SEBACEOUS HYPERPLASIA From: A Huntley A colleague of mine asked for treatment options for treatment of facial papules of sebaceous hyperplasia. Suggestions? From: Daniel.Perrenoud@chuv.hospvd.ch (Daniel Perrenoud) Few lesions can be treated with cryotherapy. If the lesions are numerous, and if non contra-indication, you can try a low dose isotretinoine (2.5 mg/day). If the condition is severe, begin with 10 mg/d and reduce progressively the dose. ============ From: KSmithDerm@aol.com ultrapulse CO2 laser. Retin-A seems to slow the growth of them, but won't get rid of existing lesions. ============== From: MDKR42A@prodigy.com (DR HOWARD L SOFEN) As long as you can deal with the side effect issues of isotretitoin, low dose s of oral Accutance (20 mg/day) for one month has proven very effective in many of my patients ============== From: Reviva@aol.com I have had great success using CO2 laser vaporization of these lesions. Patients have universally been very pleased and have had no problems =============== From: rdrugge@netaxis.com (Rhett Drugge, M.D.) Sebaceous hyperplasia is a disease of the hair follicle characterized by a voluminous overgrowth of a single follicular sebaceous structure. Destruction of the offending hair follicle by a simple epilation technique involving fine needle low current electodessication works well in my hands. ============ From: mluu@erinet.com (Mychael Luu, M.D.) Besides Ed&C and excising them, anyone doing bichloroacetic acid or TCA on these lesions? If so, what's the lowest concentration that gives the best cosmetic result? ======== From: "L.J. Gregg" <73477.361@compuserve.com> A great lo-tech means of destroying the superficial part of a seb hyperplasia isto take a 30 gauge metal hub needle and attach to hyfrecator with a needle adapter(available form derm supply co's) and using a low setting lightly desiccate the surface with the tip of the needle inserted. There is no need tocurrete and if you keep your needle tip superficial and current low the scarringis minimal. ============== From: Jerry Eisner I've had good luck freezing them with LN2. =============== From: "Patrick J. Condry" Regarding sebaceous hyperplasia, treatment with Retin A Cream .025% has given excellent results for those sho balk at surgery. Time of treatment to near clearing averages 12 to 18 months but improvement begins in 2 months. Also light electrodessication. The latter is cheaper and more available than laser. ============== From: "Mark Naylor" My favorite treatment for sebaceous hyperplasia is liquid nitrogen--which can be used to induce a kind of surgical atrophy of the type seen with nose surgery--in this case therapeutic instead of a side effect. Low dose oral accutane 10-20 mg/day can cause significant shinkage of the lesions, but is temporary (not a judicious use of Accutane in my opinion). I don't know if there is any information on larger doses as used in acne treatment--e.g., 1 mg/kg x 4 months. I would be interested if anyone out there had experience using Accutane in this manner for attempt to induce permanent remission of sebaceous hyperplasia.