Sebaceous Cyst


Last Updated December 20th, 2021

What are sebaceous cysts?

Sebaceous cysts are slightly hardened, fluid-filled bumps within the skin, which are considered to be noncancerous.  The size of a sebaceous cyst ranges from pea-sized, at about one centimeter across to around five centimeters across.

A cyst generally is a slow-growing lump that can move easily under the skin.  Sebaceous cysts are found under the skin. Palms of the hands and soles of the feet are the usual areas where a sebaceous cyst may be found.  

Blocked glands, trauma, as well as swollen hair follicles,  are some of the causes of a sebaceous cyst.  

Cysts sometimes are also inherited. Generally, a sebaceous cyst grows very slowly and does not cause pain.  However, the sebaceous cyst can become inflamed or infected, with the overlying skin becoming red, tender, and sore.  Sebaceous cysts occur on a site that is constantly irritated. When the cyst gets infected, it drains out a cheesy, bad-smelling material and can look bad cosmetically.

What do these cysts usually contain?

Sebaceous cysts are generally mobile masses that consist of:

  • Fibrous tissues and fluids.
  • A fatty (keratinous) substance that resembles cottage cheese and due to this the cyst may be called keratin cyst.  This material has a cheesy appearance to it as well as emits a foul odor.
  • It may sometime contain serosanguineous fluid.  A serosanguineous fluid generally contains purulent and bloody material.

Causes of sebaceous cyst

Some of the causes of sebaceous cyst include:

  • Blocked sebaceous gland:  The sebaceous gland produces the oil called sebum that coats the hair and skin.  Cysts can develop if the gland or its duct from which the oil is able to leave becomes damaged or blocked.
  • Swollen hair follicle:  A swollen hair follicle or folliculitis is a skin condition in which hair follicles become inflamed.  Bacterial or fungal infections are the main culprits of folliculitis.  At first, it looks like small red bumps or white-headed pimples around hair follicles, which are the tiny pockets from which hair grows.
  • High levels of testosterone:  Testosterone is the most important androgen in the human body.  Androgens encourage sebum production. Therefore, due to higher androgen levels, seborrheic glands produce more sebum, which is an oily substance leading to coarse pores of the skin.  Consequently, acne and acneiform eruptions are more common in seborrheic areas such as the face, upper thorax, back, and shoulders.  Due to androgen, there is abnormal thickening of the outer layer of the skin and the sebum is trapped within the follicle and this, in turn, leads to acne lesions and also cause cysts.
  • Use of androgenic anabolic steroids:  High dosages of anabolic-androgenic steroids increase skin surface lipids, and these lipids cover the outer layer of the skin and cause Propionibacteria acne and sebaceous cysts.
  • Hereditary causes:  Gardner syndrome is a medical condition where GI polyps, multiple osteomas, and skin and soft tissue tumors are formed.  The skin symptoms associated with Gardner syndrome include epidermoid cysts, desmoid tumors, and other benign tumors.  Basal cell nevus syndrome is a combination of health defects, which is caused by a rare genetic condition. This condition affects the skin, endocrine system, nervous system, eyes, and bones.

What are the symptoms?

Small sebaceous cysts are typically not painful.  Large sebaceous cysts can be uncomfortable and considerably painful.  Large cysts on the face and neck may even cause pressure and pain. A sebaceous cyst is typically filled with white flakes of keratin, which is also a key element that constitutes the skin and nails.  Most sebaceous cysts are soft to the touch and are considered noncancerous. Common areas on the body where cysts are usually found include:

    • Scalp.
    • Face.
    • Neck.
  • Back.

A sebaceous cyst can be possibly cancerous if it has the following characteristics:

    • The diameter of the cyst is larger than five centimeters.
    • Immediate recurrence in a very short span of time after being removed.
  • If the cyst tends to appear infected with signs and symptoms correlating to redness, pain, or pus drainage.

How is it diagnosed?

Diagnosis of a sebaceous cyst is made when a doctor conducts a simple physical examination.  If the sebaceous cyst is unusual in appearance, the doctor may order additional tests to rule out possible cancers and a person may also need these tests if he or she wishes to have the cyst surgically removed.

Common tests used for a sebaceous cyst include CT scans, which can determine the root cause of the cyst and aid in surgery.  Ultrasounds may also be performed to determine the contents of the cyst. Lastly, a punch biopsy may be required to test the tissue from the cyst to determine if the cyst is cancerous.

How is a sebaceous cyst treated?

Treating a sebaceous cyst will require a consult from a medical professional to assess the sebaceous cyst and determine if needs to be left alone or to be managed medically either by medication therapy or through surgery if found to be malignant.

Generally, sebaceous cyst needs to be left alone and they cause little harm to the daily lifestyle. Any action such as picking, rubbing, or squeezing the cyst may cause damage and lead to infection of the cyst. When the cyst gets infected, it is likely to cause pain and discomfort as well as worsen its appearance.  

Consulting a doctor is the best option to deal with skin cysts that are causing concern or producing symptoms. The doctor can treat a cyst by draining it or by surgically removing it. Since most cysts are not harmful to the health, a doctor will allow the patient to choose the treatment option that suits the patient.  

It is important to note that without surgical removal, a cyst will usually return back and the best treatment is by removing the cyst completely from the root through surgery.

When a cyst is decided to be removed by surgery, the doctor may use one of the following methods to remove the sebaceous cyst.

    • Traditional wide excision.  This method involves complete excision of the cyst, but since it involves a wide opening to perform the surgery, the patient may end up with a long scar.
    • Minimally invasive excision.  This method involves minimal excision of the cyst with a minimal amount of opening but carries a risk of recurrence of the cyst.
  • Laser incision followed by punch biopsy excision.  This method is a more sophisticated process of removing the cyst, which involves the laser to make a small hole to drain the cyst of its contents and the outer walls of the cyst is physically removed during a secondary procedure.

Reasons why it should be removed

There are several reasons that can contribute to the doctor to decide on removing the cyst through surgery.  The main reason leading to this decision may be because the cyst may be causing problems, which may be because of infection, if the cyst alters a person lifestyle, or if it is found in a prominent location.  

The sebaceous cyst may be removed a the doctor’s office and generally involves a consent from the patient, sterilizing the area to avoid spreading of the infection to other parts of the body using a drape and sterile kit, local anesthetic to numb the area, and a blade and other instruments to cut the cyst out.  The doctor may prefer to lance the cyst if the cyst is already draining due to the infection.

Doctors removing a cyst will mainly aim to remove the cyst completely since any leftover part of the cyst may cause the cyst to return at a later stage. A microincision technique involves emptying the cyst sac with the chemical phenol.  In other cases, there are many cases that a person may have a cyst and not have any symptoms or discomfort associated with it.

Steps for safe sebaceous cyst removal

    • A sebaceous cyst that is inflamed needs to be left alone and not be incised until the inflammation subsides.  Generally, inflammation settles over 4 weeks. Antibiotics may be required to subside the inflammation. Cephalexin or Cloxacillin is the first choice of antibiotics provided.
    • Incision and drainage of the sebaceous cyst is recommended only when the cyst becomes swollen due to the fluid build up.
    • Lidocaine with epinephrine can be used for hemostasis to reduce the bleeding during the incision and drainage process.  It is advisable to not inject anesthetics on the cyst to avoid rupture of the cyst. Sufficient time needs to be provided for the anesthetic take effect and monitor the pressure of the cyst by palpating.
    • Choosing the appropriate skin incision makes it much easier for the cyst to be excised.  A linear incision is advised if the cyst is not inflamed or scarred whereas a radical incision is preferred for a recurrent cyst.
    • The initial incision performed with the scalpel should be mild and not be incised applying pressure in order to avoid incising completely through the cyst.  A curved hemostat is used as the instrument of choice until visualizing the cyst.
    • Blunt dissection is a preferred method rather than a scalpel to dissect around the cyst whereas the solid areas of connective tissue can be divided with a scalpel.
    • Hemostats should be placed immediately if the cyst gets ruptured and use the scalpel to complete the process in a faster way and avoid sebum contact with the wound.
    • Small and moderate sized cysts can be closed with a vertical mattress technique whereas small incisions can be closed using interrupted stitches.  Absorbable Vicryl or Monocryl stitches can be placed for large wounds.
  • Clean wounds thoroughly and send the patient home with dressings that will not allow blood to leak through.

 

Dos and Don'ts

Dos
  • Leave it alone if not troublesome.
  • Avoid bacterial and fungal infections.
  • Avoid high dosage steroids.
  • Use home remedies to treat the cyst.
  • Consult your doctor if the cyst grows in size or is painful.
Don'ts
  • Try to pop the cyst.
  • Block sebaceous glands by applying cosmetics.
  • Incise the cyst when it is inflamed.
  • Incising the cyst at home.
  • Delay treatment if the size of the cyst increases.

 

 

 

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Vitamin K2: 8 reasons why you need this bone-building & cancer-fighting nutrient Vitamin K2 is claimed to be essential for your bone health, for reducing the risk of cancer, and…
Anhedonia: Does the chronic inability to feel joy affect you too? How often do you feel dragged down by an invisible force? Do you feel an inexplicable emotional numbness…
biopsy procedure
Biopsy Biopsy is a procedure of studying a live tissue sample collected from a specific organ for diagnosing a…
Mood swings
The real reasons for your mood swings and how to overcome them Are you prone to heated moods frequently? Do you also feel bouts of depressive feeling creeping up on…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Green, brown, & bitter: The instant advantages of including fenugreek in your diet Did you know the earliest usage of fenugreek can be traced back to the Egyptian civilization? Find out…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Glucose-6-Phosphate Dehydrogenase (G6PD) test Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that is found in every cell of the body and it plays…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
APL IgM Test
Antiphospholipid Antibody(APL)-IgM test The antiphospholipid antibodies are specific protein in the body directed against the phospholipids. It is used to detect…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
helping friend with depression
Support and care tips for helping people with depression Read to find out what is depression, its causes and symptoms. Also check out the steps describing how…
Blood Disorders cancer
Immunotherapy immunotherapy is a treatment that boosts the body's immune system to identify the cancer cells and fight cancer.
Lung cancer xray
Lobectomy Lobectomy is a surgery where a lobe of the diseased lung is removed. It is mainly done to…
heartfail_2
Open Heart Surgery An open heart surgery is a major procedure performed to treat heart diseases like congenital heart problem, heart…
Miracle extract from the root of maca: 10 ways it can help you! Maca root has been used for years in herbal medicine. Today scientific research is unearthing fresh evidence in…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Shilajit: A miracle Himalayan herb for an active and happy life The Himalayas contain more wonders than you thought. Shilajit is a miracle herb that is widely used in…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
anti ds dna test
Anti Ds-DNA antibody Test The  Anti Ds-DNA antibody test is used to diagnose the disease called lupus or more aptly the SLE(Systematic…
Ca 19.9 test
CA19.9 Test CA 19.9 is a cancer antigen that exists on the surface of cancer-causing cells. The levels of CA…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
CLA: A breakthrough weight loss supplement with minimal side effects Tried every weight loss supplement in the market with no substantial gain? Why not try CLA supplements, derived…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
What is Qigong and how can it help you channelize you inner “Qi”? Qigong is an integrated way of performing a traditional exercise regimen that can help in promoting health, mental…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Bronchoscopy procedure
Bronchoscopy Bronchoscopy is a procedure where in a scope is inserted into the lung pathway to observe any growth…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Hibiscus: Nourish your beauty and health with these vibrant blooms Hibiscus is a trumpet shaped flower found abundantly in tropical countries. It has been historically used for its…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Trisodium Phosphate: How a paint thinner made its way into your breakfast Ever thought how toxic chemicals find their way into our foods? How can they harm our body? And…
folate test
Folate test The Folate test measures and monitors the levels of folic acid in the blood. This test is also…
BRAT Diet: What is the right way to follow this diarrhea-relieving diet? BRAT diet, a simple diet consisting of just bananas, rice, applesauce, and toast, can help you combat the…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Alp enzyme-test
ALP test – Alkaline Phosphate ALP or alkaline phosphate is an enzyme mainly produced by the liver and gallbladder. ALP test measures the…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…

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