Multiple Familial Trichoepithelioma: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Multiple Familial Trichoepithelioma?
A primary care doctor is often the first person to see. They can examine the skin, arrange a biopsy, and refer the patient to a dermatologist, who usually manages treatment, including removal of the growths. A genetic counselor may also help families who want testing for the changed gene.
What it is
Multiple familial trichoepithelioma is a rare skin condition that causes many small, harmless growths called trichoepitheliomas to appear on the face. These benign tumors are not cancer. They start in the hair follicles, the tiny structures in the skin where hair grows. The growths appear in groups and run in families, which is where the word "familial" comes from.
Symptoms
The main sign is many small, firm, skin-colored bumps on the face, most often on the nose, cheeks, forehead, and around the ears. The bumps are round, smooth, not painful, and do not itch. Most people first notice them during childhood or the teenage years. The growths grow slowly and increase in number over time. They can affect how a person feels about their appearance but usually do not cause health problems.
Causes and who gets it
This condition is caused by a change in a gene called CYLD. A child only needs to inherit one changed copy from a parent to develop it. It affects both males and females and is seen in many parts of the world.
How doctors diagnose it
Doctors start by looking at the skin and asking about family history. A skin biopsy, which means removing a small piece of the growth to examine under a microscope, can confirm the diagnosis. Genetic testing can also find the changed CYLD gene.
Treatment
Treatment is not required for health reasons, but many people have the growths removed for appearance. Options include surgical removal, laser therapy, and sometimes medicines applied to the skin. The growths can come back after treatment, so follow-up care is important.
When to see a doctor
See a doctor if you notice small bumps on your face that slowly multiply, especially if other family members have them. Also see a doctor if a bump changes in size, color, or shape, or starts to bleed.
How a direct primary care or concierge doctor fits in
A direct primary care doctor is paid a flat monthly fee instead of billing insurance, while a concierge doctor charges more and often works alongside insurance. Either type can examine the skin, monitor the growths, and order a biopsy or genetic testing when needed, referring to a dermatologist for removal. Longer visits and easier scheduling make them a steady point of contact for a rare condition that needs follow-up over many years.
Common questions
Are the growths cancerous?
No. Trichoepitheliomas are benign tumors, which means they are not cancer and do not spread. Doctors may still do a biopsy to confirm the diagnosis, because some skin cancers can look similar.
Will the growths go away on their own?
No. The growths usually stay for life and may slowly increase in number. Treatment can remove them, but they sometimes return.
Can I pass this condition to my children?
If you have the changed CYLD gene, each child has a one in two chance of inheriting it. A genetic counselor can explain testing options for family members.
Does the condition cause any health problems?
Most people have no health problems from the growths. The main effects are on appearance and, for some people, on confidence and comfort in social situations.
Sources
- NIH Genetic and Rare Diseases Information Center - Familial multiple trichoepitheliomata
- MedlinePlus Genetics - Multiple familial trichoepithelioma
- MedlinePlus - Skin Conditions
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
