Skin Cyst Removal, Signs and Causes

The two most common skin cysts are epidermoid cysts and sebaceous cysts. Typically harmless, cysts are bumps that show up under the skin. In this article, we will go through what exactly are epidermoid and sebaceous cysts, what are the causes, and treatment options for cyst removal by a dermatologist.

What are epidermoid cysts? 

A cyst is a benign (non cancerous), round, dome-shaped bump that contains fluid or other material. They can appear anywhere on the skin, but are most common on the face, neck, and trunk (e.g chest and shoulders). They are also common on the scrotum and vulva.  

Credit: DermNet NZ

What are sebaceous cysts?

Unlike epidermoid cysts which originate from the skin, true sebaceous cysts are rare and originate form the sebaceous glands.

Sebaceous cysts can be found over you entire body, except for the palms of your hands and the soles of your feet. When squeezed, a small dome shaped projection called a punctum will appear. Through that opening, the sebum may be squeezed out.

Signs of an epidermoid cysts include: 

• A small blackhead on the opening of the cyst 
• A thick, smelly yellow material that may drain from the cyst 
• Often has a diameter of 1-3cm

Credit: DermNet NZ

Rupture of the contents of the cyst can lead to swelling, redness, and tenderness. This can occur from bacterial infection such as Staph.A, E.Coli, or from trauma. 

Inflamed cyst
Credit: DermNet NZ

Other names for epidermoid cysts: 

• Epidermal cysts 
• Keratin cysts 
• Sebaceous cysts (commonly mistakenly identified as these cysts do not involve sebaceous glands) 

What causes an epidermoid cyst? 

The epidermis – top layer of your skin – is made up of a thin, protective layer of cells that your body sheds continuously. Most epidermoid cysts form when these cells move into the deeper layers of your skin and multiply rather than shed. This causes a buildup of keratin in the skin, developing into cysts.

Sometimes, the epidermoid cysts can form due to irritation or trauma to the skin, or a portion of the hair follicle.  The epidermal cells are the walls of the cysts which secrete the protein keratin into the interior. The keratin is the thick, yellowish substance that sometimes drains from the cyst. 

What causes a sebaceous cyst?

Sebaceous cysts come from your sebaceous glands. Cysts can develop if the gland gets damaged, or the passage through which sebum leaves the skin is blocked. This usually occurs because of some sort of trauma in the area such as a scratch, surgical wound, or skin condition like acne.

Who gets epidermoid cysts?

Epidermoid cysts occur most commonly in adults, especially when young to middle aged. Additionally, they also occur twice as more frequently in men. Injuring the skin can also lead to development of epidermoid cysts.

Having certain rare genetic disorders may also increase the risk of developing epidermoid cysts:

• Gardner syndrome
• Basal cell naevus syndrome
• Pachyonychia congenita type 2

Epidermoid cysts vs sebaceous cysts

Many refer to epidermoid cysts as sebaceous cysts, but they are different. True sebaceous cysts are much less common. Sebaceous cysts start in the sebaceous gland. This is an oil gland in the skin that secretes oil, or sebum that lubricates the skin and hair.  

What are the options for cyst removal? 

Most epidermal cysts are slow growing and painless, so they don’t usually need treatment. However, if the cyst grows rapidly, ruptures or becomes painful, bothers you for cosmetic reasons, or occurs in a spot that causes irritation, you can see a skin specialist to have perform an epidermoid cyst removal. 

Talk to your dermatologist about these options: 

• Injection: this involves injecting the cyst with a steroid that reduces inflammation and swelling. 
• Incision and drainage: Your dermatologist will make a small cut in the cyst, and gently squeeze out the contents. While this method is fairly quick and easy, cysts tend to recur after this treatment. 
• Complete surgical excision: The most effective treatment for is a a complete epidermal cyst removal. Your doctor will remove the entire cyst with an intact cyst capsule. This is done through minor surgery in which you need to return to have stitches removed. 

Looking for cyst removal procedures in Singapore? Book a TeleConsultation with MOH accredited dermatologist, Dr. Teo Wan Lin, to have your condition addressed. Click on bottom left button to contact us or simply click here to book an appointment now.