Sebaceous cysts are common noncancerous cysts of the skin. Cysts are abnormalities in the body that may contain liquid or semi-liquid material.
Sebaceous cysts are mostly found on the face, neck, or torso. They grow slowly and are not life threatening, but they may become uncomfortable if they go unchecked.
Doctors usually diagnose a cyst with only a physical examination and medical history. In some cases, a cyst will be examined more thoroughly for signs of cancer.
Sebaceous cysts form out of your sebaceous gland—which produces the oil called sebum that coats your hair and skin. Cysts can develop if the gland or its duct, the passage where oil is able to leave, become damaged or blocked. This usually occurs due to a trauma to the area.
According to the Mayo Clinic, the trauma may be a scratch, a surgical wound, or a skin condition, such as acne. (Mayo Clinic, 2011) Sebaceous cysts grow slowly, so the trauma may occur months or weeks before you notice the cyst.
Other causes of a sebaceous cyst may include:
- developmental defect: a person may be born with a misshapen or deformed duct
- damage to the cells during a surgery
- genetic conditions, such as Gardner’s syndrome or basal cell nevus syndrome
Sebaceous cysts are generally found on skin that is easily seen—such as the face, neck, or torso. This can make the affected person uncomfortable since the cysts might be considered unattractive.
This type of cyst is typically filled with white flakes of keratin, which is also a key element making up your skin and nails. Most cysts are soft to the touch.
Small cysts are typically not painful. Large cysts can range from uncomfortable to considerably painful. Large cysts on the face and neck may cause pressure and pain.
Areas on the body where cysts are usually found include:
- skin on the scalp
- face (most common site for cyst removal)
A sebaceous cyst is considered unusual—and possibly cancerous—if it has:
- a diameter that is larger than five centimeters
- a fast rate of reoccurrence after being removed
- signs of infection, such as redness, pain, or pus drainage
Doctors often diagnose a sebaceous cyst after a simple physical examination. If your cyst is unusual, your doctor may order additional tests to rule out possible cancers. You may also need these tests if you wish to have the cyst surgically removed.
Common tests used for a sebaceous cyst include:
- computed tomography (CT) scans, which help your doctor find the best route for surgery and spot abnormalities
- ultrasounds, which identify the contents inside the cyst
- punch biopsy, which involves removal of a small amount of tissue from the cyst to be examined in a laboratory for signs of cancer
Your doctor can treat a cyst by draining it or by surgically removing it. Normally, cysts are removed. This is not because they are dangerous but rather for cosmetic reasons. Since most cysts are not harmful to your health, your doctor will allow you to pick the treatment option that works for you.
It is important to remember that without surgical removal, your cyst will usually come back. The best treatment is to ensure complete removal through surgery. Some patients do decide against surgery, however, because it can cause scarring.
Your doctor may use one of the following methods to remove your cyst:
- conventional wide excision: completely removes a cyst but can leave a long scar
- minimal excision: causes minimal scarring but carries a risk that the cyst will return
- laser with punch biopsy excision: the laser is used to make a small hole to drain cyst contents and the outer walls of the cyst are removed about a month later
After your cyst is removed, your doctor may give you an antibiotic ointment to prevent infection in the affected area. You should use this until the healing process is complete. You may also be given a scar cream to reduce the appearance of any surgical scars.
Sebaceous cysts are generally not cancerous. However, they can be unattractive. Cysts left untreated can become very large and may eventually require a surgical removal if they become uncomfortable.
If you have a complete removal, the cyst will not return in the future. You may have to spend the rest of your life with an unattractive scar, though. But without a complete removal, the cyst can come back at any point.
In rare cases, the removal site may become infected. Contact your doctor if your skin shows any signs of infection—such as redness and pain—or if you develop a fever. Most infections will go away with antibiotics, but some can become deadly if untreated.