Skin cysts are a common problem. We discuss their causes, symptoms and treatment options
What is a cyst?
A cyst is a sac that is filled with fluid or semi-fluid thicker material. Cysts can generally occur in most places of the body, including testicular, kidney or liver cysts, but this article will focus on skin cysts (also known as sebaceous cysts or epidermoid cysts)
What causes skin cysts?
The specific cause is not really understood, but it is thought to be due to skin cells becoming trapped in deeper skin layers, or when the oil glands in the skin get blocked. These trapped cells continue to multiply, or the gland still tries to produce oil, leading to growth of the cyst
What symptoms do skin cysts cause?
Cysts often cause no problems at all, but occasionally they can become painful (especially if on the scalp and caught with a hairbrush), infected, or noticeable and cosmetically embarrassing. Also, cysts can sometimes leak a thick toothpaste-like material, which can smell unpleasant. In such cases, cyst removal may be the best option
How can skin cysts be treated?
Occasionally specialists may aspirate the cyst, whereby a needle is passed into it to suck out the contents. Whilst this may temporarily remove the cyst, it very often recurs.
Cysts can sometimes rupture spontaneously, possibly having been knocked against an object without noticing. The swelling, however, often recurs. Years ago, it was common practice to try and rupture the cyst ‘with the family bible’ – this is definitely not a good idea though, as you can easily cause serious injury by trying this!
If the cyst is quite small, then laser surgery may be possible. This usually leaves very little scarring, but does have other risks such as hypopigmentation of the skin.
Generally, the most common and appropriate way for cyst removal is to perform surgery, usually under local anesthetic.
How is surgery for cyst removal performed?
Usually, cyst removal can be performed under local anesthetic. The surgeon injects the local anesthetic around the cyst, making the skin numb. It may sting a little as the anesthetic is injected. During removal of the cyst, you may feel a little tugging and pulling but should be generally pain-free.
Occasionally, depending on the location and size of the cyst, general anesthetic may be needed for surgical removal.
How long does cyst removal take?
This very much depends on the size of the cyst and the location. Usually, cyst removal takes around 30 minutes.
Can a skin cyst come back?
Yes there is a risk they can return. Occasionally they can recur after surgery in the same area but, having had one cyst, it may indicate that you are prone to forming cysts and you could have new ones forming elsewhere on your skin.
What are the risks of cyst removal surgery?
Scarring – cyst removal requires the overlying skin to be cut, which will result in a scar. Scars usually fade in time, but can be quite red for the first year. Occasionally, the scar may be more noticeable than the cyst itself.
Infection – a few days after cyst removal, the wound may become red and sore. This could be the signs of a wound infection, which may need antibiotics
Recurrence – it is said that approximately 5% of cysts may return after removal
Pain or numbness – occasionally, a nerve may have been very close to the cyst and could be injured during removal. This could lead to long-term pain and/or numbness in the area
Dips in the skin – this is a common result of cyst removal, and is due to the cyst having pushed deeper tissue away from it as it grows. After removal, this dent is still present and so can show when the skin is closed. The surgeon will usually try to reduce this effect for you, but some contour defects can still remain.
Other complications can also occur during cyst removal, depending on the size and location of the cyst. This list of risks is not exhaustive, and you should of course discuss possible complications and treatment options with your specialist.