I reviewed my Fordyce spot notes over the past week. Before I delete the file, I do not know if this information might be helpful. Someone asked why males seem to have more Fordyce spots than females. Based on the information below, perhaps it is because males have more testosterone. But testosterone is not the only cause. My testosterone is low so my spots were activated by something else.

Normal sebaceous glands on the vermilion border of the lips and the oral mucosa are common in adults. Only sebaceous glands visible through the epithelium are Fordyce's spots. Some patients will have hundreds of glands while most have only one or two. Occasionally, several adjacent glands will grow into a larger cauliflower-like cluster. The glands are similar to normal sebaceous glands of the skin but lack hair follicles and almost always lack a ductal communication with the surface. The glands are located just beneath the overlying epithelium and often produce a local elevation of the epithelium.

Sebaceous glands are highly androgen sensitive, and, although the number of sebaceous glands remains approximately the same throughout life, their activity and size vary according to age and circulating hormone levels. Testosterone and dihydrotestosterone stimulate more sebaceous glands in these areas. Estrogens have been found to decrease sebaceous gland secretion. At puberty, sebaceous glands enlarge and become increasingly active due to increased production of androgens, and they reach their maximum by the third decade of life. In case of females, antiandrogens can be recommended whereas in case of men oral isotretinoin is advised for 2-6 weeks.

It does not seem like the treatments below are effective since the spots just come back. It did not mention that the Fordyce spots came back after intense pulsed light treatment so I do not know if that works. I once had an intense pulsed light treatment on my face for a facial, but the laser was not pointed at my lips. My skin was not damaged or burned from the laser. It did not even seem to do anything, but I did not have any damaged skin on my face- the laser is supposed to target damaged skin.

Intense pulsed light also known as photo-facial, fotofacials, and photo rejuvenation can be used to remove unwanted tissue while sparing the surrounding healthy or "normal" tissue.
Accutane can reverse Fordyce spots, but new spots will develop after stopping the medication unless you also use tretinoin cream regularly. TCA chemical peels can also reverse Fordyce spots, but new spots will occur slowly after treatment.