Finding a small, soft, pliable lump growing just beneath your skin is worrisome, but it’s even more concerning if that unusual bump is painful, inflamed, or oozing pus.
While it can be an enormous relief to learn that your abnormal growth is a harmless cyst and not a cancerous tumor, your diagnosis may leave you wondering — what exactly is a cyst, and how can you get rid of it?
Johnny Serrano, DO, FACOS, a board-certified general surgeon in Glendale, Arizona, provides complete care for patients with problematic cysts — including in-office cyst removal — at Precision Surgery and Advanced Vein Therapy. Here’s what you should know about the two most common types of cysts and how they’re treated.
A cyst is an abnormal growth that can form anywhere within the skin or inside the body. While most of these soft sacs are small and filled with fluid, some cyst capsules are large, and others contain semisolid material or even air. Most are benign (noncancerous), but some do have the potential to become malignant (cancerous).
Although cysts can appear anywhere — they commonly emerge on the ovaries, breasts, and kidneys, for example — they most frequently develop in the skin. The two most prevalent skin cysts are epidermal cysts and pilonidal cysts.
Epidermal cysts are pliant, dome-shaped bumps just beneath the skin. As the most common type of external cyst, they usually have a white or yellow hue because they’re filled with keratin, a vital skin protein with an oily, cheese-like texture.
An epidermoid cyst is a product of improperly shedding epidermal (skin) cells. It develops when wayward, lingering skin cells migrate to deeper skin layers, form an enclosed capsule, multiply, and actively secrete keratin. The cyst expands as keratin builds up in the sac, concentrating into a thick, yellowish paste that sometimes oozes out.
Although epidermoid cysts are sometimes referred to as sebaceous cysts, the two are not one and the same; instead of developing from errant epidermal cells, sebaceous cysts arise from the oil-secreting sebaceous glands that lubricate your skin and hair.
Epidermoid cysts can develop on any body area but frequently appear on the face. Other common locations include the chest, shoulders, neck, arms, legs, and genitals.
While people of all ages get epidermal cysts, they appear most often in young and middle-aged adults between the ages of 20 and 60. They’re almost twice as common in men than in women and rarely appear before puberty.
Epidermoid cysts that are small, painless, or not bothersome otherwise may be left untreated, apart from regular monitoring for changes. If an epidermoid cyst grows or becomes inflamed and painful, it may be treated with a simple incision and drainage or minimally invasive surgical excision.
A pilonidal cyst is a round sac of tissue filled with fluid or air that typically develops at the cleft of the buttocks. While they don’t always cause symptoms when they first appear, most pilonidal cysts grow larger, more sensitive, and more painful over time.
Although experts are still studying exactly what causes pilonidal cysts to form, they do know that most are the result of a skin infection caused by an ingrown hair. They can be a one-time (acute) problem or a recurrent (chronic) condition that returns over time.
Most pilonidal cysts emerge on the cleft of the buttocks, but they can develop anywhere along the buttock crease — from the tailbone to the anus. Their awkward location sometimes causes the people who get them to avoid seeking medical care, but this is a mistake; left untreated, a pilonidal cyst can lead to worsening complications.
Anyone can develop pilonidal cysts, but certain factors make their appearance more likely. They occur in men up to four times more often than women; they also tend to affect younger adults between the ages of 20 and 35 more frequently.
Sitting all day, being overweight, wearing tight pants, and having thick or rough body hair can also increase your chances of having a pilonidal cyst.
Pilonidal cysts require medical treatment and often grow larger and more painful without intervention. Without care, they can also lead to complications like skin abscesses (swollen pockets of infection) and sinus cavities (empty hollows beneath the skin).
Incision and drainage, antibiotics, acid chemical injections, and laser hair removal to prevent recurrent ingrown hairs are non-surgical treatment options for mild to moderate pilonidal cysts. Chronic or worsening cysts usually require surgical removal.
Remember, any cyst that’s infected (sore, swollen, red, or oozing foul-smelling pus) or has ruptured requires prompt medical attention. In-office surgical removal is only an option once inflammation is under control and the infection has cleared.
Dr. Serrano may recommend surgery for cysts that are:
To learn more about in-office cyst removal at Precision Surgery and Advanced Vein Therapy, call 623-321-5663 or click online to schedule a visit with Dr. Serrano today.
