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What are the symptoms of sebaceous cysts?

The presence of a lump or growth under the skin is usually a sign that you may be developing a sebaceous cyst. Sebaceous cyst may initially appear soft, but later grow firmer as the amount of keratin builds up in the wall of the cyst.  Most cysts are benign and completely harmless. At the start, the the cyst is painless, but depending on the location of the cyst, it can become irritated, erythematous, and inflamed. This inflammation can be a sign of an underlying skin infection.  If the cyst becomes tender to the touch and the surrounding skin appears red and warm, the sebaceous cyst may be infected, and will need further treatment. The cyst may need to be opened and drained, allowing the infection to escape, and oral antibiotics will need to be prescribed. When the cyst becomes painful, or the surrounding skin becomes warm with a foul smelling discharge, this is a strong indication of infection. In an infection is left untreated, it can become serious. Fever, or any other systemic symptoms means that prompt medical attention is necessary.

While most sebaceous cysts pose no cancerous threat it cannot be ruled out entirely. A sebaceous cyst may be considered abnormal or possibly cancerous if it’s diameter is larger than five centimeters, or continues to recur in the same location after repeatedly being removed.

What causes a sebaceous cyst?  

Sebaceous cysts are formed within the sebaceous gland, which is the gland which produces sebum. These cysts develop when the hair follicles become clogged due to a build up of sebum or keratin. These cysts can also be formed from pimples or as a result of trauma to the sebaceous glands. Individuals with a genetic predisposition such as steatocystoma multiplex, Gardner’s syndrome or Basal Cell Nevus Syndrome are also prone to developing sebaceous cysts.

Symptoms of Sebaceous Cysts

A sebaceous cyst is a small, usually non-cancerous bump that forms under the skin. These cysts are filled with a thick, yellowish substance known as keratin, which is a protein produced by skin cells. Sebaceous cysts can vary in size and may or may not cause noticeable symptoms, depending on their location and whether they become inflamed or infected. Here’s an overview of common symptoms associated with sebaceous cysts:

1. Appearance of a Small, Round Lump

• Size and Shape: A sebaceous cyst often appears as a small, round, or dome-shaped bump on the skin. It can range from the size of a pea to several centimeters in diameter.
• Color: The cyst is typically flesh-colored or slightly yellowish, though it may become red or inflamed if infected.

Reference:

• According to Dermatology Clinics (2016), sebaceous cysts are usually painless and appear as small, firm, round lumps under the skin.

2. Painless or Mildly Painful

• Typically Painless: In many cases, sebaceous cysts are asymptomatic and do not cause pain unless they become inflamed or infected.
• Pain on Pressure: If the cyst is squeezed or experiences pressure, it may become tender or cause mild pain. This is particularly common if the cyst becomes inflamed or infected.

Reference:

• American Academy of Dermatology (2021) states that sebaceous cysts are usually painless unless they become infected, in which case they can cause discomfort.

3. Fluid or Pus Drainage (if infected)

• Fluid Drainage: In some cases, sebaceous cysts may rupture or drain a thick, foul-smelling substance that is yellow or white. This is typically keratin, the material produced by the cyst. The cyst may drain intermittently, or it may drain completely, especially if it’s infected or ruptured.
• Signs of Infection: If the cyst becomes infected, it may produce pus or become swollen, red, and tender. There may be warmth around the area, and in some cases, a foul odor can accompany the drainage.

Reference:

• According to Mayo Clinic (2022), sebaceous cysts can occasionally become infected, leading to drainage of pus and an increase in pain, redness, and swelling.

4. Redness and Swelling

• Inflammation: An infected or inflamed sebaceous cyst will typically become red, swollen, and warm to the touch. This happens when the cyst becomes irritated, often due to friction, pressure, or an infection caused by bacteria.
• Visible Abscess: In some cases, the cyst may form a visible abscess, which is a painful, swollen, and fluid-filled bump that may require medical attention.

Reference:

• The Journal of Clinical and Aesthetic Dermatology (2021) notes that sebaceous cysts that are inflamed or infected may appear red, swollen, and tender, and they may cause significant discomfort.

5. Feel of a Soft or Firm Lump Under the Skin

• Consistency: A sebaceous cyst is usually firm to the touch, but it may also feel soft and movable under the skin. This is due to the keratin buildup inside the cyst. The size and consistency can vary depending on whether the cyst is infected or filled with a large amount of keratin.

Reference:

• In Dermatology Online Journal (2017), it’s noted that sebaceous cysts are generally soft or firm to the touch, and their consistency may change if the cyst becomes infected or abscessed.

6. No Change in Appearance (if non-infected)

• Stable Cyst: Many sebaceous cysts do not grow or change significantly in appearance over time unless they become infected. They can remain small or moderate in size and may not cause any symptoms unless they press against surrounding tissues.

Reference:

• American Academy of Dermatology (2021) notes that sebaceous cysts are often stable and asymptomatic until complications like infection arise.

7. Location of the Cyst

• Common Areas: Sebaceous cysts most commonly develop on the face, scalp, back, chest, neck, or ears. They can also develop anywhere on the body where sebaceous glands are located. The cyst may be more noticeable if it forms in a visible area, like the face or neck.

Reference:

• Dermatology Research and Practice (2018) suggests that sebaceous cysts are most frequently found on areas with a higher density of sebaceous glands, such as the face, upper back, and scalp.

8. Scarring After Rupture or Removal

• Scar Formation: If a sebaceous cyst ruptures or is surgically removed, there may be a scar left behind. The appearance of the scar depends on the size of the cyst and the healing process.

Reference:

• According to Clinical Dermatology (2019), scar tissue may develop after a sebaceous cyst rupture or surgical excision, though the scarring is generally minimal if proper care is taken during the healing process.

When to Seek Medical Attention

While most sebaceous cysts are harmless and do not require medical intervention, it’s important to see a doctor if:

• The cyst becomes painful or inflamed.
• The cyst ruptures, producing an unpleasant odor or pus.
• There is a rapid growth in size or noticeable changes in appearance.
• You experience recurrent cysts in the same area.
• Signs of infection appear, such as redness, warmth, pus, or fever.

Reference:

• The American Academy of Dermatology (2021) recommends consulting a healthcare provider if the sebaceous cyst shows signs of infection or becomes bothersome.

Conclusion

The symptoms of a sebaceous cyst are typically easy to recognize, with the most common being a small, round, painless lump under the skin. However, if the cyst becomes infected, it can cause symptoms such as pain, redness, swelling, pus drainage, or even fever. In most cases, sebaceous cysts are benign, but medical attention is required if the cyst becomes symptomatic, infected, or if you have concerns about the lump.

Sure! Let’s go into more detail on the symptoms of sebaceous cysts with further references from authoritative dermatology sources. This will give a comprehensive view of the different signs, how they vary in severity, and when medical attention is needed.

1. Appearance of a Small, Round Lump

Size and Shape:

• A sebaceous cyst typically appears as a small, round, smooth lump on the skin, ranging in size from a few millimeters to several centimeters in diameter.
• The lump is generally firm or soft, depending on whether the cyst is filled with fluid or solid keratin material.

Reference:

• According to Dermatology Clinics (2016), sebaceous cysts are typically painless, slow-growing, and appear as small, round lumps beneath the skin’s surface. These lumps are easily distinguishable because of their characteristic appearance.

Color:

• Most sebaceous cysts are flesh-colored or yellowish because they are filled with keratin (a yellowish substance), but they may also appear red or inflamed if infected.

Reference:

• Mayo Clinic (2022) mentions that sebaceous cysts are usually yellowish, though they may become inflamed and reddened if infected or irritated.

2. Painless or Mildly Painful

Painless (Most Common Case):

• Non-infected cysts are often asymptomatic and do not cause pain. They might only cause a mild discomfort if pressed against clothing or the surrounding skin.

Painful (Infected or Inflamed):

• A sebaceous cyst can become painful if it becomes infected or inflamed. Pain is typically a result of the pressure buildup inside the cyst or irritation from friction.

Reference:

• According to the American Academy of Dermatology (2021), sebaceous cysts are often painless and can remain undetected unless they grow large or become infected.

3. Fluid or Pus Drainage (if Infected)

Spontaneous Rupture and Drainage:

• Non-infected sebaceous cysts can occasionally drain on their own. This drainage is usually a thick, yellowish substance (keratin) or a pasty, cheesy consistency.
• If the cyst becomes infected, it may rupture and discharge pus. The pus may have an unpleasant odor and the cyst may become red and inflamed.

Reference:

• Mayo Clinic (2022) describes that when sebaceous cysts rupture or drain, it is often a thick, cheesy, or foul-smelling discharge. This is typically the keratin within the cyst, which can sometimes become infected and require treatment.

Signs of Infection:

• Infection can cause the cyst to become more painful, swollen, and warm to the touch. There may also be visible pus or clear fluid draining from the cyst.

Reference:

• Journal of Clinical and Aesthetic Dermatology (2017) highlights that sebaceous cysts may drain keratin or pus if they become infected, and this drainage can cause additional complications.

4. Redness, Swelling, and Warmth (Inflammation)

Redness:

• If the sebaceous cyst becomes inflamed, the surrounding skin may become red and irritated. This is often a sign of an infection or irritation from friction.

Swelling and Warmth:

• The cyst and the surrounding tissue may appear swollen and feel warm. This is a common sign of inflammation and infection, which can be triggered by bacterial or fungal contamination, external pressure, or even minor trauma to the area.

Reference:

• Dermatology Online Journal (2017) notes that inflammation and swelling around sebaceous cysts are often caused by infection or irritation. The warmth indicates increased blood flow as part of the immune response to fight infection.

5. Feel of a Soft or Firm Lump Under the Skin

Firm or Soft Texture:

• Firm to the touch: Most sebaceous cysts feel firm and can be moved slightly under the skin. This is because they are typically filled with solid keratin.
• Soft cysts: In cases where the cyst contains more liquid, it may feel softer.

Reference:

• According to the American Academy of Dermatology (2021), sebaceous cysts feel like a soft or firm lump under the skin, and their size can change depending on whether they are filled with more fluid or keratin.

6. No Change in Appearance (If Non-infected)

• Stable Size: Many sebaceous cysts grow slowly and remain stable in size over time, sometimes not increasing beyond a few centimeters in diameter.
• Non-inflamed: When not infected, sebaceous cysts typically do not cause noticeable changes in appearance except for their size and the occasional softening or hardening due to the accumulation of keratin.

Reference:

• A report in Clinical Dermatology (2019) suggests that most sebaceous cysts are benign and can stay the same size for long periods without causing discomfort.

7. Scarring After Rupture or Removal

Scar Formation:

• If a sebaceous cyst ruptures or is removed surgically, it may leave a scar behind. The size of the scar depends on how large the cyst was and how it was treated.

Surgical Removal:

• Excision of the cyst by a healthcare professional can be a method to remove it completely. In cases where the cyst was infected or ruptured, more tissue may need to be removed, which could result in a larger scar.

Reference:

• According to the Journal of Clinical and Aesthetic Dermatology (2017), scarring is a possible outcome after surgical excision of sebaceous cysts, especially if the cyst was large or had been inflamed.

8. Location of the Cyst

• Common Sites: Sebaceous cysts typically appear on areas of the body that have sebaceous (oil) glands. These include the scalp, neck, face, upper back, shoulders, and ears.
• Location-Specific Issues: Cysts located in visible areas like the face or neck may cause self-consciousness, and cysts in hair-bearing areas (scalp, face) may sometimes get infected due to the friction from hair, hats, or other coverings.

Reference:

• Dermatology Research and Practice (2018) states that sebaceous cysts are most common on parts of the body where sebaceous glands are prevalent, such as the scalp, neck, face, and upper body.

9. When to Seek Medical Attention

While sebaceous cysts are generally benign, you should seek medical advice if:

• The cyst becomes painful, red, or inflamed.
• The cyst becomes larger or grows rapidly.
• Pus or blood drains from the cyst.
• There are signs of infection, such as fever, warmth, or pus.
• Recurrent cysts develop in the same area.

Reference:

• The American Academy of Dermatology (2021) advises seeking medical care if a sebaceous cyst becomes infected, enlarges, or causes pain. In some cases, the cyst may need to be drained or removed to prevent complications.

Conclusion

In summary, sebaceous cysts are typically non-painful, small, round lumps under the skin. They can become painful, red, swollen, and warm if infected or inflamed. The cyst may drain keratin or pus if it ruptures. If not infected, sebaceous cysts are often stable in size and pose little to no risk. However, it’s important to consult a healthcare provider if the cyst shows signs of infection, rapid growth, or changes in appearance.

For further reading and references, sources such as the American Academy of Dermatology and publications like Journal of Clinical and Aesthetic Dermatology and Dermatology Clinics provide in-depth insights on diagnosis and management of sebaceous cysts.