Fordyce spots on the penis are small, raised, pale or white-yellow bumps that appear on the shaft or foreskin. They are enlarged oil glands and are completely normal, non-contagious, and harmless. These spots are a common anatomical variation and typically require no treatment unless for cosmetic reasons.

What Are Fordyce spots on the penis?

Fordyce spots are small, painless, pale or white-yellow bumps that can appear on the shaft or foreskin of the penis. They are enlarged sebaceous (oil) glands that are not associated with any disease or infection. Unlike normal oil glands, Fordyce spots are located in areas where there are no hair follicles, which is why they become visible.

These spots are:

• Benign – They are not harmful or dangerous.
• Non-contagious – They cannot be spread through sexual contact.
• Common – Many people have them, often without noticing.

Fordyce spots usually don’t cause any symptoms, but in some cases, they may become more noticeable during puberty or due to increased oil production. No treatment is needed unless someone is concerned about their appearance.

Causes of Fordyce spots on the penis

Fordyce spots are not caused by an infection, poor hygiene, or sexual activity. Instead, they are a natural and harmless anatomical variation. Here’s what causes them:

1. Ectopic Sebaceous Glands:
   Fordyce spots are simply sebaceous (oil-producing) glands that appear in unusual locations — such as the shaft or foreskin of the penis — where there are no hair follicles. This is called an “ectopic” location.
2. Normal Development:
   These spots are present from birth but often become more visible during puberty due to increased hormonal activity and oil production.
3. Hormonal Changes:
   Androgens (male hormones) during puberty stimulate sebaceous glands, making Fordyce spots more prominent in teenagers and young adults.
4. Genetic Factors:
   Some people may be more prone to visible Fordyce spots due to genetic predisposition.

Important Note:
Fordyce spots are not caused by sexually transmitted infections (STIs), friction, or any underlying health condition. They are entirely benign and don’t require treatment unless for cosmetic concerns.

Symptoms of Fordyce spots

Fordyce spots typically don’t cause any symptoms beyond their visible appearance. Here’s what you might notice:

• Small, raised bumps: Usually pale, white, yellow, or slightly red.
• Size: Typically 1 to 3 millimeters in diameter.
• Location: Commonly found on the shaft or the foreskin of the penis, but can also appear on the scrotum or other areas.
• Texture: Smooth or slightly rough to the touch.
• No pain or itching: Fordyce spots are usually painless and don’t cause any discomfort.
• No discharge or inflammation: They don’t ooze, bleed, or become inflamed.

Because they don’t cause symptoms like itching, pain, or discharge, Fordyce spots are often discovered incidentally during routine examination or personal hygiene.

Diagnosis

Diagnosing Fordyce spots is usually straightforward and based mainly on their characteristic appearance. Here’s how it’s typically done:

1. Physical Examination:
   A healthcare provider will visually inspect the bumps on the penis. Fordyce spots have a distinct look—small, pale or yellowish, raised spots that are evenly distributed.
2. Medical History:
   The doctor may ask about any symptoms, recent changes, sexual history, or other concerns to rule out infections or other conditions.
3. No Tests Usually Needed:
   Since Fordyce spots are benign and harmless, further tests like biopsies or lab work are rarely necessary unless the diagnosis is uncertain.
4. Differential Diagnosis:
   The doctor may distinguish Fordyce spots from other conditions such as genital warts, molluscum contagiosum, pearly penile papules, or infections by considering the appearance and symptoms.

If there is any doubt, a dermatologist or urologist may perform a biopsy to confirm the diagnosis, but this is uncommon.

Are Fordyce Spots on the penis important?

Fordyce spots on the penis are generally not medically important because they are:

• Completely harmless — they do not cause pain, discomfort, or health problems.
• Non-contagious — they cannot be transmitted to others through sexual contact.
• Benign anatomical variations — normal oil glands located in unusual spots.

However, they might be important from a psychological or cosmetic perspective for some people who feel self-conscious or worried about their appearance. In those cases, consulting a healthcare professional can help reassure and discuss treatment options if desired.

In summary, Fordyce spots are normal and don’t require medical treatment unless they cause significant distress.

Differential diagnosis of Fordyce spots on the penis

When evaluating small bumps on the penis, it’s important to distinguish Fordyce spots from other conditions that may look similar but have different causes and implications. Here are some common conditions to consider:

1. Pearly Penile Papules
   • Small, dome-shaped, flesh-colored bumps usually arranged in rows around the corona (the rim of the glans).
   • Benign and normal, often confused with Fordyce spots.
2. Genital Warts (Condyloma Acuminata)
   • Caused by human papillomavirus (HPV).
   • Irregular, cauliflower-like growths that can be itchy or spread.
   • Contagious and require medical treatment.
3. Molluscum Contagiosum
   • Small, smooth, dome-shaped bumps with a central dimple caused by a viral infection.
   • Contagious and can spread to other body parts or people.
4. Lichen Nitidus
   • Tiny, shiny, flat-topped bumps that can appear on genital skin.
   • Usually asymptomatic but different texture from Fordyce spots.
5. Sebaceous Hyperplasia
   • Enlarged oil glands, similar to Fordyce spots but usually occur on the face.
   • Rare on genitalia but considered in differential diagnosis.
6. Folliculitis or Other Infections
   • Inflamed or infected hair follicles or glands, often painful or itchy, sometimes with pus.

If you notice changes such as rapid growth, pain, itching, discharge, or bleeding, it’s important to seek medical evaluation to rule out infections or other conditions. Fordyce spots themselves are benign and do not cause these symptoms.

Treatment of Fordyce spots

Fordyce spots are harmless and typically do not require treatment. However, if someone finds them bothersome for cosmetic reasons or feels self-conscious, there are some options to reduce their appearance:

1. No Treatment (Most Common Approach):
   Since Fordyce spots are normal and painless, most people choose to leave them alone.
2. Topical Treatments:
   • Some doctors may recommend creams containing tretinoin (a vitamin A derivative) to reduce the size of the spots.
   • Effectiveness varies, and these can sometimes cause skin irritation.
3. Laser Therapy:
   • Laser treatments (e.g., CO2 laser) can be used to remove or reduce Fordyce spots with minimal discomfort.
   • Usually done by dermatologists or specialists.
4. Electrodesiccation or Micro-punch Surgery:
   • Small, targeted procedures to remove spots.
   • Less common and reserved for severe cosmetic concerns.
5. Avoiding Irritants:
   • Gentle hygiene and avoiding harsh soaps or excessive friction can help keep the area comfortable.

Important:
Always consult a healthcare professional before attempting any treatment, especially on sensitive areas like the genital skin, to avoid complications or misdiagnosis.

Summary

Fordyce spots on the penis are small, harmless, pale or yellowish bumps caused by enlarged oil glands located in an unusual spot. They are a normal anatomical variation, non-contagious, and typically require no treatment. While they don’t cause symptoms or health issues, some people may seek cosmetic treatment for appearance concerns. Diagnosis is usually made by visual examination, and no serious medical intervention is needed.

Prof. Dr. Emin ÖZBEK

Urologist

Istanbul – TURKIYE