Cysts

Cysts are extremely common and can vary dramatically from very small to very large, often feeling like a little bump or knot under the skin. They usually start as a small lump and can grow with time. A skin cyst is a common, fluid filled lump that can develop beneath the surface due to blocked glands or other causes. Most cysts are harmless and grow slowly, but some, like epidermoid cysts or ganglion cysts, may become painful or lead to inflammation if left untreated. While a small cyst may not need immediate care, others, especially those caused by severe acne or showing signs of infection or swelling, may require a doctor’s diagnosis and treatment options, which can include antibiotics, drainage, or a minor surgical procedure to have the cyst treated completely.

Common Types of Cysts

There are many different types of cysts but three common types of cysts in the skin include Epidermoid Inclusion Cysts, Sebaceous Cysts, Pilar Cysts, and Digital Mucous Cysts, and each are unique. Different types of cysts occur in different parts of the body for different reasons, so it’s important to have a general understanding of cysts. If you notice one developing, have it checked by a board-certified Plastic Surgeon or Dermatologist. 

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Sebaceous Cysts

Sebaceous cysts are non-cancerous, typically slow-growing lumps beneath the skin that form when sebaceous glands become blocked. These cysts are usually filled with a yellowish, oily substance called sebum and are most commonly found on the face, neck, or torso. While they are often painless, sebaceous cysts can become swollen, inflamed, or infected, sometimes requiring medical treatment or surgical removal.

Epidermoid Inclusion Cysts

A common type of cyst in the skin made famous in “pimple-popping videos”, these cysts return repeatedly after you squeeze them. They most commonly occur on the face and upper body. Epidermoid inclusion cysts can form on their own or when a hair follicle becomes disrupted/clogged and creates a pocket that traps skin cells that would normally be sloughed off (keratin).

Epidermoid inclusion cysts are benign and usually do not cause any discomfort. They sometimes can become inflamed or infected in which case the cyst becomes suddenly more swollen, painful and red.

Many people find epidermoid inclusion cysts bothersome or not aesthetically pleasing and wish to have them removed. This can be performed in a simple in-office excision with local anesthetic, with minimal to no downtime. These cysts should only be removed when they are not inflamed/infected.

Pilar Cysts

Pilar cysts (sometimes known as trichilemmal cysts) are skin-coloured bumps that appear on your scalp and can feel like a knot under your hair. It is a keratin-filled cyst, that occurs when the hair follicle gets clogged. While generally not harmful, pilar cysts can be irritating and cause pain when brushing hair.

Pilar cysts can be completely removed with a simple in-office surgical excision so that they do not return again.

Techniques used for Cyst removal

Cryotherapy

The cyst is drained and then liquid nitrogen is used to alternately freeze and thaw the cyst.

Steroid injection

The cyst is injected with intralesional corticosteroid.

Surgical Excision

The cyst is completely removed surgically and the skin is sutured closed. This is the most common treatment offered at Pacific Plastic Surgery. Complete surgical excision gives the greatest chance of the cyst not returning or growing again.

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