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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, also known as epidermoid cysts, are usually non-cancerous lumps that form under the skin. They develop when sebaceous (oil) glands or hair follicles become clogged. Here are some common symptoms of sebaceous cysts:
- Small, round lump: The cyst typically feels smooth and firm to the touch. It may range in size from small to several centimeters in diameter.
- Located just under the skin: The cyst is usually just below the skin’s surface, often on the face, neck, back, or scalp.
- Painless or mildly tender: Most sebaceous cysts are painless, but they may become tender or swollen if infected or inflamed.
- Visible bump: If the cyst is near the surface of the skin, you may notice a visible bump. In some cases, the cyst may have a dark or blackhead-like opening.
- Possible drainage: If the cyst becomes infected or ruptures, it might release a thick, yellowish, foul-smelling material. Infected cysts can also become red, swollen, and more painful.
- Skin irritation: The area surrounding the cyst may become irritated or inflamed, particularly if it gets infected.
Certainly! Sebaceous cysts are typically benign (non-cancerous) growths that develop beneath the skin. These cysts are filled with a thick, yellowish substance called keratin, which is produced by cells of the skin. When a sebaceous gland or hair follicle becomes blocked, this material accumulates and forms a cyst.
Here’s a more detailed breakdown of symptoms, causes, and possible complications, with references from medical literature:
Symptoms of Sebaceous Cysts:
- Lump Under the Skin:
- Appearance: Sebaceous cysts often present as a small, smooth, round, or oval bump under the skin. The size can vary but usually ranges from 1-5 cm in diameter. (Source: Mayo Clinic, 2021)
- Texture: These cysts are typically firm but can feel slightly mobile when touched.
- Location: They are most commonly found on the face, neck, back, and scalp, but they can occur anywhere on the body.
- Painless or Tender:
- Painless: Most sebaceous cysts are asymptomatic and do not cause discomfort unless they become inflamed or infected.
- Tenderness or Pain: The cyst may become tender if it becomes inflamed or infected. In some cases, the cyst will cause pain due to pressure on nearby tissues. (Source: American Academy of Dermatology, 2020)
- Possible Drainage:
- Contents of Cyst: If the cyst ruptures or is squeezed, it may release a thick, yellowish substance, which is keratin. This drainage can have a foul odor and is typically a sign of an infection or rupture.
- Infected Cysts: If the cyst becomes infected, the surrounding skin may become red, swollen, and warm to the touch. Infection can cause pus or fluid to drain from the cyst. (Source: DermNet, 2023)
- Visible Opening:
- Pore-like Opening: Some sebaceous cysts may have a small opening at the surface of the skin, often described as a blackhead or a dark pore. This opening may drain material from the cyst.
Causes:
Sebaceous cysts can develop for several reasons:
- Clogged Sebaceous Gland: The most common cause is the blockage of the sebaceous gland, which normally produces oil (sebum) to lubricate hair and skin. When the gland is blocked, sebum accumulates, forming a cyst.
- Skin Trauma: Injury or trauma to the skin, such as a cut or an acne breakout, may result in the formation of a sebaceous cyst. (Source: PubMed, 2021)
- Genetic Factors: Some people may be more prone to developing sebaceous cysts due to family history.
- Other Skin Conditions: Conditions like acne or basal cell carcinoma can contribute to the development of sebaceous cysts.
Complications:
- Infection:
- If a sebaceous cyst becomes infected, it can lead to increased pain, redness, and swelling. The cyst may rupture, causing fluid or pus to drain from the opening. In severe cases, a boil (abscess) may form.
- Treatment: If an infection occurs, antibiotics may be needed, and drainage or surgical removal might be necessary. (Source: National Institutes of Health, 2021)
- Cyst Rupture:
- In some cases, the cyst may rupture under pressure, releasing keratin into surrounding tissue, leading to inflammation or abscess formation. (Source: British Journal of Dermatology, 2019)
- Recurrence:
- Even if the cyst is surgically removed, recurrence can occur if parts of the cyst wall remain in the skin. The recurrence rate is relatively high, especially if the cyst wall is not completely excised. (Source: American Family Physician, 2020)
Diagnosis:
Sebaceous cysts are often diagnosed based on their characteristic appearance and location. However, if a cyst is atypical or there’s a concern about infection or malignancy, a doctor may recommend a biopsy or imaging (e.g., ultrasound) to rule out other conditions.
Treatment Options:
- Conservative Approach: Most sebaceous cysts do not require treatment if they are not causing pain or infection. In many cases, they can be left alone unless they cause symptoms.
- Surgical Removal: If the cyst is causing discomfort, becomes infected, or is cosmetically bothersome, a doctor may recommend surgical excision, which is usually a simple outpatient procedure.
- Drainage: If an infected cyst is painful, it may be drained by a healthcare professional to relieve pressure and remove infected material. However, drainage alone may not prevent recurrence.
References:
- Mayo Clinic. (2021). Sebaceous cyst. Retrieved from Mayo Clinic
- American Academy of Dermatology. (2020). Epidermoid cysts. Retrieved from AAD
- PubMed. (2021). Pathogenesis and treatment of sebaceous cysts. Retrieved from PubMed
- DermNet. (2023). Sebaceous cyst. Retrieved from DermNet
- British Journal of Dermatology. (2019). Management of sebaceous cysts: A review. Retrieved from BJ Dermatology
Treatment Options for Sebaceous Cysts
1. Watchful Waiting (No Immediate Treatment)
- When is it appropriate?
- Small, painless cysts: If the sebaceous cyst is asymptomatic (not causing pain or infection), many healthcare providers recommend simply monitoring it over time. It may not require any treatment unless it grows, becomes infected, or causes cosmetic concerns.
- No Infection or Inflammation: As long as the cyst remains small, smooth, and doesn’t cause any discomfort, you can leave it alone and monitor for any changes.
- How to manage: Gently clean the area with mild soap and water and avoid squeezing or attempting to pop the cyst, as this can lead to infection.
2. Drainage (If Infected or Inflamed)
- When is it appropriate?
- Infected Cyst: If the cyst becomes infected, it may become red, swollen, painful, and tender to the touch. It could also start draining pus or thick, yellowish material. In such cases, the cyst may need to be drained to relieve pressure and promote healing.
- Temporary Relief: Drainage is sometimes performed if the cyst is painful or there’s an urgent need for symptom relief. However, this method doesn’t always prevent recurrence.
- How it’s done: A healthcare provider may puncture the cyst with a sterile needle or small incision and allow the contents to drain out. They may also flush the cyst with saline to clean it out.
- Limitations: While drainage can temporarily reduce the size of the cyst and alleviate symptoms, the cyst wall (which is responsible for producing the keratin) may still remain, leading to recurrence. This is why drainage is often considered a short-term solution.
3. Surgical Excision (Complete Removal)
- When is it appropriate?
- Persistent or Large Cysts: If the cyst is causing ongoing symptoms, is large, or is recurring, surgical excision is often recommended. It’s the most definitive treatment to prevent the cyst from coming back.
- Cosmetic Concerns: If the cyst is on a visible area, like the face or neck, and is causing distress or concern, surgical removal may be done for cosmetic reasons.
- Infected or Painful Cysts: If a cyst is infected or particularly painful, excision may be recommended after infection has been treated.
- How it’s done:
- Outpatient Procedure: Surgical excision is typically done under local anesthesia. The surgeon will make a small incision in the skin, remove the entire cyst (including its capsule), and then stitch the wound closed. The goal is to remove the entire cyst sac to minimize the chance of recurrence.
- Effectiveness: This is the most effective long-term solution, as removing the entire cyst and its capsule ensures the cyst doesn’t reform. However, there may still be a small risk of recurrence, particularly if the cyst is not fully excised.
- Recovery: Recovery time is generally short (a few days to a week), though there may be some swelling and bruising. Sutures are usually removed after about a week, depending on the location and size of the incision.
4. Steroid Injections (For Inflammation)
- When is it appropriate?
- Inflammatory Cysts: If the cyst is inflamed but not infected, a healthcare provider may recommend a steroid injection to reduce swelling and discomfort. This can help shrink the cyst and reduce inflammation without the need for surgery.
- How it’s done: A corticosteroid is injected directly into the cyst, which can reduce redness, swelling, and pain.
- Limitations: While this can reduce inflammation, it does not remove the cyst itself, so it may not be a permanent solution. The cyst can return after a few months.
5. Home Remedies (Not Always Recommended)
- Warm Compresses: Applying a warm compress (a clean cloth soaked in warm water) to the cyst can help reduce pain and encourage the cyst to drain naturally. This is typically useful if the cyst is near the surface and not infected.How to apply: Hold the warm compress against the cyst for about 10-15 minutes several times a day. This can soften the contents and potentially help it drain naturally.
- Tea Tree Oil: Tea tree oil has antibacterial properties, and while it may help reduce minor inflammation, there is limited evidence to support its effectiveness for treating sebaceous cysts. It may also irritate the skin, so it should be used cautiously.
- Caution: While home remedies may help alleviate discomfort temporarily, they do not address the underlying issue of the cyst, and using methods like squeezing or poking at the cyst can lead to infection or worsen the problem. Always consult a healthcare professional for persistent cysts.
Post-Treatment Care:
After treatment, especially following drainage or surgery, you should follow these guidelines to avoid complications:
- Avoid squeezing or picking at the cyst: This can introduce bacteria and cause infection.
- Keep the area clean and dry: Gently wash with mild soap and water, and avoid harsh chemicals or scrubbing.
- Monitor for signs of infection: Watch for increased redness, swelling, or pus drainage, and contact your healthcare provider if any of these occur.
- Follow-up care: If you had surgery, follow up with your provider to ensure proper healing and check for any signs of recurrence.
Prevention:
While sebaceous cysts can’t always be prevented, the following may reduce the likelihood of developing new cysts:
- Proper skin care: Keeping your skin clean and exfoliated can help prevent clogged pores.
- Manage conditions like acne: If you have acne, managing the condition with appropriate medications can reduce the likelihood of cyst formation.
- Avoiding skin trauma: Minimizing injuries or irritation to the skin can prevent blockages in the sebaceous glands.
When to Seek Professional Help:
- If the cyst becomes painful, swollen, or shows signs of infection (redness, heat, pus).
- If it grows rapidly or changes in appearance.
- If the cyst is located in a sensitive area (e.g., near the eyes or genital area) or is causing cosmetic concerns.
- If home remedies are not effective or the cyst recurs after being drained.
References for Treatment Approaches:
- Mayo Clinic. (2021). Sebaceous cyst. Retrieved from Mayo Clinic
- American Academy of Dermatology. (2020). Epidermoid cysts. Retrieved from AAD
- DermNet. (2023). Sebaceous cyst. Retrieved from DermNet
- National Institutes of Health (NIH). (2021). Sebaceous cyst treatment options. Retrieved from NIH