Sebaceous Cysts

Sebaceous cysts are closed sacs of cells under the skin surface, which are filled with a white, cheese-like substance called keratin. Sebaceous cysts are sometimes referred to as epidermoid cysts or epidermal cysts. They are mostly developed in areas where there are small hair follicles with large sebaceous glands such as face, scalp, ears, arm, neck, back and in parts of the genitalia. In fact, they can occur in any part of the body, except the palms and soles. Sebaceous cysts are more common in men than women.

Causes of Sebaceous Cysts

Sebaceous cysts are caused due to abnormal proliferation of epidermal cells of the skin. The skin epidermis is made of a thin, protective lining of cells that usually sheds periodically. Sometimes, these epidermal cells instead of exfoliating themselves penetrate deep into the skin and multiply, resulting in the formation of sebaceous cysts. The epidermal cells form the walls of the cysts and secrete keratin.

Some of the causes of sebaceous cysts are skin trauma, damage of hair follicles and rupturing of the sebaceous glands. Very often, sebaceous glands are ruptured due to skin inflammations such as acne and result in the formation of sebaceous cysts. Other causes of sebaceous cysts include genetic disorders (for e.g. Gardner's syndrome) and developmental defect in the fetus.

Symptoms of Sebaceous Cysts

One of the noticeable symptoms of sebaceous cysts is a lump under the skin, which is often non-painful. It is common to have one or more cysts. In general, they are smooth, mobile, round in shape and whitish-yellow in color. The size of a sebaceous cyst ranges from 5 mm to about 5 cm. They get infected in very rare cases. In case of infection, the affected area swells, becomes red, tender and painful. After two to three days, the infected cyst erupts and a thick, cheesy, whitish-gray, foul-smelling material drains from them.

Diagnosis and Treatment of Sebaceous Cysts

Sebaceous cysts are diagnosed based on their appearance. For confirmation of cysts, the physician may recommend a biopsy test.

Sebaceous cysts need no treatment, until and unless they become painful. Usually, they disappear on their own after few days. Mostly, people opt for treatment due to cosmetic reasons. Treatment of small-inflamed sebaceous cysts is done with the administration of prescribed steroids and antibiotics.

In case of large cysts, complete removal is recommended. There are basically two methods for removing large sebaceous cysts, namely, traditional open excision and minimal excision. Traditional open excision is prescribed for recurrent cysts and those that are ruptured internally. In this technique, the affected part is disclosed and the entire capsule is removed from its surrounding tissues.

Likewise, non-ruptured large sebaceous cysts are removed with minimal excision technique. As the name suggests, the capsule is removed by making a small incision of about 2-3 mm in the affected area. Both these techniques have their own advantages and disadvantages. Though, a traditional excision results in significant scarring, chances of recurrent development of cysts is minimum. In contrast to this, a minimal excision results in less scarring and a higher rate of recurrence.

Since sebaceous cysts are idiopathic, there is no significant way to prevent their formation. However, it is advisable to take proper care of your skin and avoid using oily skin care products. Don't squeeze the cysts as it leads to scarring of the affected areas. It is recommended to consult and seek advice from a dermatologist before opting for any treatment procedure.