Sebaceous cysts are common noncancerous cysts of the skin. Cysts are abnormalities in the body that may contain liquid or semiliquid material.
Sebaceous cysts are mostly found on the face, neck, or torso. They grow slowly and are not life-threatening, but they may become uncomfortable if they go unchecked.
Doctors usually diagnose a cyst with only a physical examination and medical history. In some cases, a cyst will be examined more thoroughly for signs of cancer.
Causes of a sebaceous cyst
Sebaceous cysts form out of your sebaceous gland. The sebaceous gland produces the oil called sebum that coats your hair and skin. Cysts can develop if the gland or its duct, the passage where oil is able to leave, becomes damaged or blocked. This usually occurs due to a trauma to the area.
The trauma may be a scratch, a surgical wound, or a skin condition, such as acne. Sebaceous cysts grow slowly, so the trauma may have occurred months or weeks before you notice the cyst.
Other causes of a sebaceous cyst may include:
- a misshapen or deformed duct
- damage to the cells during a surgery
- genetic conditions, such as Gardner’s syndrome or basal cell nevus syndrome
Symptoms of sebaceous cyst
Small cysts are typically not painful. Large cysts can range from uncomfortable to considerably painful. Large cysts on the face and neck may cause pressure and pain.
This type of cyst is typically filled with white flakes of keratin, which is also a key element that makes up your skin and nails. Most cysts are soft to the touch.
Areas on the body where cysts are usually found include:
- scalp
- face
- neck
- back
A sebaceous cyst is considered unusual — and possibly cancerous — if it has the following characteristics:
- a diameter that is larger than five centimeters
- a fast rate of reoccurrence after being removed
- signs of infection, such as redness, pain, or pus drainage
Diagnosis of a sebaceous cyst
Doctors often diagnose a sebaceous cyst after a simple physical examination. If your cyst is unusual, your doctor may order additional tests to rule out possible cancers. You may also need these tests if you wish to have the cyst surgically removed.
Common tests used for a sebaceous cyst include:
- CT scans, which help your doctor find the best route for surgery and spot abnormalities
- ultrasounds, which identify the contents inside the cyst
- punch biopsy, which involves removal of a small amount of tissue from the cyst to be examined in a laboratory for signs of cancer
Treatment of sebaceous cyst
Your doctor can treat a cyst by draining it or by surgically removing it. Normally, cysts are removed. This is not because they are dangerous but rather for cosmetic reasons. Since most cysts are not harmful to your health, your doctor will allow you to pick the treatment option that works for you.
It is important to remember that without surgical removal, your cyst will usually come back. The best treatment is to ensure complete removal through surgery. Some people do decide against surgery, however, because it can cause scarring.
Your doctor may use one of the following methods to remove your cyst:
- conventional wide excision: completely removes a cyst but can leave a long scar
- minimal excision: causes minimal scarring but carries a risk that the cyst will return
- laser with punch biopsy excision: the laser is used to make a small hole to drain cyst contents and the outer walls of the cyst are removed about a month later
After your cyst is removed, your doctor may give you an antibiotic ointment to prevent infection. You should use this until the healing process is complete. You may also be given a scar cream to reduce the appearance of any surgical scars.
Outlook for a sebaceous cyst
Sebaceous cysts are generally not cancerous. Cysts left untreated can become very large and may eventually require surgical removal if they become uncomfortable.
If you have a complete surgical removal, the cyst will most likely not return in the future.
In rare cases, the removal site may become infected. Contact your doctor if your skin shows any signs of infection such as redness and pain or if you develop a fever.
Most infections will go away with antibiotics, but some can be deadly if untreated.
Distinguish between a sebaceous cyst and epidermoid cyst. An epidermoid cyst is more common than a sebaceous cyst. Each will have slightly different symptoms and will be treated just a little differently. Therefore, it is important that the cyst you have on your skin is diagnosed appropriately for effective treatment.oth types of cysts are flesh-colored or white-yellow and have a smooth surface.
Epidermoid cysts are more common. These are slow growing and often painless. They don’t usually require treatment, unless they are causing pain or become infected.
Pilar cysts are composed primarily of keratin (the protein that makes up hair and nails) and form from the outer hair root sheath, typically on the head. A pilar cyst is often thought to be another term for a sebaceous cysts, but they are in fact different.
Sebaceous cysts are commonly found in the hair follicles on the head. They form inside the glands that secrete sebum, an oily substance that coats the hair. When these normal secretions are trapped, they develop into a pouch containing a cheese-like substance. They are commonly found in areas near the neck, upper back, and on the scalp. Sebaceous cysts are often confused with pilar or epidermoid cysts.
Distinguish between cysts in the breast and tumors. Cysts can be in one or both breasts. Without a mammogram or needle biopsy it is almost impossible to distinguish between the two different types of lumps in the breast. Symptoms of a breast cyst will include:
Smooth, easily movable lump with distinct edges
Pain or tenderness over the lump
Size and tenderness will increase just before your period starts
Size and tenderness will decrease when your period ends
Understand cystic acne. Acne is a general term that describes a variety of different types of pimples, blackheads, pustules, whiteheads and cysts. Cystic acne are nodules that are red, raised, often 2–4 mm in size and nodular and are the most severe form of acne. The infection in a cystic acne is deeper than that in other pustules or whiteheads. Cystic acne is painful.
Identify a ganglion cyst. These are the most common types of lumps found on the hand and wrist. They are not cancerous and often harmless. Filled with fluid, they can quickly appear, disappear or change in size. They do not require treatment unless they interfere with function or are unacceptable in appearance.
Determine if pain is from a pilonidal cyst. In this condition there is a cyst, abscess or dimple that forms in the crease between the buttocks that runs from the lower end of the spine to the anus. It can be caused from wearing tight clothing, excess body hair, sitting for long periods of time or obesity. Symptoms can include pus from the area, tenderness over the cyst, or the skin may be warm, tender or swollen near the tailbone. Or there may not be any symptoms beside a pit or dimple at the base of the spine.
Distinguish a Bartholin gland cyst. These glands are located on either side of the vaginal opening to lubricate the vagina. When the gland becomes obstructed, a relatively painless swelling forms called a Bartholin’s cyst. If the cyst is not infected you may not notice it. An infection can occur in a matter of days causing tenderness, fever, discomfort walking, pain with intercourse, and a tender, painful lump near the vaginal opening.
See a doctor for swelling in the testicles. All testicular swelling must be diagnosed by a physician to determine the differences between a cyst, cancerous growth, hydrocele or infection in the testicles. A testicular cysts, also called a spermatocele or epididymal cyst, is typically a painless, fluid-filled, noncancerous sac in the scrotum above the testicles. T
Consider getting a second opinion if you are not satisfied with your physician’s diagnosis and treatment. Although most epidermoid and pilar cysts do not require treatment from a physician, if you do seek medical advice and are not satisfied with the results seek a second opinion. Most sebaceous and epidermoid cysts are straightforward, but there are other conditions that may mimic these cysts.
In a case study written in the Royal College of Surgeons of England, the authors presented two cases in which melanoma and a deep oral cavity were originally mistaken for a sebaceous cyst.
There are a variety of other infectious processes that may be mistaken for a sebaceous cyst, including boils, furuncles and carbuncles.
Treating a Cyst at Home
Treat uninfected epidermoid and sebaceous cysts at home. Signs of infection include the area becoming swollen, red, tender, or red and warm. If your home treatment for these cysts is not effective or if you experience symptoms, which indicate an infection, you should seek medical care from your physician.
If the cyst causes pain or discomfort with walking or intercourse, medical care is needed to treat the cyst.
Use a wet, warm compress over an epidermoid cyst to encourage it to drain and heal. The washcloth should be hot but not so hot that it burns the skin. Place it over the cyst two to three times a day.
Cystic acne responds better to ice than it does to heat.
Bartholin gland cysts can be treated at home using warm water sitz baths. This involves sitting in several inches of warm water to encourage the cyst to drain.
Refrain from picking, squeezing, or trying to pop either an epidermoid cyst or sebaceous cyst. This can increase the risk of infection and scarring. Also, never pick, squeeze or attempt to pop a cystic acne. This drives the infection deeper and increases the risk of scar tissue.
Allow an epidermoid cyst to drain naturally. Once it begins to drain, cover it with a sterile dressing, which you can change twice a day. If a large amount of pus begins to drain from the cyst, the skin surrounding the cyst turns red, the area becomes warm and tender, or blood begins to drain from the cyst, it is time to seek medical care.
Keep the area clean. To prevent an infection, keep the cyst and the area surrounding it clean. Wash it daily using an antibacterial soap or cream.
Cysts are fluid-filled pockets that form on the skin. While not usually dangerous, they can be painful and annoying. Depending on the type of cyst, you can usually have a cyst medically removed with the assistance of a doctor.
Dealing with Facial Cysts
Decide if medical intervention is necessary. Facial cysts, medically referred to as sebaceous cysts, can be annoying and unsightly but they don’t necessarily require medical intervention. If the cyst is not painful, it might be best to leave it alone to avoid complications having it removed. However, you should see a doctor if any of the following develop:
-Facial cysts are usually small, round lumps just underneath the skin. They may be black, reddish or yellowish, and occasionally release foul-smelling discharge. Cysts are generally more painful than other skin conditions, such as pimples.
-If the cyst ruptures, this can lead to a potentially dangerous boil-like infection. Prompt treatment and removal is required.
-If the cyst suddenly becomes painful and swollen, it may be infected. See a doctor to get the cyst removed and get the proper antibiotics.
-In very rare cases, a cyst can lead to skin cancer. During your regular annual doctor’s exam, ask your doctor to look at the cyst and determine if it poses a risk for cancer.
Dealing with Facial Cysts
Ask your doctor for an injection. If the cyst is infected or painful, your doctor can inject the cyst with a medication. While this will not fully remove the cyst, it will reduce redness and swelling. This can make the cyst less noticeable.
Have the cyst drained. If the cyst grows significantly or becomes painful and uncomfortable, you can have it medically removed. The cyst can be cut open and drained by your doctor.
– The doctor will make a small cut in the cyst and gently drains out the built up fluid. The procedure is fairly quick and usually not painful.[6]
– The major downside to this method is that cysts often reoccur after being lanced and drained.
Ask about surgery. The only way to fully remove a cyst is through surgery. Talk to your doctor about undergoing surgery if you want a cyst removed.
– Cyst removal surgery is minor. It does not take very long and recovery time is relatively brief. However, you may have to return to your doctor’s office after the surgery to remove any stitches.
– Surgery is very safe and usually prevents cysts from occurring. However, cysts do not usually pose a medical threat. Therefore it may be difficult to get surgery covered by insurance.
