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.
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.
Both 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.