Cysts in the Skin: How They Form and How to Treat Them
In some people, small lumps can be felt under the skin. They may be visible among the hair, on the face, or on the body. These are soft lumps that, when pressed, feel like a small sphere filled with fluid.
These lumps are called cysts and occur in the subcutaneous tissue.
How They Form – Cysts
These epidermal cysts are often mistakenly called “sebaceous cysts” due to the belief that they are filled with sebum caused by blockage of a sebaceous gland. In reality, the cyst is lined with epidermis internally, and its contents are made up of shed epithelial cells and fatty acids. This gives the cyst its “creamy” texture and characteristic unpleasant smell when ruptured.
Cysts that do not become inflamed mainly cause cosmetic rather than functional issues, as they never evolve into malignancies.
However, if a cyst becomes inflamed, antibiotic treatment is required, followed by its removal after the infection has subsided.
Epidermal cysts grow slowly until a certain size and then remain stable for life. It is recommended to remove them surgically, entirely with their wall and a portion of the overlying skin, to prevent recurrence.
Cyst Removal Is Recommended:
- In cases of frequent or recurring infections
- For cosmetic reasons when the cyst is “unsightly”
- When it causes functional problems (rarely)
The hallmark of an inflamed cyst is redness, warmth, swelling (edema), and significant pain. Inflammation may evolve within hours into an abscess, where the cyst becomes a purulent infection.
Treatment of a purulent cyst involves opening it with the aid of local anesthesia, draining its contents, daily dressing changes, and a course of antibiotics. After the infection has resolved, the cyst can be completely removed.
When a cyst appears on the body, it is best to plan its early, scheduled removal using Plastic Surgery techniques. Our goal is to prevent the potential infection of the cyst, which is very common when the cyst tends to grow over time.
Of course, if the cyst remains stable in size, then it is not urgent. It can be treated when the patient feels ready to proceed with its removal. The procedure is best performed in a properly equipped medical environment that ensures patient safety and compliance with medical protocols.
Important Advice:
Do not manipulate the cyst in any way! Do not pick or squeeze the area, and never attempt to puncture the cyst with a sharp object to remove its contents, as this significantly increases the risk of infection!
In the overwhelming majority of cases, cyst removal is performed in the doctor’s office under local anesthesia. The removed tissue is always sent for a biopsy. This allows for a confirmed pathological examination to determine the nature of the removed cyst and ensure its proper diagnosis and treatment.
So, if you are concerned about a cyst, make an appointment at our clinic as soon as possible, so we can assess the situation, discuss your options, and find the best solution for your needs!
References
- Weir CB, Scharf R. (2023). Epidermal Inclusion Cyst. StatPearls https://www.ncbi.nlm.nih.gov/books/NBK532310/
- Wu P, et al. (2024). Diagnosis and therapy of giant epidermoid double cysts. Medicine (Baltimore). https://journals.lww.com/md-journal/fulltext/2024/02090/diagnosis_and_therapy_of_giant_epidermoid_double.27.aspx
- Trinh CT. (2019). Overview of epidermoid cyst. European Journal of Radiology Open. https://www.sciencedirect.com/science/article/pii/S2352047719300401
