Sebaceous glands

[Geoswife]

Hello,
I am a 34 yr old female who has had acne on my face, back and shoulders for over 20 years.  Although the breakouts have gotten less and less, I do still breakout around the time of my period and my skin is still incredibly oily.  About 3 years ago, I noticed "fordyce" spots on my lips.  They are tiny white spots you can see when you pull the skin of your lips tight.  My top lip is affected more than my right, but the bottom has quite a few too.  My lips look lighter in the areas of greatest number.  Also around the same time I noticed the"fordyce" spots on my lipds, I started noticing what looked like close to the same thing on my shoulders and upper back area.  I do have some scarring there and atrophy from past acne, but these tiny white spots look remarkably like the same "fordyce" spots on my lips when I pull the skin tight.  They are too numerous to count, not just one or 2.  Is it possible to have "fordyce" spots on your shoulders and back?  You can see them without pulling the skin tight, but when you do pull the skin tight it looks just like the fordyce spots.  They look like they are inside the skin and not sitting atop.  I know this is a weird question.  As I said before, I have incredibly oily skin and I think this might be enlarged sebaceous glands showing through my skin.  I would like to know if this is even possible.  Thank you.

[Bhupinder Kaur, MD]

Hello,
Sorry eplied toan earlier question first. From the symptoms it can be sebaceous hyperplasia, folliculitis or lichen nitidus. Lichen nitidus is characterized by asymptomatic, flat-topped, skin-colored micropapules. I suggest you to get an evaluation done from a dermatologist. Treatment is diagnosis specific and hence diagnosis needs to be confirmed.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Bhupinder Kaur, MD]

Hello,
From your post I can understand that it is localized hair loss due to nicking of hair. If there is no damage to the hair, then they should grow back. But if it is diffuse hair loss, then telogen effluvium needs to be ruled out. . It is nonscarring alopecia characterized by diffuse hair shedding, often with an acute onset. There is a chronic form also which persists for a longer duration and starts with insidious onset.

I suggest you to get an evaluation done from a trichologist. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Geoswife]

Okay, you must think I am an idiot.  I mean my top lip more than my BOTTOM lip!  

[Geoswife]

I meant my top lip is affected more than my right with the fordyce spots.  Sorry for the mistakes.  Typing too fast, I guess.  My only other guess about my spots on my shoulder could be follicular macular atrophy, and I do think I might have some of that too from past acne, but I mainly am concerned with the tiny white spots I can see through the skin of my shoulders and upper back that also look a lot like fordyce, although I haven't been able to find any info about them being found there, only on the lips, gums, and genitals.  Thanks again.