amount of 85% trichloracetic acid on these spots. The acid dissolves the fat of the sebaceous gland, but the collagen (protein) of the dermis resists the acid.
If you have other issues you might avail yourself of the more pricey choices including photodynamic therapy and laser. Two recent papers demonstrated the substantial benefit that photodynamic therapy ( Levulan followed by Blu-light). Also, the Smoothbeam laser, a type of diode laser leads to very good results.
If there is scarring from any of the above treatments, it is minimal.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.