Skin care - Fordyce spots granules - disease - lips - genitalia - areolae

Fordyce spots granules → Treatment and cure of fordyce spots disease → White bumps on skin, lips, fingernails, teeth, tonsils and genitalia → Nevus pigmentosus

What are fordyce spots (granules)?

Fordyce spots are sebaceous glands without connection to hair follicles.

They are benign, painless, small, pale, white or whitish yellow, raised bumps of 1-3 mm diameter appearing on the the vermilion region of lips, inside of the mouth, aureole or genital area(not a disease).

These granules are named after John Addison Fordyce, an American dermatologist.
Fordyce spots are sebaceous glands. Sebum may be discharged from them.
Sebaceous glands are normally connected to the pore in hair follicle and lie in the skin without showing bumps.
However these fordyce granules are ectopic glands and have no connection to hair follicles and open out directly.
These granules are out of place glands (ectopic) as instead of being at level with skin, they appear as small raised bumps usually on lips, nipple, penis and labia.

Fordyce spots disease prevalence

Though this granules condition is seen in both men and women, it is very common in men and about 80% of them have it.
The incidence is found to get reduced with old age, as is the case with other sebaceous glands.
fordyce glands are found in newborns and in the children though they are present they are dormant.
These granules become active after reaching of puberty as in the case of other sebaceous glands in the body.
It is believed that there is a genetic link to this 'disease'.
It is an idiopathic disease condition arising from unknown or an obscure cause or arising spontaneously.
Fordyce granules is not a contagious disease or caused by pathogens.
However if the lesions are squeezed and skin gets damaged, infection and disease of skin may result.
They can appear as single lesion or as a cluster on the affected area.

Though no particular treatment is necessary, the fordyce bumps are of cosmetic concern.
Men and women are known to go into depression fearing that, it may be some form of sexually transmitted disease (STD), genital warts or cancer.
Sometimes fordyce spots are mistaken for pearly penile papules (Hirsuties papillaris genitalis). However pearly penile papules have nothing to do with sebaceous glands and are just skin overgrowth and are benign.
They spoil the aesthetic appearance of the affected persons if they occur on lips or genitalia.
Fordyce spots granules disease have been successfully treated with topical application, laser therapy and electro-desiccation.

Fordyce spots on the lips (enlarge)

Treatment for dry skin

Home › Homemade treatments › Dry skin treatment

Treatment of dry skin condition is very important as, if neglected, it can lead to chronic dermatitis. For dry skin treatment, the basic problems in hydration of stratum corneum layer of epidermis and in the production of sebum have to be addressed.

The process of hydration makes the stratum corneum layer hold sufficient water to make the skin supple and healthy.

The sebum produced by the sebaceous glands also fills up the intercellular spaces within the stratum corneum and adds to the smoothness and glide of the epidermis. Any disturbance or damage to the above processes leads to dry conditions known as xeroderma requiring proper care and corrective measures.

Balanced food for dry skin treatment

When any nutritional deficiency is experienced by the body, sebum production, stratum corneum hydration and shedding of dead cells (desquamation) are affected.

Correction in sebum production and dehydration starts with eating nutritious food.

Eat food rich in proteins of both plant and animal origin.

Food must contain complete protein (containing all the essential amino acids).

This can be achieved by adding some quantities of animal sources of proteins like egg, fish, dairy products and lean meat to your diet.

Avoid taking excess of sugars, sugar preparations, soft drinks, sweets and other junk food.

Avoid saturated fats as much as possible.

Include polyunsaturated and monounsaturated fats moderately.

Your food must contain essential fatty acids, omega-6 fatty acid and omega-3 fatty acid (olive oil, fish and fish oil) in required proportions and quantities.

Take lots of fibrous food to avoid constipation, as toxins released by constipated material in bowl can cause dry skin and other problems requiring treatment.

Eat food rich in micronutrients like dietary minerals and vitamins, as their deficiencies can cause dehydration and reduced sebum production.

Take supplements if necessary to bridge the nutritional deficiencies.

Drink plenty of water to keep the epidermal and body cells sufficiently hydrated.

Up to one liter of safe drinking water is recommended for every 20 kg of body weight per day.

Cut down on smoking and alcohol as both are found to aggravate the dry condition.

Nicotine and alcohol constrict capillaries in the skin and cut down its blood supply.

Caffeine and alcohol, having diuretic effect, remove water from the body and cause further problems.

Treat dry skin by protecting it from environmental factors

Protect yourself from long exposure to sun, strong winds, cold weather and rain as such exposures can further disturb your natural protective epidermis layer. Sun exposure for a long duration dehydrates the stratum corneum and causes oxidative damage to epidermis. Avoid exposure to strong winds, hot winds and cold climate for longer duration as the water in the stratum corneum is very quickly lost into the atmosphere.

If you are using air-conditioning or room heater, the enclosed air tends to become very dry. Install a room humidifier to protect your epidermis from further dehydration. Getting drenched in rain or swimming in a pool, though soaks up your skin initially, affects the lipid stacking holding the moisture in stratum corneum leading to dehydrated epidermal conditions. For treatment of xerosis of hands and restoration of moisture use of gloves in kitchen chores and washing will help.

Baths and showers

Take bath with lukewarm water; bathing with hot water or cold water further aggravates the dry skin condition.

Do not take bath more than once a day. Make the bath as short as possible.

Avoid using chlorinated water for bath as chlorine further removes moisture from epidermis.

Use only neutral pH bath soaps. Do not use alkaline soaps as they destroy the acid mantle of the epidermis.

Soon after bath apply moisturizers to hold back the moisture.

Harsh chemicals and cosmetics

May be your skin problem is due to cosmetics you use. Avoid cosmetics with chemicals as your problem may be due to some of the ingredients in them. Only go in for cosmetics specially made for dry conditions and prefer cosmetics containing natural products and herbal products. For treatment of dehydrated epidermis use cosmetics containing natural products like aloe vera, olive oil, honey, calendula, oatmeal, tea tree oil, beeswax, and almond oil, which are soothing and beneficial for the skin.

For dry skin treatment, exfoliate, cleanse and moisturize

Cleanse your face daily to remove makeup, grime, scales and cell debris. This may be preferably done before going to bed. For treatment of dry skin, moisturize your face every day before going to bed and also when you go out. Exfoliate at least once a week as skin desquamation process remains disturbed in dehydrated condition. Apply sunscreen to protect from further damage by UV rays in sunlight.

For treatment for dry skin change lifestyle

Have regular food habits as our body is naturally tuned for it. Erratic food habits not only lead to dehydration of epidermis but many other serious problems. Sleep sufficiently, as much of the cellular repair process takes place during sleep. Exercise regularly to tone up the muscles and increase blood circulation. Good blood flow repairs the damages to skin and increases the cell division for replacing the damaged stratum corneum with healthy and hydrated one.

Treatment of skin ailments and other diseases reduces dry conditions

Do not neglect ailments like itch without visible rash, eczema, dermatitis, contact dermatitis, seborrhea, open sores and cuts from scratching and psoriasis. Start immediate treatment by consulting a dermatologist to avoid further aggravation of dry condition. For treatment of dry skin due to hypothyroidism take hormone supplements only under the advice of qualified health care consultant.

Treatment for diabetes, cures the dry skin condition arising due to chronic diabetes. For treatment of dry conditions due to hereditary diseases like ichthyosis, consult a dermatologist who may prescribe medication to alleviate the condition. Do not neglect dry skin, as over a period the condition worsens with bleeding and infection of the skin requiring prolonged treatment.

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Current topic: Dry skin treatment

Skin care -Skin histology

Skin histology shows two main regions namely epidermis and dermis.

Skin histology

Skin consists of squamous keratinised outer layer called epidermis and fibrous and elastic connective tissue called dermis.

The dermis is connected to underlying subcutaneous connective tissue layer called hypodermis (primarily made up of adipose tissue).

Skin histology: epidermal layers

The epidermal cells are arranged into four/five distinct layers.

1. Stratum basale layers
   Stratum basale, also known as stratum germinativum, contains dividing stem cells.
2. Stratum spinosum The cells have spiny projections in this layer which is made up of several cell layers.
3. Stratum granulosum
   Keratohyaline protein granules are found in cells in Stratum granulosum
4. Stratum Lucidum (histology image) Stratum Lucidum layer is found only in thick skin like palm.
5. Stratum corneum layers Stratum corneum layer consists of layers of dead cells (corneocytes) containing keratin.

Skin histology: dermal layers

Dermis is made up of two layers.

1. Papillary dermis
   Papillary dermis is the upper layer of dermis and is intertwined with ridges of epidermis.
2. Reticular dermis
   Reticular dermis is found beneath the papillary dermis and is packed densely with collagen fibers.

Skin histology - specialized cells of epidermis

1. Melanocytes
   Melanocytes are located in the bottom layer of epidermis (stratum basale) and skin pigment is produced by them.
2. Langerhans cells
   Langerhans cells are dendritic cells (with immune function) with clear cytoplasm having antigen-presenting function.
3. Merkel cells
   Merkel cells are small cells associated with nerve endings, found in stratum basale, at the bottom of seat duct ridges.

Skin histology - image of layers

A. Epidermis layers B. Dermis layers C. Subcutis/ Hypodermis D. Blood and Lymph Vessels E. Stratum Germinativum 1.Hair Shaft 2.Stratum Corneum 3.Pigment Layer 4.Stratum Spinosum 5.Stratum Basale

6.Arrector Pili Muscle 7.Sebaceous Gland 8.Hair Follicle 9.Papilla of Hair 10.Nerve Fiber 11.Sweat Gland 12.Pacinian Corpuscle 13.Artery 14.Vein 15.Skin sensory Nerve ending (for touch) 16.Dermal Papillary 17.Sweat Pore

Skin histology: epidermal appendages

1. Hair follicles
   Hair follicles are tubular invaginations towards the bottom of which are processes of cell multiplication, growth and differentiation yielding a cylindrical column of dead cells with keratin deposit, emerging as hair.(see histology image) Small packs of smooth muscle cells (arrector pili) are connected to the connective tissue of each hair follicle.
2. Sebaceous glands
   Sebaceous glands are associated with hair follicles with function of secretion of sebum.
3. Skin histology: sweat glands
   a)Ecrine sweat glands
   Ecrine sweat glands are the common sweat glands and are distributed throughout the body. b)Apocrine sweat glands
   Apocrine sweat glands are found on circumanal region, axilla, external genitalia and areola.

Epidermal layers Melanocytes Hair follicleSkin histology studies give us clear information in knowing its functions.

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Skin care - Skin hydration - Skin desquamation - Stratum corneum

Skin hydration and skin desquamation are continuous processes in stratum corneum to keep it healthy.

Stratum corneum is the outermost layer of epidermis which in turn is the outermost part of skin.

Continuous hydration of the stratum corneum and continuous desquamation of dead skin cells is necessary to keep the skin soft, supple and smooth. Any damage to these processes of hydration and desquamation results in scaly, rough and dry skin leading to many problems and diseases.

Skin hydration and stratum corneum

There is continuous production of cells at the lowermost layer of epidermis, basal layer.
The maturing cells move towards the outer most layer of epidemis (stratum corneum).
Here the cells die (now called corneocytes) and losing cellular structures and nuclei start the hydration and desquamation processes.
These corneocytes are flat and hexagonal in shape and are filled with keratin proteins ,which are hygroscopic in nature.
These keratin proteins are enveloped by lipids and proteins.
The shape of the corneocyte cells as well as structural orientation of the keratin proteins gives strength, hydration and pliability to stratum corneum.
Depending upon the area, 10-30 tiers of corneocyte layers can be found on the skin.
Desmosomes are protein bridges which connect the corneocytes, the loss which can cause desquamation.
Stacked Lipid layers surround the corneocyte extra cellular spaces.
The resultant stratum corneum structure of skin, functions as a natural physical and water-retaining cover helping skin hydration which is vital for desquamation.

Stratum corneum breakdown and skin hydration

Simultaneously during the movement of viable cells towards stratum corneum, proteins present in granular cell layer clump to form granules and get filled by filaggrin protein.
Keratin proteins form complexes with filaggrin proteins and resist proteolytic breakdown.
On reaching stratum corneum, enzymes breakdown filaggrin-keratin complex, for skin hydration and desquamation, with keratin remaining on the inside of the corneocytes and filaggrin occupying the outside.
When water content of the stratum corneum decreases, specific enzymes, proteolytic in nature, are released to breakdown filaggrin to its basic components, amino acids.
The amino acids along with salts, urea and lactic acid present in the stratum corneum, form natural factors of moisturizing, by attracting and holding water by their hygroscopic action.

Skin desquamation and stratum corneum

Apart from skin hydration, desquamation is an important process going on in the stratum corneum for the health and smoothness of skin.
Desquamation is again an enzymatic process in which the inter-cellular protein bridges of desmosomes are dissolved for shedding of the outer most layer of stratum corneum.
With the loss of protein bonds between them, cornecytes separate and their desquamation takes place.
These proteolytic enzymes, located in inter-cellular space, function well in presence of good hydration of stratum corneum.
In absence of hydration, these enzymes of desquamation do not function resulting in dry, thickened and scaly epidermis.
If the balance between the production of corneocytes and desquamation is upset, as in the case of many skin diseases and conditions, dry scaly skin is caused due accumulation of dead cells on its surface.

Intercellular lipids in skin hydration and desquamation of stratum corneum

The intercellular lipids are products of cell degradation of granular skin layer.
They surround the corneocytes and forming into stacks, they incorporate water into stratum corneum structure and accomplish its hydration.
The cell membranes also release lipids on degradation.
These lipids are mostly made up of sphingolipids (derived from the aliphatic amino alcohol sphingosine), fatty acids and cholesterol.
Ceramide is a major constituent of these lipids forming the stacked structure to trap molecules of water for epidermis hydration and desquamation.
These stacked lipids surround the corneocytes and form an impermeable barrier for moisture leaching out from the moisturizing factors formed naturally.
With old age inter-cellular lipids decrease sharply leading to reduced desquamation and dry scally epidermis conditions.

The water content of the outer epidermis (stratum corneum) fluctuates with environmental humidity.
There is a sharp TEWL (transepidermal water loss) in hot or cold dry air affecting the skin hydration and also desquamation of stratum corneum.

Skin care - Skin physiology - Function of epidermis

Physiology of skin - Function of epidermis → function of dermis

Human skin has two important and main layers, dermis and epidermis with different physiology and function.

Epidermis, the outermost layer of skin, functions as a chemical and physical barrier between the interior of the body and external environment.

Its physiology and function include secretion, excretion, insulation, protection and pigmentation. Dermis is the deeper layer and its main action is to provide structural support to the skin.

Skin physiology: function of epidermis in protection

The main action of bottom most layer of epidermis, which lies adjacent to dermis, is the cell multiplication.
The new cells progressively move towards the outer layers, simultaneously maturing and differentiating.

The physiology and shape of the cells also changes and by the time they reach the top most layer, they are flattened, lacking nuclei they become lifeless.
At this stage they are called corneocytes and are filled with keratin proteins capable of water retention and also lipids.
The outer most layer, which contains 10-30 layers of stacked corneocytes, is called Stratum Corneum and is semi-permeable, becoming a barrier between the interior of the skin and external surroundings.
Epidermis physiology also includes functions as physical barrier protecting the internal tissues from bacterial invasion, physical abrasion and ultraviolet rays.

Skin physiology: function of epidermis in thermoregulation, excretion and sensation

In hot weather, skin physiology is tuned to produce sweat.
Sweat on reaching the epidermis surface, evaporates cooling the surface by the latent heat of evaporation.
In response to low temperatures, sweat is decreased and blood flow to the skin is increased to maintain the temperature.
Besides removing excess water and temperature control, the sweating process also removes smaller quantities of waste salts and many organic compounds.
The nerve fibers (Merkel cells) reach upto the outer most layer of dermis and stratum basale and pick up sense signals of touch, temperature, pain and pressure.

Skin physiology: function of epidermis in immunity

Certain specialized cells of epidermis, Langerhans cells, have immune functions.
Though these cells originate from bone marrow, they migrate to epidermis layers.
These dendritic cells have Birbeck granules.
They interact with white blood cells (helper T cells) and help in destroying the invading organisms.
Apart from detection of foreign bodies, Langerhans' cells, have a major role in the physiology of allergies.

Skin physiology: function of epidermis in skin coloration

The black-brown melanin pigment, is produced by the melanocytes present in basal layer of epidermis.
Melanocytes comprise up to 10% of the cells in epidermis.
skin layers

Epidermis and dermis
The slender projections of melanocytes extend to keratinocytes and help in the transfer of melanin granules.
Melanin granules apart from imparting color to skin also protect it from UV rays.
Melanin granules clump on the surface side of keratinocytes, protecting the nucleus from UV light and genetic damage.
The scattering and absorbing of Uv rays by melanin protects the internal cells by blocking free radical formation and damage.

Thus with multiple functions, epidermis plays a major role in skin physiology.

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Skin care - What causes dry skin

Causes of dry skin → What is dry skin? → Moisturizers → Homemade face moisturizer recipe → Oily epidermis treatments
Dry skin causes can be either external or internal, which have to be addressed specifically for relief. There are many factors and causes inducing dry skin condition and some of them are dietary deficiencies, weather elements and sun exposure, frequent baths and harsh soaps, hormonal deficiencies, genetic factors and skin diseases.

The causes of dry skin can be corrected easily by removing the affecting factors.
However the internal factors, especially diseases, take long term medical management.

Dry skin causes: dietary deficiencies

This condition can result very easily when there is insufficient intake of water or dehydration of body cells.
The deficiencies of B-complex vitamins and vitamin A have been found to be causes of dry skin.

Riboflavin deficiency leads to cracks in the corner of the mouth.
Higher amounts of alcohol, caffeine and fried food are likely causes of dry skin.
Irregular food habits and smoking lead to chronic xeroderma.

Dry skin causes: weather and sun exposure

Winter leads to xeroderma condition as the epidermis loses water due to lowest humidity levels prevailing in winter.
There is a mistaken notion that winter with its cold conditions is rich in moisture; but the reverse is true.
Winter winds are dry and whatever moisture in it is already deposited as snow.
A good example is the refrigerator, wherein if a plump tomato is left in circulating air, it appears shriveled after some time due to loss of water.
Similarly hot air can also be devastating for the epidermis, robbing it of its moisture as it happens in desert regions.
Pollutants, smoke, dust and high levels of ozone can be causes of dry skin condition.
Lack of balanced diet along with malnutrition results in xeroderma.
Direct sunlight by its heating effect dehydrates the epidermis.
Longer exposure also damages the inner dermis cells affecting their functions in moisturizing the epidermis.
The deeper collagen and elastin tissues are also damaged due to long exposures to sunlight; this causes wrinkles and increase in surface area for evaporation.
Sunstroke and heatstroke leads to xeroderma.

Dry skin causes: low humidity induced by air-conditioning and heating

When there is low humidity (low concentration of moisture in air) epidermis may easily lose its moisture, especially when the protective mantle is damaged or disturbed.
Apart from winter, reasons of low humidity can be due to air-conditioning, central heating, fireplaces, space heaters and furnaces.
In these situations the conditions can be greatly improved by installation of humidifiers.

Dry skin causes: frequent baths and chemicals in water

Bath tends to remove the protective mantle of the epidermis.
However to keep our skin from excess of sebum, dead cells and bacteria bath is required.
Too frequent baths or showers remove much of the protecting sebum layers resulting in xerosis conditions.
Hot baths and bathing for long time also damages the lipid barriers.
Heavily chlorinated bath water or swimming pool can also damage the protective layer leading to xerosis.

Dry skin causes: detergents, harsh soaps, shampoos, wrong moisturizers and makeup

Most of the bath soaps and detergents are alkaline in nature.
The protective lipid layer of the epidermis is acidic in nature and it gets neutralised and damaged by the harsh alkaline soaps.
Most of the anti-bacterial preparations, deodorants and shampoos are made to give the proclaimed results, but are devastating for the protective lipid layer.
Use of unsuitable cleansers, toners, moisturizers and make-up are major reasons for xeroderma.
Cosmetics made for oily skin conditions when applied on normal epidermis may take away extra moisture and oil causing xerosis.
Many of the chemical ingredients in cosmetics can be the causes of xeroderma.
Mineral oils and pH balancers damage acid mantle protecting the epidermis.

Dry skin causes: aging process

With old age the collagen and elastin tissues become thinner; adding to this condition is the decreased out put of sebum due declining androgen secretion.
The loss of sebum layer leads to xerosis conditions in the aged.

Dry skin causes: hypothyroidism and hormonal imbalance

Thyroid disorder like hypothyroidism causes decrease in the production of thyroid hormones.
The activity of the sebaceous glands and sweat glands is reduced in the absence of thyroid hormones and causes scaly skin.

Hormonal imbalance also causes dry skin.
Many women experience oily or dry skin conditions at some stage of their pregnancy due to changing hormonal profile.
Persons with affected androgen production experience lowered sebum production and xerosis.
Hormonal imbalances of progesterone and estrogen during menopause drastically reduces the sebum production.

Dry skin causes: genetic factors, diseases and skin ailments

Many people are genetically prone to xerosis.
Due to certain genetic diseases androgen production is reduced resulting in xerosis.
Ichthyoses are mostly genetic skin disorders. All these disorders are characterised by thickened, flaky or scaly epidermis.
The most common among them is ichthyosis vulgaris accounting for nearly 95% of cases.
In such genetic disorders even infants can have severe dry skin.
Diseases, especially skin diseases, lead to xerosis. Kidney ailments, diabetes, auto-immune diseases, sarcoidosis, chemical poisoning, rubbing of chemicals like alcohol and kerosene, Anorexia Nervosa, HIV/AIDS, Sjogren's syndrome, Hodgkins' disease, cancer, chronic diarrhea, pituitary deficiency, allergies, seborrhea, eczema, lichen infection, dermatitis, fungal skin infections and psoriasis are major medical causes of xerosis.
Sebaceous glands

Certain antihistamines, antispasmodics, retinoids, cholesterol lowering drugs (niacin) and diuretics can lead to dry skin.

Lack of exercise, lack of sleep and poor blood circulation are some of the causes of dry skin.

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What is dry skin - Dry skin problems and conditions

What is dry skin - Conditions and problems → What causes dry skin? → Moisturizers → Homemade face moisturizer recipe → Oily skin treatments

What is dry skin(xerosis or xeroderma)

The medical term for dry skin is Xerosis cutis. Xerosis conditions and problems results from insufficient moisture in the stratum corneum (outermost layer of epidermis). Xerosis results when the capacity of stratum corneum to hold back moisture is lost and is unable to protect the inner layers from losing water. Knowing what causes dry skin (xerodrma or xerosis) help us in taking preventive measures, alleviating the conditions and finding treatments and remedies. The outer most layer of epidermis region of our skin (stratum corneum) is made up of dead cells embedded in natural oils (sebum) secreted by underlying cells of epidermis.

X-linked Ichthyosis genetic disorder

This protective layer of sebum, holds back the epidermis moisture from evaporating into atmosphere and also protects epidermis from entry of harmful substances and germs.

Dry skin problems and conditions

The affected region has red, parched, dull or flaky look and the affected person feels skin tightness and itching.
Problems like extreme itchiness may overwhelm the affected person and can causes him sleepless nights.
The affected area in extreme conditions may show wrinkles, cracking, chapping, bleeding, and dermatitis.
In chronic conditions thin expression lines may form on the forehead, near the eyes and the corner of mouth.
These conditions are exacerbated by frequent baths, air-conditioning, cold winds and room heating.
These problems are found to affect both men and women equally.
Elderly people are more prone to get xerosis due to falling secretions of sebum.
Persons whose occupation requires frequent wetting of hands or body and persons working in cold or hot draught of wind may also get xeroderma if proper protective measures are not taken.
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Usually hands, arms, legs, feet and sides of the abdomen are first affected. There are various levels of severity of xerosis.
It conditions may be temporary, as in the case of winter dry skin and it may last for a few days to few months.
Xerosis conditions caused by environmental factors and use of wrong moisturizers can be alleviated and corrected by certain corrective measures including use of right moisturizers.

Severe dry skin conditions due to health problems

However severe to very severe xerosis problems can be caused by skin diseases and other health problems.

Hormonal imbalances and hormonal deficiencies may also give rise to xerosis as sebum production is linked to androgen secretion.
These types of xeroderma conditions have to be tackled at the root cause level and the disease behind it has to be treated in order to get lasting relief. Very severe dry skin problems are caused by certain genetic disorders (Ichthyosis) and only some measures can be taken to get some relief from these problems and cure is still a distant hope with all the research going on.

Though severe and chronic dry skin problems require evaluation by a dermatologist, understanding the root causes of dry skin conditions can helps us in taking certain preventive measures to alleviate the problems.

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