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What’s a sebaceous nevus?

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A sebaceous nevus is a hairless patch of skin that appears on the scalp or face and is usually benign. It can become cancerous later in life, but treatment is only necessary if it becomes malignant or a cosmetic concern. It is caused by a minor genetic defect during prenatal development and can be diagnosed through a skin biopsy. Treatment options include surgery or photodynamic therapy.

A sebaceous nevus is an unusual lesion or patch of hairless skin that most commonly appears on the scalp or face. In most cases, the lesions are benign and cause no health problems, although there is a very small chance that a nevus could become cancerous in later life. The spots are typically noticed at birth or in early childhood and tend to be soft, smooth, and more orange or yellow than the surrounding skin. By puberty, they may become bumpy or rough to the touch. Treatment in the form of excision surgery is only necessary if a sebaceous nevus becomes malignant or becomes a major cosmetic concern for a patient.

A sebaceous nevus is thought to arise during prenatal development when the outer layers of the skin are forming. Research suggests that a minor genetic defect is responsible for abnormal formation of the sebaceous glands within the skin of the scalp and face. At birth, a lesion typically appears as a round, slightly raised bald patch that is velvety to the touch. There may be just a single lesion or a close group of raised patches surrounded by normal hair.

Hormonal changes at the time of puberty can cause a sebaceous nevus to grow and develop a wart-like appearance. A lesion typically has an orange, brown, or yellow tint. If the condition is left untreated, there is a very small risk that the lesion will become malignant. A hard, rough tumor can develop and potentially become very large on the head. However, the cancer is unlikely to spread quickly to other areas of the skin or to other parts of the body.

Doctors often notice sebaceous nevus symptoms shortly after a baby is born. Very small lesions may go unnoticed until late childhood or occasionally after puberty, when the patches begin to change in appearance. Skin biopsies are usually collected and analyzed to confirm the diagnosis and to make sure the lesion is not cancerous. After diagnosing the condition, your doctor can explain different treatment options.

Most patients with small noncancerous lesions do not require aggressive treatment. Patches on the scalp can usually be hidden with a hat or by parting the hair in a certain way. If a sebaceous nevus is malignant or causing appearance problems, it can be cut out during a fairly simple outpatient surgical procedure. Photodynamic therapy, which involves eroding a lesion with a combination of acid and laser light, is a new and promising nonsurgical option for some patients.

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