Sebaceous Hyperplasia vs. Acne: What’s Causing Those Bumps?

Not every bump on your face is acne. Sometimes what looks like a stubborn pimple may actually be sebaceous hyperplasia, a harmless but often confusing skin condition. Because it resembles acne in appearance, tiny, flesh-colored or yellowish bumps, it’s often mistaken for breakouts. But the causes, treatments, and long-term management differ significantly.

If you’ve been treating what you thought was acne but aren’t seeing results, it might be time to understand sebaceous hyperplasia better.

This guide breaks down the differences between acne and sebaceous hyperplasia, their causes, and the best treatment approaches.

What Is Sebaceous Hyperplasia?

Sebaceous hyperplasia occurs when sebaceous (oil) glands on the skin become enlarged and overactive. Instead of producing oil normally, the glands grow bigger and create small bumps, usually on the forehead, cheeks, or nose.

• Appearance: Small (1–3 mm), soft, dome-shaped bumps with a central indentation (“dimple” or “umbilication”).
  
• Texture: Smooth to the touch, often skin-colored or slightly yellow.
  
• Common sites: Forehead, nose, and cheek areas with high sebaceous gland density.
  
• Who gets it: More common in middle-aged to older adults, though it can occur earlier, especially in those with oily skin or long-term sun exposure.
  

Sebaceous hyperplasia is benign (non-cancerous) but can be a cosmetic concern because of its visible bumps.

What Is Acne?

Acne, on the other hand, is an inflammatory skin condition that develops when pores get clogged with oil, dead skin, and bacteria.

• Appearance: Blackheads, whiteheads, inflamed pimples, pustules, nodules, or cysts.
  
• Texture: Varies can be raised, red, pus-filled, or painful.
  
• Common sites: Face, chest, back, and shoulders.
  
• Who gets it: Most common in teenagers and young adults, but can persist into adulthood.
  

Unlike sebaceous hyperplasia, acne often involves inflammation and infection, and in severe cases, it may leave scars or dark spots.

Key Differences Between Sebaceous Hyperplasia and Acne

Causes of Sebaceous Hyperplasia

While the exact reason isn’t always clear, some factors increase the risk:

1. Aging and Hormones – With age, sebaceous glands enlarge and become less efficient at releasing oil, causing buildup.
   
2. Sun Damage – Chronic UV exposure thickens skin and stresses sebaceous glands.
   
3. Genetics – Family history plays a role.
   
4. Oily Skin Types – People with oily skin are more prone.
   
5. Medications – Certain drugs, like long-term cyclosporine use, can trigger it.
   

Causes of Acne

Acne has different underlying triggers:

• Excess sebum production due to hormones.
  
• Clogged pores from dead skin buildup.
  
• Bacterial overgrowth (Cutibacterium acnes).
  
• Hormonal fluctuations (puberty, menstrual cycles, PCOS).
  
• Diet and lifestyle factors like high sugar intake, stress, or poor sleep.
  

How to Tell the Difference at Home

• Look closely at the bump: If there’s a small dimple in the center and it’s not red or painful, it’s more likely sebaceous hyperplasia.
  
• Check your age and history: If you’re in your 30s or beyond and acne treatments don’t work, sebaceous hyperplasia could be the cause.
  
• Location matters: Acne often appears on the chest, back, or jawline; sebaceous hyperplasia is usually confined to the central face.
  

Treatment Options for Sebaceous Hyperplasia

Sebaceous hyperplasia won’t clear up with typical acne products. But several treatments can help reduce or remove the bumps:

• Topical Retinoids
  
  • Prescription retinoids (like tretinoin) help regulate cell turnover and shrink sebaceous glands over time.
    
  • Useful if you also deal with acne or signs of photoaging.
    
• Laser and Light Therapies
  
  • Pulsed-dye laser (PDL), CO2 laser, or photodynamic therapy (PDT) can help shrink sebaceous glands.
    
  • Effective but usually require multiple sessions.
    
• Electrocautery or Cryotherapy
  
  • Dermatologists can safely remove bumps by burning (cautery) or freezing them.
    
• Oral Medications (in rare cases)
  
  • For widespread sebaceous hyperplasia, oral isotretinoin may be prescribed, though this is less common.
    
• Sun Protection
  
  • Daily broad-spectrum sunscreen reduces further sun-induced gland changes and prevents worsening.
    

Treatment Options for Acne

Since acne is an inflammatory condition, treatments aim to unclog pores, control bacteria, and reduce oil:

• Over-the-counter treatments with salicylic acid, benzoyl peroxide, or niacinamide.
  
• Prescription retinoids to prevent clogged pores.
  
• Oral prescription medications like antibiotics, hormonal therapy, or isotretinoin for severe cases.
  
• Lifestyle changes including balanced diet, stress management, and proper skincare habits.
  

For acne-prone skin, explore Dr. Su’s Skincare Collection with dermatologist-formulated solutions tailored for Indian skin.

Preventing Confusion: Skincare Tips

Since sebaceous hyperplasia and acne may coexist, here’s how to care for your skin:

• Keep your routine gentle and consistent – Avoid harsh scrubbing or over-cleansing.
  
• Use retinoids carefully – They benefit both acne and sebaceous hyperplasia but should be introduced gradually only under prescription.
  
• Moisturise daily – Even oily or acne-prone skin needs hydration.
  
• Apply sunscreen every morning – Protects against sun-induced sebaceous gland changes and prevents acne marks from darkening.
  
• Don’t self-diagnose – If bumps persist, seek a dermatologist’s evaluation to avoid unnecessary treatments.
  

It’s easy to mistake sebaceous hyperplasia for acne since both show up as small bumps on the skin. But while acne is driven by clogged pores and bacteria, sebaceous hyperplasia stems from enlarged oil glands.

The biggest difference? Sebaceous hyperplasia won’t respond to acne spot treatments. If your “acne” isn’t improving despite consistent care, it may be time to consider this alternative diagnosis.

With the right guidance, whether through retinoids, professional dermatology treatments, or a tailored skincare routine, you can manage both acne and sebaceous hyperplasia effectively.

If you’re unsure about the bumps on your skin, don’t guess. Book a consultation and explore dermatologist-formulated solutions with Dr. Su’s Skincare Collection designed to help Indian skin achieve balance, clarity, and long-term health.