You may have never heard of Syringomas before developing them yourself, but Dr. Schulz says, “Syringomas are a common problem. This condition is not particular to any racial or ethnic group. Anybody can have them.” Syringomas look like a tiny plateau, wider than they are tall. They very simply are an enlargement of the duct coming out of the sweat gland. The condition creates tiny, firm bumps about one to three millimeters wide. They usually grow in small groups or clusters in either white, yellow, brown, or pale pink, skin-toned colors. Interestingly enough, they seem to form symmetrically across the face. So if you develop them under your right eyelid, you may also develop them under your left. Most of the people affected by Syringomas develop them for the first time in their late twenties, but if untreated, they persist.
Your sweat gland is in the middle layer of your skin and when it makes the sweat it then has to get the sweat up to the surface of the skin. To do this, it sends the sweat up through a tube called a sweat duct. As it comes out of this middle layer of the skin, it then enters the epidermis, the upper layer of the skin. When the duct going through the epidermis becomes enlarged, it forms Syringomas. The enlargement of this part of the duct forms what you see as a white, firm, round, flat-topped bump. Dr. Schultz explains, “If you squeeze them, nothing comes out, if you put a pin in them, nothing comes out. That’s because they’re solid, they’re just enlargements of those tissues and cells that make the sweat channel.”
If you’re noticing these white, hard bumps around your eyes, you might have confused them for pimples at first. But Dr. Schultz says, “They don’t act like pimples and they don’t respond to treatment like pimples. That’s for a very good reason — they’re not pimples!” Pimples and whiteheads usually form due to excess oil in the skin. But Syringomas develop from the enlargement of the sweat duct, which produces watery materials, not oily ones.
Some of the most common places for Syringomas to appear is on the face, including the upper cheeks, lower eyelids, upper lids, and even forehead. But they can also appear on the armpits, chest, abdomen, and even genitalia. Although these tiny bumps won’t typically itch or cause pain, in very sensitive areas of the body, there is an increased risk of irritation.
Doctors who don’t typically treat Syringomas may suggest you use topical or oral treatments to start. These medications are typically the first line of treatment because there is a lower risk of scarring. You may have been prescribed topical or oral retinoids or topical atropine. However, it may take months or years of consistent use to see a difference with these treatments, if at all. You may be better off leaving the Syringomas alone or going to a dermatologist who will physically treat the condition.
There are plenty of doctors who prescribe topical medications to get rid of these bumps, but Dr. Schultz says, “No medication will work, because you need to mechanically remove the Syringomas one way or the other.” Because Syringomas aren’t dangerous and typically don’t need to be removed for health reasons, many doctors are afraid to treat these tiny bumps for fear they will cause scarring that’s worse than the Syringomas themselves. But Dr. Schultz has the experience and a few painless techniques he uses to mechanically treat this condition. He says, “What I find to be the most effective is one of three things: I may shave off the top part of the bump. Or, alternatively, I may eliminate the top part with a strong acid like bichloracetic acid (BCA). Or finally, I may use an electric needle, all of course with local anesthesia so it’s painless.” With those three techniques, there may be some temporary discoloration, some darkening from injuring the skin, or some brownness and redness that would need to be addressed to give the best cosmetic result. Dr. Schultz also has extensive experience in treating any discoloration that may occur, giving you a smooth, even-toned finish. In addition, once the Syringomas are treated, they typically don’t come back.
Dr. Schultz says the best candidates for Syringoma treatment are people with Syringomas! There are no special circumstances that would prevent you from getting these tiny bumps treated and smoothed out. He does stipulate, “If you’re an entertainer and need to be on stage or on camera, don’t do it two days before your show.” You’ll want a few days to recover after treating the area. But, other than someone with a history of forming keloid scars on their face, anyone can have these procedures done.
If you haven’t already developed Syringomas, there are a few things you can do to help prevent them from forming. By using exfoliants, astringents, and other therapies that attempt to reduce sweat gland activity, you may be able to prevent your sweat gland ducts from enlarging. In Dr. Schultz’s opinion, glycolic exfoliation is the gold standard when it comes to daily exfoliation that is both effective and non-irritating to your skin. Other ways to reduce the risk of developing these tiny bumps are to always wear and reapply sunscreen and avoid allergens or other irritants that may bother your skin. Syringomas can also be a complication from diabetes, so keeping your blood sugar levels in a healthy range is very important and can help reduce the risk of developing Syringomas as well.
By the time patients come to see Dr. Schultz for Syringoma treatment, they’ve typically already been to other dermatologists. Many doctors do not want to treat Syringomas because these tiny little bumps are not dangerous and if they don’t have the proper experience, they may be afraid of causing scarring that’s worse than the condition. Dr. Schultz, however, does treat Syringomas and his patients have had great success in smoothing out these hard bumps from their skin. This is because Dr. Schultz is realistic in his approach. He will expertly assess which removal technique is best for your skin, so you can be assured his approach is customized to what your skin needs. Because other doctors don’t want to touch Syringomas and many patients end up with Dr. Schultz, he has a large amount of experience treating this condition. That experience, his skill in treating any discoloration that may be a result of treatments, and his careful procedure in accurately assessing the Syringomas, make him the best choice to remove those unsightly bumps.
When you first come in for your appointment, there is no need to prepare anything. If you’ve visited another dermatologist and have already had a biopsy done of your Syringomas, you should bring that information with you. You’ll meet with Dr. Schultz and he’ll take a look at what you think may be Syringomas. When assessing the lesions, some may very obviously be Syringomas, but for the bumps that are harder to know for sure whether they’re Syringomas or not, he’ll do a biopsy to be certain. As Dr. Schultz says, “There’s no reason to treat Syringomas if they’re not actually Syringomas.” After using a local anesthetic through a painless, tiny injection, he’ll remove one or two Syringomas and send them to the lab. Then he’ll take some close up photos of the area, so that later, you can objectively assess the improvements you’ve been able to make. After this initial assessment, at the next visit if the diagnosis is confirmed Dr. Schultz will hand you a mirror, and together, you’ll decide which clusters of Syringomas you’d like to treat initially. Local anesthesia is painlessly used again and usually at least two of the above mentioned techniques are used. After the treatment is done, Dr. Schultz will give you a soothing healing ointment to apply for the next three weeks. In three weeks, you’ll come back for a follow up so he can assess which technique worked best in removing the Syringomas. Depending on how many you have, the results of the first removals, and what the distribution of them is like, Dr. Schultz will then formulate a plan to treat the rest of your Syringomas.
I've been seeing Dr. Schultz for the last 8 years and during that time, I've recommended him to countless friends for both cosmetic and medical dermatologic help. I trust him completely both diagnostically and aesthetically. When I had shingles, he was wonderful, incredibly supportive and kind. And when I eased into doing more cosmetic dermatology, he was– and continues to be– patient, careful and cautious. He listens to concerns and really hears what your goal outcome is and works with you to make it happen. I wanted to maintain a natural look while keeping my skin looking fresh and that's just what he's done for me. I always leave his office feeling prettier and well-cared for! If you have a medical concern or something about your skin you want to upgrade, you can't do better than Dr. Schultz and his wonderful team. And the products are amazing as well!
- Laura B.
Dr. Schultz is the most thorough and good natured dermatologist I have ever seen. I have been a patient of his for more than 20 years. He has taught me everything I know about the value of taking care of my skin, a gift that keeps on giving. He also takes the time to listen to me, to see me as an individual and doesn't treat my needs as a one size fits all doctor. I really appreciate his kindness, patience and expertise. I absolutely love his product line and have definitely reaped the rewards from using it, especially his glycolic peel pads and moisturizer, which I can't live without. My skin feels softer, smoother, appears more translucent and actually looks younger! Dr. Schultz helped me to see beyond the lines and wrinkles, although he so good at helping to keep those at bay while maintaining a very natural appearance. His staff is outstanding. They make you feel welcome, like family, from the moment you walk through the door. Angela, Monika, Deborah and all of the support staff are extraordinary at what they do. Thank you Dr. Schultz and everyone at Park Ave Skincare. You're the best!
- Laura M.
Dr. Schultz has truly transformed my skin, so much so that I can confidently leave the house without wearing makeup now. During my first meeting with Dr. Schultz, he intently listened to my skin concerns, we discussed what my goals were, and he explained pragmatically what treatments and products he recommended for me. I truly appreciate his fantastic bedside manner and conservative approach. I am a perfectionist in every aspect of my life, including my skin, and Dr. Schultz understood this and was committed to helping me achieve every skin goal I had. The entire staff is just so fantastic and friendly, from reception to the PAs. They make you feel welcome and extremely comfortable, which to me is very important when visiting any doctor’s office. As someone who works too much and never gets enough sleep, my skin was looking very dull and lifeless. My skin is now full of life again and has an incredible glow to it which I have never had before. And I owe it all to the incredible Dr. Schultz.
- Kelly D.
My partnership with Dr Schultz began more than 30 years ago. As a generous friend, advisor, skilled surgeon, and superb cosmetic diagnostician, he has enabled me to look my best. He has kept me abreast of the most sophisticated procedures and in so doing, has maximized my appearance, always guided by what will be most beneficial for me. He is someone I go to for advice and care and his staff is another manifestation of this care. I don’t know many patients who can say this, and I feel fortunate to be among them.
- Ellen R.
In the four years that I've been a patient of Dr. Schultz, my acne-prone skin has gone from constant breakouts to smooth and clear. These days, I feel confident and comfortable enough in my skin to wear minimal makeup, if any—which I never would have done in years past. Dr. Schultz and his warm, friendly staff always go above and beyond; he takes the time to listen, talk with me, and create the best plan for my skin. It's clear he has my best interests in mind, and I trust him wholeheartedly. I would highly recommend him to friends, family, and frankly, anyone who asks.
- Deanna P.
Each session with Dr. Schultz is a mini education in skin care. He approaches each patient as a unique individual with different needs. I’m Asian and he’s explained to me how that impacts treatment in a clear manner that a layperson can understand. At each examination, Dr. Schultz recites detailed notes to his staff which he then refers back to at each future appointment, adjusting and tweaking treatment plans when necessary. Over the past two years I’ve seen a remarkable improvement in my blemishes and overall complexion and wholeheartedly recommend Dr. Schultz to anyone looking to enhance their appearance.
- Sherry G.
I have been a patient of Dr. Schultz for many years, and I continue to be amazed at his medical approach, patience, and professionalism. He takes the time to listen to my health concerns, explains how and why he would like to issue a treatment in a way that I understand , answers all of my questions, and all of his procedures and painless and thorough. Dr. Schultz is very attentive, results-oriented, and extremely knowledgeable. He follows up and is committed to my health and satisfaction. The Park Avenue Skincare is a calm environment and the staff are all very friendly, warm, and respectful. It's easy to get appointments at a time that works for me and they are always on time and considerate. I think so highly of Dr. Schultz and his practice that I sent my mom to him, and continue to go to his office even though my life is based in midtown west! I have great confidence in the care that Dr. Schultz gives.
- Katrina A.
Syringomas are small, benign, flat-topped bumps. They’re typically found on facial skin,Read More
Syringomas are an enlargement of the sweat gland duct, which results inRead More
Dr. Schultz typically uses a topical chemical treatment that destroys the syringomas.Read More
After syringomas are removed, healing takes place over the next few days.Read More
No, results are visible after the healing process is complete.
Dr. Schultz does not recommend at-home treatments for syringomas. They require mechanicalRead More
Make your skin care a priority with leading-dermatologist and New York Magazine’s “Top Doctor”: Dr. Neal Schultz.