Have you ever noticed something like a small lump or ball growing under your skin? Sometimes we call these 'sebaceous cysts', right? But what exactly are these, why do they form, and are they dangerous? Let's talk about all this today.
What is an Epidermal Inclusion Cyst?
Simply put, this is a small sac filled with something like fluid that forms under the top layer of your skin (the epidermis). It looks like a little ball hidden under the skin. Many people also call this
a sebaceous cyst . But that is a bit of a misconception. Because these cysts do not contain `(Sebum)` (an oily substance produced by the oil glands in the skin to keep our skin moist). They actually contain things like
keratin (a type of protein found in our skin, nails, and hair) and dead skin cell fragments. Most of the time, doctors only use the name `(Sebaceous cyst)` for cysts that develop with specific skin conditions like `(Steatocystoma Multiplex)`. Those cysts are actually filled with `(Sebum)`. That is why they are really `(Sebaceous cysts). But these true sebaceous cysts are not very common. But the epidermal inclusion cysts we are talking about are very common.
How common are these epidermal inclusion cysts?
Epidermal inclusion cysts are actually
the most common type of skin cyst. You've probably had one or two.
What does an epidermal inclusion cyst look like?
Now let's see what this tumor looks like. You may see features like these:
- It looks like a round knot or a small lump.
- Sometimes you can see a small black dot (`(Punctum)`) in the middle of the fruit.
- They can range in size from about one-half (0.25) inches to more than two (2) inches. They can grow slowly.
- The skin color may vary. It is usually a pinkish-red color, or it may be a slightly darker color than your skin tone.
- You may feel a slight stinging or warmth when you touch it.
- This fruit may feel like it moves easily when you move it around with your hand.
What's inside an epidermal inclusion cyst?
As I mentioned before, these cysts are filled with
keratin and dead skin cells . When a dermatologist drains one, the fluid that comes out is thick, yellow, and may have a slightly
foul odor .
Do these nuts hurt?
Usually, an epidermal inclusion cyst
is not painful . However, sometimes this cyst
can become inflamed (swelling).. Then it will feel painful when touched. As the cyst grows, if it ruptures (ruptures), you may experience itching and pain. Sometimes you may also feel an itch in the area where the cyst is. If you have pain in the area where the cyst is, or if you have any other unusual symptoms, you should definitely see a doctor.
Where do epidermal inclusion cysts most commonly occur?
These tumors can actually form anywhere on the body, but they are most commonly seen in these areas:
- On the face
- In the chest
- On the back
- Scalp
- On the neck
- In the legs
- In the hands
- Genitalia (related to the genitals)
What causes epidermal inclusion cysts?
These cysts form when a hair follicle (`(Hair follicle)`) in our skin – that is, the hole through which a hair comes out of the skin – becomes blocked at its top (`(Follicular infundibulum)`). Think about it, our skin cells also have a life cycle. When they die, they are shed from the skin. That is a normal process. But if your skin gets injured, like a scrape, a surgical wound, or a skin condition like acne, or if your skin is damaged by sunburn, these dead skin cells cannot be shed properly. Then these cells and things like keratin accumulate under the surface of the skin and get stuck. That is how this cyst, or cyst, is formed. Sometimes, even in places where there are no hair follicles on your body, this type of cyst can develop due to an injury to the skin. Because of that injury, the cells in the upper layer of the skin are pushed down to the lower layer (`(Dermis)`). There, too, keratin accumulates and forms a tumor.
Who is at higher risk of developing epidermal inclusion cysts?
Although these tumors can develop at any age, they are most common
between the ages of 20 and 60. They rarely develop before puberty. They are also more common
in men than in women. Some rare genetic conditions and other diseases can also cause multiple tumors to develop at the same time. For example:
- Gardner syndrome (`(Gardner syndrome / familial adenomatous polyposis)`)
- Gorlin syndrome (`(Gorlin syndrome / basal cell nevus syndrome)`)
- Favre-Racouchot syndrome (`(Favre-Racouchot syndrome)`)
- Human papillomavirus ( HPV ) infection .
Also, some
medications can increase the risk of developing these tumors:
- BRAF inhibitors
- Imiquimod (`(Imiquimod)`)
- Cyclosporine (`( Cyclosporine )`)
Are these tumors contagious?
No, epidermal inclusion cysts are
not contagious .
What are the possible complications of an epidermal inclusion cyst?
These tumors can sometimes cause complications such as:
- Inflamed epidermal inclusion cyst: The cyst becomes swollen and painful to the touch.
- Infected epidermal inclusion cyst: Harmful bacteria grow inside the cyst, causing swelling, pain, and skin discoloration as the body fights against it.
- Ruptured epidermal inclusion cyst: The cyst ruptures, causing swelling, pain, skin discoloration, and a yellow (often foul-smelling) fluid to ooze out.
Is an epidermal inclusion cyst a sign of cancer?
Epidermal inclusion cysts are
usually harmless . However, very rarely, researchers have found cases where cancer cells (`(Malignancy)`) have developed inside these cysts. Specifically:
- Squamous cell carcinoma (Squamous cell carcinoma)
- Basal cell carcinoma (`(Basal cell carcinoma)`)
If your tumor has these characteristics, it's something to be concerned about:
- Signs of an infection: pain, skin discoloration, swelling, and/or drainage.
- Growing up very fast.
- Greater than 5 centimeters in diameter.
If you notice any changes in your tumor, talk to a doctor immediately.
How do you recognize an epidermal inclusion cyst?
A doctor can diagnose an epidermal inclusion cyst by examining you, looking at the lump, and asking about your symptoms (if any). Although not usually necessary, they may also order tests such as these to confirm the diagnosis:
- Radiology or imaging tests: An ultrasound can help find out what's inside the tumor. If the tumor is large, a CT scan (computed tomography scan) can confirm the diagnosis and help the doctor decide the best way to remove it.
- Biopsy: The doctor takes a small piece of tissue from the tumor and tests it in the laboratory.
Do I need to see a specialist for a tumor like this?
If you notice any changes or new lumps on your skin, see a doctor first. You can see your family doctor (Primary Care Physician - PCP). He or she can refer you to a dermatologist if necessary. Not all doctors remove epidermal inclusion cysts. Therefore, your doctor may refer you to a specialist who is trained to remove these cysts, for example, a dermatologist, a general surgeon, or a plastic surgeon.
How are epidermal inclusion cysts (sebaceous cysts) treated?
In most cases, if you don't have any symptoms or problems with your cyst, your doctor may tell you to just
observe it and not treat it . However, if the cyst is swollen and you feel uncomfortable, you can try
a warm compress at home to help reduce your symptoms. However, if your symptoms persist or get worse, see a doctor. He or she may recommend removing it or injecting the cyst with steroids to temporarily reduce the swelling. If the cyst is infected, it is treated with
antibiotics .
Epidermal Inclusion Cyst (Sebaceous Cyst) Removal
Your doctor may remove the tumor using these methods:
- Incision and drainage: The doctor makes a small incision over the cyst and drains the fluid inside. This does not completely cure the cyst, as the cyst capsule is not removed. However, it does provide relief from swelling and inflammation.
- Surgical excision: This is a surgical procedure that completely removes the tumor. This is done under local anesthesia . This means you are not put to sleep and you will not feel any pain. The outer covering of the tumor (capsule) is completely removed, which prevents the tumor from coming back.
The most important thing is, you should never try to squeeze, pop, or pop these cysts yourself! Doing so can cause infection and the cyst may even grow back.
Are there any side effects of the treatment?
Risks associated with surgical removal of a tumor are very rare, but they can include:
- An infection
- Bleeding
- A scar
- A pain
- Recurrence of the tumor (`(Recurrence)`)
Can epidermal inclusion cysts (sebaceous cysts) be prevented?
Epidermal inclusion cysts are usually a random occurrence. However,
avoiding injury to your skin, avoiding damage , and
getting proper treatment for skin conditions (e.g., acne) can help reduce this risk.
What will happen to these nuts? What is the outlook?
Once you've been diagnosed, you can either wait for the cyst to go away
on its own , or talk to your doctor about treatment options. Most of the time, these cysts don't cause any symptoms. But if a cyst develops in a visible area, like your face or scalp, or if it's causing you pain, it can be a little concerning. If the cyst is bothering you, talk to your doctor about having it removed.
Will an epidermal inclusion cyst go away on its own?
Some tumors will shrink in size, but others may continue to grow until you receive treatment. If left untreated, you may have the tumor for the rest of your life.
Can epidermal inclusion cysts get worse?
Sometimes epidermal inclusion cysts can remain small and asymptomatic for years. However, they can grow in size and cause discomfort and itching. If the cyst is bothering you, talk to your doctor about treatment options.
When should I see a doctor?
Always see a doctor if you notice a lump or bump on your skin. It could be an epidermal inclusion cyst, another type of tumor, or something more serious.
Don't self-diagnose . See a doctor for a clear diagnosis and specific treatment.
What should I ask my doctor?
You can ask the doctor questions like:
- Do I have an epidermal inclusion cyst, or another type of tumor?
- Will this get better on its own, or do I need treatment?
- Do you think this tumor will get bigger?
- What treatment options do you recommend?
- Should I see a specialist or a surgeon?
- What should I do if the tumor comes back after being removed?
Are epidermal inclusion cysts (sebaceous cysts) dangerous?
Most epidermal inclusion cysts
are not dangerous . They usually do not cause symptoms. Not all cysts become infected, but they can become infected. Infections can be dangerous if left untreated. Although very rare, some cysts can become cancerous, so see a doctor if you notice any changes in your skin. Seeing a new lump or growth on your skin can be scary and worrying. It could be a harmless epidermal inclusion cyst, or it could be a more serious diagnosis. See a doctor as soon as you notice any changes in your skin. He or she can give you a proper diagnosis and answer any questions or concerns you may have. Epidermal inclusion cysts do not always require treatment. However, having them removed by a doctor may make you feel more comfortable.
Do not try to pop or pop these cysts at home.It can cause an infection. Your doctor will safely drain the cyst, so you don't have to worry about it.
So, what are the most important things we should take home from this story?
Okay, so here are some of the key things to remember about the epidermal inclusion cysts we talked about today:
- These are a type of cyst that forms under the skin, filled with keratin, and are often harmless .
- The name 'sebaceous cyst' can be a misconception.
- These usually don't hurt, but they can swell, become infected, and burst.
- If you notice a new lump or bump on your skin, don't self-diagnose, but definitely see a doctor.
- Never try to squeeze or pop these cysts yourself. This can make the condition worse.
- Although treatment is not necessary in most cases, if the tumor is bothersome, there are ways to safely remove it.
- Since it can very rarely be cancerous, be aware of things like rapid growth, color change, and pain in the tumor.
So, if you have something like this, don't panic. The best thing to do is to be informed and seek medical advice if necessary.
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