Sebaceous cyst

What is a sebaceous cyst?
A sebaceous cyst is a soft lump of skin surrounded by an outer shell. The cyst forms under the skin and contains:

  • Tallow
  • Keratin
  • dead cells.

This material has:

  • a whitish color,
  • an unpleasant odor.

The consistency can be semi-solid or creamy or liquid, such as oil.
It is a small elevation that develops under the skin, especially at:

  • face (cheek, forehead, chin, nose, zygomatic bone, under the eyelid (hailstone or chalazion) and behind the ear),
  • neck and occipital area (here they could be confused with enlarged lymph nodes),
  • Scalp
  • Armpits
  • Back
  • Breast
  • Arm
  • area and buttocks,
  • groin or genital area (scrotum and vulva).

The size of sebaceous cysts ranges from:

  • a few millimeters,
  • five to six centimeters.

The sebaceous glands are located next to the hair follicles.
These glands produce sebum, which is an oil that lubricates the skin and coats the hair.

The sebaceous glands are able to drain the sebum produced and the other substances:

  • into a hair follicle,
  • on the skin.

Each hair grows from a follicle, a small pocket of skin in the dermis (layer of skin that is located under the epidermis).


Types of subcutaneous cysts

The most common types of cysts that appear under the surface of the skin are:

  1. Epidermoid cyst, it forms in the dermis and forms in the subcutaneous layer of the skin and has a hard-elastic consistency.
    The epidermoid cyst contains semi-solid material (keratin and fat).
  2. pilar or trichilemmal cyst, it arises in the lower part of the hair follicles; they are often seen on the scalp.
    The hair cysts contain creamy sebaceous material and compact keratin. These cysts are usually:

    • multiple
    • smooth
    • dome-shaped,
    • covered with pink and hairless skin.
  3. Dermoid cyst, it is caused by a developmental defect. Dermoid cysts are located in the deep dermis. These cysts can develop in a developing fetus, so they can also affect children. As a rule, a single cyst is formed in the area of:
    • eyebrows, near the temples,
    • Nose
    • Mouth
    • Sacrum/coccyx.
  4. Hidradenitis suppurativa (acne inversa), a chronic inflammatory skin disease.
    This disease is accompanied by cysts and abscesses in certain areas of the body, such as:- armpits, – groin,
    – entire thigh,

    – Perianalzone.In these areas there are hair follicles and apocrine sweat glands.
    Due to chronic pain and the discharge of pus from the blisters, hidradenitis suppurativa is a disabling disease in physical, social and psychological terms.

The dorsal wrist cyst is filled with synovial fluid and forms on the joint or in the tendon sheath. So it should not be confused with a sebaceous cyst, which is located on the skin.

Causes of sebaceous cysts

The sebaceous cyst is formed as a result of blockage of the sebaceous gland (or its excretory duct) due to a solidification of the sebum, which thus cannot reach the outside.

The reasons include:

  1. Damage to a hair follicle. The follicles that have been damaged by lesions, abrasions or surgical wounds can become clogged by superficial cells.
  2. The rupture of a sebaceous gland.
    In the case of an inflammatory skin disease, they can be easily damaged, especially acne favors the formation of epidermoid cysts.
  3. Heredity. Epidermoid cysts can develop in people with relatives who also have these cysts, that is, if there is a family predisposition. Dermoid cysts may be related to Gardner syndrome, a rare genetic condition that causes:
    • lipomas,
    • fibromas,
    • multiple osteomas,
    • Growths (polyps) in the large intestine.

According to conventional medicine, sebaceous cysts are not related to poor nutrition.

Risk factors for sebaceous cysts

Nearly anyone can develop one or more epidermoid cysts, but the following factors increase the likelihood:

  • After puberty. They can be found at any age, but epidermoid cysts rarely develop before puberty.
  • Male gender. Men are more likely to develop epidermoid cysts.
  • Acne history. Epidermoid cysts are especially common in people who have had acne.
  • Skin lesions. Any kind of traumatic lesion or skin contusion. For example, if a hand has been crushed in a car door, the risk of an epidermoid cyst increases.
  • Smoking.
  • Alcohol.
  • Stress.
  • Use of certain cheap cosmetics.

Is the sebaceous cyst dangerous?
No. Epidermoid cysts are harmless and are almost never related to skin cancer (basal cell carcinoma or squamous cell carcinoma).

Symptoms of the sebaceous cyst

Most cysts are soft to the touch.

  • Small cysts are usually not painful and do not cause itching.
  • Large cysts can cause discomfort and severe pain if they are infected and inflamed.

Large cysts on the face and neck can cause pressure and pain.

Signs of infection:

  • Pain
  • redness,
  • Accumulation of pus (pus cyst).

Complications of sebaceous cysts

The inflamed sebaceous cyst is characterized by:

The purulent sebaceous cyst follows a bacterial infection (for example, by streptococci or staphylococci) and leads to:

  • overheating, the skin is warmer in the area of the cyst,
  • inflammation,
  • Accumulation of pus inside.

Diagnosis of a sebaceous cyst

Doctors diagnose a sebaceous gland after a physical examination.
If the cyst appears unusual, the doctor may order further examinations to rule out possible tumors.
The following investigations may be necessary:

  • Ultrasound, which allows you to see the contents of the cyst.
  • Biopsy, which means the removal of a small amount of the cyst contents for a histological examination in order to rule out cancer.

Treatment of sebaceous cysts

Usually, cysts that do not cause aesthetic or functional problems are not treated.
An inflamed, opened or infected cyst can be treated as follows:

  1. Injections. The doctor may infiltrate an inflamed (but not infected) cyst with corticosteroids or triamcinolone acetonide® (triam inject) to reduce inflammation.
  2. Sulmycin with Celestan V (gentamicin + betamethasone) can be introduced into the infected cyst with purulent secretion, but it is important to show this structure to the doctor.
  3. Laser. To reduce scarring, the doctor may use a CO2-Use laser to vaporize an epidermoid cyst on the face and other sensitive zones.

When should you operate on a sebaceous cyst?

The doctor may advise removal of the cyst if it is inflamed. In addition, the patient can decide whether it should be removed for aesthetic reasons.

  1. Incision and drainage. In this procedure, the doctor makes a small incision in the cyst and removes its contents.
    Even though the incision and drainage are relatively simple and fast, the cysts often recur after such treatment.
  2. Total removal. This surgical procedure removes the entire cyst and prevents recurrences. Removal is most effective if the cyst is not inflamed.
    If the cyst is infected, it cannot be removed.
    Before the procedure, the doctor prescribes medications to treat the infection, such as: antibiotics and cortisone.
    Once the inflammation has passed, it can be removed after four to six weeks.

    • The operation is performed on an outpatient basis and under local anesthesia.
    • After a total removal, the area must be sutured.
    • The doctor pulls the stitches about a week after the total removal of the cyst.
    • Recovery times after the procedure are about 7-10 days.
  3. There is an electromedical device called PlexR®, which allows the cyst to be dissolved without a skin incision.
  4. Minimum distance. Some doctors prefer this technique because it removes the cyst wall and leaves minimal scarring.
    During the procedure, the doctor makes a small incision in the cyst, removes its contents, and after that the cyst wall with an incision.
    Usually a small incision remains, which heals naturally.

Natural remedies for a sebaceous cyst

The natural treatments for sebaceous cysts are a tolerable and cost-effective option that often prevents painful medical therapy.
Although these remedies are referred to as alternative and harmless treatments, they can have side effects. Therefore, a doctor or alternative practitioner should be consulted beforehand.

Moist heat: You can apply a moist, warm wrap to the sebaceous cyst to promote spontaneous drainage and healing.
Hot heating pads should be avoided because it could promote the proliferation of bacteria in the cyst, which can cause an infection.
It is better to apply only a little heat for a short time.
If the cyst does not respond to the moist, warm poultice, you should consult a doctor.

Tea tree oil: Tea tree oil has powerful antibacterial and anti-inflammatory properties.
Since many sebaceous cysts become infected with bacteria, the application of tea tree oil can:

  • counteract infection,
  • favor healing.

Aloe vera: Some naturopaths recommend the gel of this plant to treat the sebaceous cysts, as it fights the bacteria and relieves the pain. Some studies show that aloe vera gel kills bacteria and has a beneficial effect on wound healing.

As a natural remedy, some doctors recommend making poultices with cotton lobules soaked in alcohol.

Nutrients that boost the immune system: A strong immune system helps the body heal on its own. Consumption of fruits rich in antioxidants and vegetables, for example:

  • Berries
  • Citrus fruits
  • dark green leafy vegetables.

One can take herbal remedies based on red clover and burdock root. In this way, you will:

  • strengthens the immune system,
  • Poisons removed from the body.

Cleanliness. To avoid infection, wash the affected area daily with antibacterial soap.

Natural remedies also include ichthyol ointments, which have an antibacterial effect.

Can I put on a sebaceous cyst?

You might be tempted to push a cyst open, but that’s not a good idea.
If the cyst is infected and opened without proper precautions, the infection could spread.
If the cyst does not cause any discomfort, it is better to do without it.
If the blister appears to be infected, causes discomfort or is disturbing to the sight, it is better to contact a dermatologist to have it examined.

How long does it last? Prognosis for patients with sebaceous cyst

The prognosis is very good, usually the cyst heals completely. Sometimes the cyst is reabsorbed without therapy. Sometimes she recurs.

Read more: