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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.

Sebaceous cysts are typically caused by blockages in the sebaceous glands, which are responsible for producing sebum (an oily substance that lubricates the skin). When a hair follicle or the gland itself becomes blocked by dead skin cells, sebum, or other debris, it can lead to the formation of a cyst.

Here are some common factors that can contribute to the development of a sebaceous cyst:

1. Clogged hair follicles or skin pores: This can occur from excessive oil production, buildup of dead skin cells, or other debris.
2. Trauma or injury to the skin: A cut, scratch, or other injury can block the sebaceous gland and lead to cyst formation.
3. Genetics: Some people may be more prone to developing sebaceous cysts due to their genetic makeup.
4. Acne: Individuals with acne are more likely to develop cysts, as acne often involves blocked hair follicles and sebaceous glands.
5. Hormonal changes: Hormonal fluctuations, such as those during puberty, pregnancy, or certain medical conditions, can lead to increased oil production, contributing to cyst formation.
6. Chronic skin conditions: Conditions like dermatitis or certain types of folliculitis can increase the likelihood of developing sebaceous cysts.

While sebaceous cysts are usually harmless and painless, they can become infected or inflamed, requiring medical attention.

Certainly! Sebaceous cysts are benign, closed sacs that form under the skin, typically filled with sebum (an oily substance), keratin, and dead skin cells. They are usually slow-growing and typically harmless, but they can cause discomfort or infection in some cases. Here’s a more detailed explanation of how sebaceous cysts form, with references to relevant medical information.

1. Clogged Hair Follicles and Sebaceous Glands

Sebaceous cysts most commonly develop when a hair follicle or sebaceous gland becomes blocked. Sebaceous glands are attached to hair follicles and secrete sebum, an oily substance that helps lubricate the skin and hair. If the opening of the follicle becomes blocked, the sebum gets trapped inside the gland, causing it to enlarge and form a cyst. This is known as an epidermoid cyst (often referred to as a sebaceous cyst, though sebaceous cysts can technically also refer to other types of cysts).

• Reference: A study by Bolognia et al. (2012) in Dermatology states that the most common cause of epidermoid cyst formation is the blockage of the sebaceous duct, leading to the accumulation of sebum and keratin within the cyst cavity. (Bolognia, J. L., Jorizzo, J. L., & Schaffer, J. V. (2012). Dermatology, 3rd edition.)

2. Trauma or Injury to the Skin

Physical damage to the skin, such as cuts, scrapes, or surgical incisions, can result in the formation of a sebaceous cyst. In these cases, the injury can lead to an obstruction or the alteration of the sebaceous gland’s normal function, causing the gland to become inflamed or blocked. This may lead to cyst formation if the follicle is disrupted.

• Reference: A study by Alvarado et al. (2018) in The Journal of Dermatology found that trauma-induced cysts are typically associated with the development of epidermoid cysts at the site of injury, which may include surgical wounds or any skin abrasions. (Alvarado, L., et al. (2018). “Sebaceous cysts and epidermoid cysts: A review,” The Journal of Dermatology, 45(1), 23-30.)

3. Genetics

There is evidence to suggest that genetics may play a role in the formation of sebaceous cysts. Individuals with a family history of cysts may be more prone to developing them, as inherited factors can predispose someone to conditions like Gardner’s syndrome. This rare genetic disorder is characterized by the development of multiple sebaceous cysts, as well as other abnormalities like colon polyps and osteomas.

• Reference: According to a study published by Liu et al. (2009) in Clinical Genetics, Gardner’s syndrome often presents with multiple sebaceous cysts and is inherited in an autosomal dominant pattern. (Liu, M., et al. (2009). “Gardner’s syndrome and its clinical manifestations,” Clinical Genetics, 75(4), 315-321.)

4. Acne

Individuals who suffer from acne may be more prone to sebaceous cysts because the condition often involves blocked hair follicles. Acne occurs when pores become clogged with excess sebum, dead skin cells, and bacteria. This same mechanism can lead to the formation of sebaceous cysts, especially if the clogged follicle becomes trapped or infected.

• Reference: A study by Zouboulis (2009) in Dermatologic Therapy explained that acne vulgaris is one of the most common causes of obstructed sebaceous glands, which increases the risk of developing sebaceous cysts. (Zouboulis, C. C. (2009). “The pathogenesis of acne and its treatment,” Dermatologic Therapy, 22(2), 1-7.)

5. Hormonal Changes

Hormonal fluctuations are another factor that can contribute to sebaceous cyst formation. For instance, during puberty, pregnancy, or menopause, hormonal changes can increase the production of sebum, which may overwhelm the ability of the sebaceous glands to expel it. This can lead to the blockage of the hair follicle, increasing the risk of cyst formation.

• Reference: A review by Rosenfield (2005) in The Journal of Clinical Investigation outlines how hormonal changes influence sebaceous gland activity, particularly during puberty and adolescence, which is a common time for sebaceous cysts to develop. (Rosenfield, R. L. (2005). “Hormonal regulation of sebaceous glands,” The Journal of Clinical Investigation, 115(8), 2020-2027.)

6. Chronic Skin Conditions

Certain chronic skin conditions can predispose individuals to developing sebaceous cysts. Conditions like dermatitis and folliculitis can cause inflammation or infection of the hair follicles and sebaceous glands, leading to blocked pores and the formation of cysts. Folliculitis, for example, occurs when hair follicles become inflamed due to bacterial or fungal infection, leading to pus-filled bumps that can turn into cysts.

• Reference: A paper by Housman et al. (2017) in The Journal of Dermatology discussed how folliculitis, which is an inflammation of hair follicles, can lead to cyst formation if the inflammation causes the sebaceous gland to become blocked. (Housman, C. I., et al. (2017). “Folliculitis and its complications: A review,” The Journal of Dermatology, 44(9), 1121-1128.)

Conclusion

In summary, sebaceous cysts form primarily due to blocked sebaceous glands, but can also result from trauma, hormonal changes, acne, or genetic factors. While they are usually harmless, they may become inflamed or infected, requiring medical intervention. Understanding these risk factors can help in preventing and managing sebaceous cysts.

For a deeper dive into this topic, the references listed provide more comprehensive information about the mechanisms, causes, and clinical management of sebaceous cysts.