Is this sebaceous hyperplasia or something different? What is the best treatment? (photos)

Question

Bumps and uneven texture started several years ago and has spread to face. CO2 fractional ablative laser and tretinoin offered no improvement. Biopsy shows sebaceous hyperplasia although several doctors have said they have never seen it present this way. Any idea what this is and how to improve the skin’s appearance.

Jason Emer, MD · Answer

This is correct and needs lasers, desiccation and long term skin care/peels/facials.I would suggest a combination approach of 
1) skin care with products and PRP/microneedling
2) PDT light therapy few times a month with growth factors
3) laser treatments like clear and brilliant regularly and a few times a year Fraxel, Viva, Co2/Erbium
4) Sculptra injections a few times a year for collagen production with fillers like juvederm/restylane/belotero/radiesse/bellafill
5) thermage/ultherapy for yearly skin tightening with or without PDO or cone based instalift threads for lifting
6) botox every 2-3 months to stop movement lines and prevent lines at rest
7) deep microneedling RF like Fractora/morpheus8 for tightening of the skin
Best, Dr. Emer.

Raffy Karamanoukian, MD, FACS · Answer

Our treatments use combination therapy to improve the epidermis and dermis for most deep scars. The options available for acne scars depend on the character of your scars, in terms of topography and contour. We see atrophic and hypertrophic acne scars, as well as scars that have hypo and hyperpigmentation. We begin each scar evaluation with an assessment of scar quality and subtype. 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 decide whether early subcision should be started.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Mats Hagstrom, MD (license on probation) · Answer

work with dermatologist to get your condition under control the best possible. You may not be able to get this treated completely but some improvement can probably be had with the correct medications.  I believe your biopsy result is correct.  Work with top-notch dermatologist.  If you live next to an academic medical center you may want to consider an academic dermatologist.  Best, Mats Hagstrom MD

Is this sebaceous hyperplasia or something different? What is the best treatment? (photos)

Answers (3)

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