How to Treat Sebaceous Hyperplasia, According to Derms

Don't Try to at Home

As tempting as it may be to attempt one of the Internet's many DIY treatments, both Levin and Maiman strongly advise against doing so.

“Unfortunately, there are no effective treatments at home,” Levin says. “Treating sebaceous hyperplasia effectively requires in-office procedures in order for the results to be noticeable,” Maiman adds. “A brief Google search of my own did result in purported at-home remedies... but I can tell you that this is of little to (more accurately) no benefit.”

...Unless You Opt for Prescription-Strength Retinoids

The one exception to the ineffective-at-home rule is prescription-strength retinoids like tazarotene, which Maiman says can potentially prove beneficial. “Prescription-strength retinoids are sometimes employed because they may help prevent the formation of new lesions by speeding cellular turnover, however, they are not generally capable of resolving existing lesions,” she says.

Always Use Sun Protection

Since sun exposure plays a major role in the formation of sebaceous hyperplasia, Levin says that daily sun protection is a must. (It ought to be mentioned, though, that that’s the case for everyone, as sun exposure can lead to a whole array of complexion concerns.)

Ask Your Dermatologist About Oral Isotretinoin

Visiting a dermatologist for your sebaceous hyperplasia concerns can prove beneficial for multiple reasons: They can either recommend an in-office treatment or prescribe medication. If the latter occurs, Levin says that oral isotretinoin (aka Accutane) can decrease the size of sebaceous hyperplasia. “But once discontinuing isotretinoin, the sebaceous hyperplasia can recur,” she warns.

Do Laser Therapy

Maiman says that many lasers have been used in the treatment of hyperplasia, ranging from vascular lasers such as PDL (pulsed dye laser) and the 1450-nm diode laser to fractionated ablative resurfacing lasers like Erbium: YAG and CO2 (carbon dioxide). 

“Responses to these modalities range from complete elimination of lesions to flattening,” she says. Since there are so many lasers to choose from, she says that the best way to determine the right laser for your complexion concern is to sit down with your dermatologist to evaluate your skin. 

Consider Chemical Peels

Maiman says that chemical peels, like trichloroacetic acid (TCA) in a concentration of 70 percent performed monthly for a period of four to five months, can prove to be effective in the treatment of sebaceous hyperplasia. However, it’s important that the concentrations are chosen with the utmost care. “To mitigate potential complications, lower concentrations, such as of 20 percent to 30 percent, can be used. However, this would be expected to produce less robust results and thus require more treatments,” she says.

While chemical peels can be effective at lessening the appearance of sebaceous hyperplasia, Maiman points out that they can also lead to side effects such as burning, itching, tingling, peeling, and redness. 

Get Sebaceous Hyperplasia Removed With Electrocautery

Many dermatologists will recommend electrocautery—including Levin and Maiman. “I prefer to treat with electrocautery as this is well-tolerated, effective, quick, and [has] minimal risks,” Levin says, though she notes there can be a recurrence. Nevertheless, it’s a proven treatment (however short-lived) for sebaceous hyperplasia. 

“This procedure involves the use of an electrical cautery needle to burn the lesions using thermal energy induced by the electrical charge it creates,” Maiman says. “In most cases, a small curette is then used to scrape away the lesions. In other cases, the practitioner may elect to leave the lesions alone. In either case, the patient walks out of the office with a small superficial burn at the treatment site.” Within a day or two of treatment, Maiman says that the burn will form into a scab which will then fall off within five to 10 days. 

The only downside is that, depending on the size of the initial breakout, Maiman says that multiple treatments may be required to manage the sebaceous hyperplasia—potentially at monthly intervals. As far as pricing for this treatment goes, Maiman says that it’s highly variable based on the lesion site, the practitioner, and the area of the practice, but you can expect to pay as low as $50 and as much as $750. 

Freeze Bumps With Cryotherapy

Cryotherapy is less efficient, but also a little less serious, than cautery. Maiman tells us that cryotherapy utilizes liquid nitrogen to kill sebaceous glands via freezing. “Much like electrocautery, the result is a small burn (although in this case from extremes of cold temperatures), that turns into a scab and flakes off over the ensuing days,” she says. “[Though] cryotherapy tends to be less efficacious to electrocautery, comparatively, and usually necessitates multiple treatments for complete removal.”

Don't Forget Aftercare

Chemical peels, laser therapy, and prescription retinoids can help heal your sebaceous hyperplasia--but don't forget that they may require aftercare. Be sure to take care of your skin so that it can properly recover. You'll likely need to avoid the sun even more than usual, and opt for stronger sun protection than you typically use. Be sure to consult with your practitioner about the right aftercare for the treatment you choose.