A cyst is a pocket or saclike structure in the skin, which usually contains fluid or keratin material. The epidermoid cysts (also called epidermal inclusion cysts) are the most common type of cysts on the skin. They are primarily found on the trunk, face, and neck of oily- skinned individuals, and less frequently on the arms and legs. These cysts are very common in adults and can range in size from less than a centimeter to several centimeter. A punctum or opening can often be seen and an odorous material can sometimes drain from this opening.

Another common cyst is the pilar cyst, which usually occurs on the scalp as multiple firm, round, enlarging nodules and is thought to derive from hair shaft cells.

Most cysts do not present problems, but some cysts can rupture spontaneously or if it has been traumatized. If the cyst contents leak into the adjacent skin, the area may become inflamed, red, and swollen or infected.

Why do cysts occur?

Most cysts arise spontaneously. In some patients, there may be a familial tendency to develop either sebaceous (epidermoid) or pilar cysts.

Most cysts on the skin are benign (not cancerous) and usually remain asymptomatic and stable in size for years. Some cysts, however, enlarge either slowly or rapidly and may become painful, inflamed or cosmetically distressing. If a cyst ruptures, it typically can be red and exquisitely painful, and may become infected. Prompt medical attention is required.

Although most cysts are benigh, some bumps that appear to be cysts but may in fact be tumors and should be evaluated by a dermatologist. Signs of possible abnormal development include rapid growth and any appearance or behavior that seems unusual.

How are cysts treated?

Benign and unchanging cysts may not require any treatment, although surgical excision may limit the possibility of future problems with the cyst, such as rupture or infection. If cysts are growing and painful, surgical excision with local anesthesia is commonly done to remove the cyst.

An inflammed cyst is often treated by a procedure called incision and drainage (I&D) in which the cyst is lanced and the contact drained to reduce inflammation. A bacterial culture may be performed to determine if any bacteria is present that require treatment with oral antibiotics.

Some inflammatory cysts respond well to corticosteroid injection into the cyst. This can shrink the cyst promptly, and is most effective for large inflammatory acne cysts.

What can Dr. Mann and The Dermatology Center do for me?

Dr. Mann is experienced in the diagnosis and treatment of cystic lesions. Appropriate treatment depends upon a correct diagnosis, and this requires both an accurate history and skilled physical examination. Whether the cyst is stable or inflamed, schedule a consultation with Dr. Margaret Mann for evaluation and proper diagnosis. Dr. Mann performs the full spectrum of treatment for cysts, including surgical excision, corticosteroid injection and incision and drainage in the office with a local anesthetic.

If you have any questions, please contact us at (615) 266-3376 (DERM).