CYSTS

What is a Cyst and How Can You Treat It?

There are many different types of cysts (hundreds in fact), and they can occur anywhere on the body and vary in terms of their size and shape. Generally speaking, Cysts are defined as abnormal, closed ‘sac-like’ structures that contain a liquid, gaseous, or semi-solid substance. The outer layer surrounding them (or capsular portion of a cyst) is termed the cyst wall.

 

Cysts can occur within almost any type of the body's tissue, and take many different sizes and forms, from microscopic to large structures – some get so large that they can even displace our internal organs. Although a cyst can refer to potentially any abnormal sac formation in the body, a distinguishing feature is that they have very specific membranes (or cyst walls). When the sac of the structure contains pus, it is often considered an abscess, rather than a cyst.

What Causes the Formation of Cysts?

There are many factors that potentially cause a cyst to develop. Some of the causes are genetic in nature, while other causes can relate to infectious disease, or cysts can be a symptom of a more serious underlying medical condition.

 

Most cysts are asymptomatic and show no signs; they go completely unnoticed by us while hanging out in our bodies’ tissues. However, some cysts, usually on the skin, mucous membranes, and those located in palpable organs can be felt as a strong lump or bump; sometimes this can cause pain and be very uncomfortable.

How Can Cysts Be Treated?

Most cysts do not require treatment, and often go unnoticed or are not at all bothersome. For cysts that are painful or symptomatic of a more serious underlying medical issue, more attention will certainly be given by your healthcare specialist. Physicians may use a needle aspiration technique or surgical removal to treat some cysts depending on their size and symptoms.

 

Most cysts upon examination are found to be harmless and do not require any treatment. Physicians generally diagnose cysts by palpation, ultrasound, X-rays, CT scans, MRI scans, and needle biopsies. In a small number of cases, malignant cells are found and these have a much more guarded prognosis. The majority of cysts cannot be prevented, they are a natural occurrence in the human body; cysts that are considered preventable are generally the ones that develop from infectious diseases.

 

You may wish to explore treatment options for a benign cyst for cosmetic reasons or if it is causing any discomfort. If you seek out treatment, here are a few options you can discuss with your doctor:

 

  • Injection – This treatment option involves injecting the cyst with medication to reduce swelling and inflammation.

  • Incision and drainage – With this treatment method, a small incision is made in the cyst and the contents are gently squeezed out, this is a quick and relatively easy treatment method, however cysts can often recur after this type of treatment.

  • Minor surgery – With minor surgery your doctor is able to remove the entire cyst, which usually prevents reoccurrence. Minor surgery for the treatment of cysts is very effective and safe.

What are the Different Types of Cysts?

Almost anywhere in our bodily tissues is fair game for a cyst to develop, they can occur on the face, scalp or back, behind the knee, arm, groin, or within organs such as the liver, ovaries, kidneys, or brain. Most of the time cysts are found to be benign, but never try to treat them with home remedies – always get them checked out and make sure you are not at risk of a more serious health problem.  Trying to deal with a cyst on your own may cause the cyst to enlarge or become infected, and you certainly don’t want that.

 

There are three types of cysts found in the skin that are considered more common than others. These include the Epidermal inclusion cyst (EIC, or sebaceous cyst), trichilemmal (pilar) cyst and milium cyst. An epidermoid cyst (sebaceous cyst) is a term that can refer to two similar types of cysts: those found in the skin (epidermoid), and those found around hair follicles (pilar). Pilar cysts are similar to epidermoid cysts but are different in that they start from a different part of the hair follicle, and are more likely to be found on the scalp.

 

Some general facts about epidermoid cysts include:

  • They are filled with material that is often described as cheesy, fatty, oily, or fibrous. The material in them can be thick (like cottage cheese) or liquid. This is because this type of cyst is composed of macerated keratin, which is a fancy term meaning "wet skin cells," which is what creates the consistency of the content (and why it’s compared to cottage cheese).

  • They form slowly under the skin and can be found on most parts of the body, most commonly they develop in hairier areas like the scalp, face, upper back, and genitals.

  • You can usually move them around slightly if you try.

  • They range in size and can be as small as a pea or as large as a few inches wide/deep.

  • They are usually not painful, except when they become irritated from inflammation or infection.

  • The area around the cyst can smell bad, and if it breaks open, the material inside the cyst often smells bad too.

 

The following list, by no means exhaustive, further describes some of the common types of cysts we see in a dermatology office.

  • Epidermoid (or sebaceous) cyst:  This type of cyst presents itself via swelling in the skin. This swelling arises from the sebaceous gland, which is typically filled with yellowish sebum. Although these are usually benign, if they get too big they can become quite painful.

  • Trichilemmal (pilar) cyst:  These appear very similar to epidermal cysts, however, they are different in that they generally form on the scalp and there are usually multiple cysts that are present. The wall is thicker on this type of cyst, so the contents can usually be removed more easily in one solid piece. This contrasts to the epidermal cyst which often will rupture when being removed, and when any contents of a cyst are left behind they have a tendency to reform.   

  • Milia are usually found around the eyes and present as small firm whitish lesions. These generally arise for no apparent reason but there are some diseases and dermatologic treatments that can trigger their development. They are also commonly seen on the faces of newborns and infants but are not treated as they will resolve over a few weeks. Adult patients may wish to have the milia treated for cosmetic purposes.

  • Lipoma is characterized as a lump of fat growing inside your body’s soft tissues. These are sometimes mistaken for cysts but are actually classified as a tumor. Although it is a type of tumor these are usually harmless and very commonly form beneath the skin. About one out of every 1,000 people will develop a lipoma at some point in their lives.

  • Hidrocystomas, also known as cystadenomas, sudoriferous cysts, and Moll’s gland cysts, are benign cystic tumors that are derived from either the eccrine or the apocrine sweat gland in the body. They usually are asymptomatic, and grow at a slow pace. Generally, these tend to occur on the face or scalp, commonly affecting the eyelid.

 

These are just a few common types of cysts that we often see in patients at the Idaho Skin Institute, a lengthier list can be found here.

What is the Prognosis of a Cyst?

Deciding on a treatment plan for patients that have cyst(s) really depends on the underlying causes associated with the type of cyst being treated. It’s always better to be on the safe side and seek treatment as soon as you notice any bump or lump under your skin. Cysts that become very large may require surgery in order to remove them effectively and relieve the patient’s symptoms.

 

Cysts can be recurring, particularly when the contents are reduced but not fully removed and the cyst lining remains intact; others may reoccur due to other underlying medical conditions or causes. At the Idaho Skin Institute, we have several types of Dermatologists, Physicians and Skin Specialists that are excellent at determining the correct treatment plan when it comes to cysts and other skin irregularities.

 

If you have a lump or bump in your skin, don’t hesitate to reach out to us. We also hold free walk-in skin cancer screenings on the first Tuesday of every month, from 5 pm to 6:15 pm (except when the date falls near a holiday or on an election day). Book an appointment or come see us during our walk-in clinic hours for free skincare consultations.

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