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A skin cyst (also called an epidermal inclusion cyst or sebaceous cyst) is an enclosed capsule inside the skin that is filled with keratin. They are frequently a result of clogged pores or hair follicles, and are common in areas such as the scalp, neck, shoulder, or back as a result; however, it is possible for cysts to appear anywhere else on the body as well.
The vast majority of skin cysts are usually only a cosmetic concern and aren’t life threatening; however, they can be uncomfortable and can get inflamed or infected. Cysts in the scalp for instance can get irritated by a comb while styling hair and can cause pain. Cysts in the shoulder or back can create an unsightly lump that is easily noticeable, and can interfere with daily routines such as putting on a seatbelt or wearing a backpack. If left untreated, it is also possible for cysts to become infected. Infected cysts become red due to inflammation, and can develop an unpleasant smell due to the presence and leaking of pus or keratin.
The causes of skin cysts are not 100% certain. Many of them develop simply due to genetics. Multiplying cells move inwards as opposed to moving away from the skin’s surface and shedding away like normal. Skin cysts can also develop from some form of damage that causes epidermal skin cells to be implanted in the dermis.
Some of the common causes are:
Other common causes include blocked sebaceous glands, high levels of testosterone, and the use of androgenic anabolic steroids.
Epidermal inclusion cysts are extremely common, and may be due to damage to a hair follicle or oil gland. These types of cysts are often benign, and are a buildup of keratin below the skin’s surface. Epidermoid cysts that involve damage to a hair follicle are known as pilar cysts, and more than 90% of pilar cysts occur in the scalp. It is very common for multiple pilar cysts to be present at the time time.
Dermoid cysts are growths present at birth. These are derived from residual embryonic cells from the epidermis becoming trapped during fetal development. Because they grow slowly, many people notice them for the first time during childhood or early adulthood.
Sebaceous cysts are usually rare. These contain a buildup of sebum in the sebaceous glands. Multiple ones commonly form at once (known as steatocystoma multiplex), but can also be find in single instances as well (steatocystoma simplex). Sebaceous cysts can occur inside of a pore or hair follicle on the back, face, or scalp. Due to them containing sebum, as well as their location, they can grow to be a very large size and can cause pain and pressure.
Epidermoid, dermoid, and sebaceous cysts frequently consist of benign swelling in the skin from the sebaceous gland or hair follicle. They are filled with a yellowish substance known as either keratin of sebum, depending on the type of cyst. This substance has a consistency that is comparable to cottage cheese. Oftentimes they are easily visible due to the swelling, and can cause pain if large enough.
Many cysts are asymptomatic and don’t have any visible signs. They can be seen & felt as a lump or bump in an area of the skin. They can sometimes cause pain if a cyst is infected or irritated, although many cysts have no pain. The easiest way to determine if a lump is a possible cyst is if it can be freely moved around within the skin.
If a cyst is not visible, they can be diagnosed via ultrasound, x-ray, medical scans, or a biopsy. Because cysts can become infected, they can become swollen and tender, and may even develop a pustule. Permanent scarring or discoloration can also happen if a cyst is left untreated for extended durations. While most cysts are harmless, a cyst that has burst or otherwise leaked out of its capsule has a very high risk of infection, can lead to other problems.
It is important to note that cysts can be commonly confused with other conditions, such lipomas. Acne cysts are a collection of inflamed and clogged skin oil ducts. These are considered to be an abscess instead since the sac is filled with pus instead of keratin or sebum, and require different treatment methods.
Cysts that are located behind the ear or around an area where an injury occurred can by mistaken as a keloid instead.
Certain cases of basal cell carcinoma can mimic a cyst, but are actually a skin cancer. A professional examination from a board-certified dermatologist such as Dr. Behroozan can ensure that the condition is properly identified, and can be treated with the appropriate methods.
The most common treatment for skin cysts is removal via excision. The excision process is an out-patient surgical procedure that is quick, and can often be completed in about 10 minutes.
During excision, local anesthetic is used to numb the area. Most patients report not feeling any pain at all while the excision is being performed, and compare the feeling to be similar to someone rubbing the area while wearing multiple layers of clothing. The entire cyst capsule and its contents are removed during excision. No part of the sac wall is left behind, as this prevents the same cyst from forming again. It is still possible for brand new, unrelated cysts to develop, however.
After the cyst excision has been completed, sutures are applied, and will be removed within 5-7 days. A few days of swelling and mild soreness are normal at the excision site, and can be controlled with over-the-counter pain medications. Most normal activities, including returning to work, can be resumed the next day after the cyst removal. Heavier levels of exercise can be resumed within a couple of weeks after the healing process has had enough time to be completed. Sun exposure to the treated area should be limited, and use of sunscreen with at least SPF 30 is strongly advised.
For smaller cysts, drainage may be possible. Dr. Behroozan will help you determine what the best course of action is for your cyst removal during your consultation.
While cyst removal is a relatively quick procedure, it does have its risks. Poor technique can lead to infection and prominent scarring. Additionally, the entire capsule must be removed in its entirety. Any remnants of the cyst that are left behind can lead to the reoccurrence of the same cyst. Selecting a well-experienced dermatologist for your cyst removal will ensure that the entire cyst is successfully removed with minimal scarring and the least amount of risk.
As a board-certified dermatologist, Dr. Behroozan and his team have successfully removed thousands of cysts over the years. Due to his experience, he and his team can remove even the toughest cysts with the lowest risk of any complications.
After removal of your cyst, Dr. Behroozan performs a full examination of the growth to ensure it is not malignant. During your consultation, he is also able to diagnose any other conditions or concerns you may have, and is available anytime for your follow-up anytime after your procedure has taken place. For your convenience, Dr. Behroozan also offers his own personal line of sunscreen at both of his locations which is available for purchase immediately after your cyst removal has been completed.