Are these raised, white and wrinkled marks hypertrophic scars or sebaceous hyperplasia and what is the best procedure? (photos)

Question

I have raised, white and wrinkled marks on my nose, chin, back, chest and pubic area. I don't know what type of scar it is. What kind of treatment method should be preferred? How much success is achieved?

Anna Chacon, MD, FAAD · Answer

Thank you for sharing your photos and describing where you’re seeing these changes. I know this can be confusing—and understandably frustrating—especially when similar-looking bumps appear in multiple areas of the body.

Based on the appearance in your photo and the locations you mentioned (nose, chin, chest, back, and pubic area), these do not look like hypertrophic scars.

Why these are unlikely to be hypertrophic scars

Hypertrophic scars typically:

Form only after clear skin injury or surgery

Are pink, red, or firm, not white

Stay confined to the exact area of trauma

The lesions you’re describing and showing appear raised, pale/white, soft, and clustered, which is not typical for hypertrophic scarring.

What these most likely represent

The findings are more consistent with benign oil-gland or keratin-related conditions, such as:

Sebaceous hyperplasia – enlarged oil glands that appear as small white, yellow, or skin-colored bumps, often with a soft or slightly wrinkled surface

Milia or keratin-filled cysts – tiny white bumps caused by trapped keratin

Follicular prominence or textural change in oil-rich or hormonally sensitive areas

These conditions are harmless, but they can be persistent and cosmetically bothersome.

Best treatment options

The most effective treatments depend on the exact diagnosis and skin location, but commonly include:

Electrodessication or cautery – very effective for sebaceous hyperplasia

CO₂ or Er:YAG laser – helpful for multiple lesions and texture refinement

Manual extraction (in select cases, such as milia)

Topical retinoids – help prevent recurrence by normalizing cell turnover, though they do not remove existing raised lesions

Expected success

Individual lesions can usually be treated with good cosmetic improvement

Recurrence is possible over time, especially with sebaceous hyperplasia, because oil glands remain active

Results are typically much better than scar treatments, since this is not true scarring

Important reassurance

Because these lesions appear in multiple body areas, this supports a glandular or follicular cause rather than scarring. Treatments aimed at scars (like steroid injections) would not be appropriate and could worsen the appearance.

Bottom line

These raised white marks are far more likely sebaceous hyperplasia or related benign skin growths—not hypertrophic scars. Procedural treatments such as electrodessication or laser offer the best results, with good cosmetic improvement and low risk when done correctly.

You’re asking the right questions—and the good news is that this is a treatable and non-dangerous condition, even though it can be persistent.

Nelson Lee Novick, MD · Answer

Photos are not the ideal way to diagnose, but from what can be seen the appearance, size, shape and distribution of the bumps is very consistent with papular acne scars, which are typically seen on the chin and nose, but can be on the back and chest, as well. They are much like small hypertrophic scars. Intralesional anti-inflammatory injections, Scalpel Sculpting and light electrocautery all may be used to treat this condition, and I typically try a test area of each type of treatment to see which works best for a particular patient.  Most often, in my experience, light electrocautery excels as the treatment of choice and numerous sites can be treated in one treatment session.  Overall, there is typically a sixty to eighty percent overall improvement in appearance. 
No doubt in your quest for treatment you will be hawked all kinds of expensive, light and energy-based gizmos. But, you would be wise to keep in mind that the reality is that the hard science to support the use of these "bells and whistles" devices lags woefully behind the heavy marketing and social media buzz that surrounds them. You would therefore also be wise to consult with a board certified cosmetic dermatology expert. And, one final word to the wise; don't go into any consultation requesting any particular treatment that Dr TikTok or your favorite skinfluencer has been pushing because to your later disappointment, frustration, and financial loss, you were likely to get what you asked for. Hope this helps and best of luck.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis. We see atrophic and hypertrophic scars, as well as scars that have hypo and hyperpigmentation. Our main concern is rebuilding collagen and that is why we use a HIDEF protocol that includes combination therapy. Morpheus 8, scar subcision, fibrous release, fractional laser, CO2 laser, Thulium laser, PDL Vbeam laser, and fractional resurfacing can be used in addition to TCA Cross and chemical peels to further improve skin. Patients should start Melarase AM and Melarase PM for active hyperpigmentation. Always begin with a consultation to discuss the best treatment options for your type of skin. .

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Are these raised, white and wrinkled marks hypertrophic scars or sebaceous hyperplasia and what is the best procedure? (photos)

Answers (3)

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