What are these bumps on my face? More on lumps, bumps and moles.

I’ve received several questions like yours recently, so I’m thinking these must be on people’s minds. I’ve noticed that our patients tend to identify most bumps on the face as “acne.” While that’s a common cause for “bumps on my face” problem, it’s not always the case. What are these bumps, and what do we do about them? Below are the most common causes and treatments.

Note: Skin cancers can mimic pretty much everything below.  If a bump or texture change or sensitive area, doesn’t go away in 1-2 months, please see a dermatologist or your primary care doctor!!

What could these bumps on my face be?

1. Adult Acne
   This IS more common that you would think.  But acne comes and goes in cycles.  If a bump comes and stays, chances are it isn’t acne.  These can be plugged pores, white heads that get stuck, it’s very reasonable to try non prescription acne meds for a month or two.  But, if it isn’t getting better at that point, please see your doctor. more about adult acne here.
2. Enlarged Oil Glands (sebaceous hyperplasia)
   These are small 1-4 mm bumps in areas where our skin is or was oily.  They usually have a slightly yellowish color because they are full of oil and cells filled with fatty material.  Picking or squeezing these won’t work because there is deep root to them.  They just get irritated and reform.
3. Cosmetic Moles on the Face
   These can be flat or raised, and can be anywhere light from tan to black.  New moles are suspicious, especially if odd looking.  See your doctor, if you are not sure. More on moles here.
4. Lentigoes (sun damage freckles)
   These accumulate over time and are caused by genes and sun damage.  They can be prevented and removed…..see below.  These can also mimic a skin cancer, so if you’re not sure, ask your doctor.

What can I do about these bumps on my face?

1. Adult Acne
   If acne is more superficial (whiteheads and clogged pores), the non prescription medications often work, especially if supplemented by microdermabrasion every 4-6 weeks.  Vitamin A creams like retinol or the prescription tretinoin are helpful also.   The deeper, tender last a month type acne, will need a dermatologist’s care.
2. Enlarged Oil Glands (sebaceous hyperplasia)
   This requires a dermatologist.   These can be removed by flattening them with a tool called a hyfercator, scraping the base with a tool called a curette.  Then the deeper coil can sometimes be extracted.  A CO2 laser can be used by a dermatologist who is very experienced with CO2 lasers.  Maintenance is needed because some will reform, and new ones will grow.  Many of our patients come in every 2-5 years for a touch up.  The healing time is about a week.
3. Cosmetic Moles on the Face
   A plastic surgeon or dermatologist can remove these.  Most dermatologists do a good job and are less expensive.  There are several different methods, so please discuss with your doctor.  Insurance will not cover this usually.
4. Lentigoes (sun damage freckles)
   These can be improved with strict sun avoidance with sunscreen and hats.  Vitamin A creams (retinoids) and antioxidants also help.  If present for years, the sunscreen and creams won’t be enough.  Then a laser, usually either a Fraxel or an IPL,  done well will usually help.

Hope this helps,  Dr. I