What are Cysts?

Cysts are benign nodules located underneath the skin that form when the skin cells from the epidermis do not shed appropriately. These cells along with keratin buildup become trapped underneath the top layer of skin. Keratin is a protein that makes up the hair and nails. A “sac” or cyst wall then forms and encapsulates the skin cells. Cysts may continue to enlarge over time and can occasionally become red, painful and inflamed.

What Are the Different Types of Cysts?

There are many different types of cysts and they vary based on the location of origin of the cyst. The most common type of cyst is an epidermal cyst, sometimes referred to as an epidermoid inclusion cyst. Other types of cysts include milium, pilar cysts, and pilonidal cysts.

Different Types of Cysts - Epidermal Cyst

Epidermal Cyst

Epidermal cysts are formed from the uppermost portion of the hair follicle known as the infundibulum. They have a predilection for the extremities. The cyst can form for various reasons. Common causes include trauma to the skin or inappropriate shedding of skin cells causing them to be trapped underneath the skin. An epidermal cyst may stay stable for years and be asymptomatic. Occasionally, the cyst grows, ruptures, or becomes inflamed and causes pain. This is often dependent on body location. Some patients state they are in pain when they sit down or rest their back on the chair. A small black dot is commonly seen on the surface of the epidermal cyst, this is called the punctum. This punctum is the opening of the cyst and turns black due to oxidation.

Different Types of Cysts - Epidermal Cyst (body)

When they become inflamed, the surrounding skin becomes erythematous (red). This often is misinterpreted as a skin infection. Infection of cysts is not very common, although it may occur. More commonly, the redness occurs when the cyst sac ruptures and the body’s natural inflammatory response causes the redness. If there is excessive redness, warmth, or the patient has a fever, an infection should be suspected and evaluation with a provider is recommended right away.

Treatment: Epidermal cysts that are inflamed or irritated can be treated with a steroid injection right underneath the skin to help reduce local inflammation and shrink the size of the cyst. If the cyst becomes markedly inflamed, painful and fluctuant an incision and drainage may be recommended. After this in-office procedure, the cyst will continue to drain from the small opening in the skin for about a week. Cysts are packed with a sterile gauze dressing that is to be removed two days later. Patients may be placed on a course of oral antibiotics to further help reduce inflammation. Draining the cyst offers initial relief but does not remove the cyst completely. The remaining cyst sac will likely refill over time and continue to cause pain for the patient. Excision of the entire cyst with the sac is the preferred treatment for symptomatic cysts. This includes numbing the surrounding area and making a small incision to remove the entire cyst. Cysts that are inflamed are often not excised until the inflammation subsides. This allows for a smaller scar and decreases the risk of recurrence in the future.

Milia Cyst

Milia are very common tiny, white pinpoint cysts filled with keratin that are situated right below the epidermis. These benign lesions are often located on the face, particularly on the forehead and surrounding the eyes. The milia cyst also forms due to trapped dead skin cells underneath the skin. The cysts are non-painful and do not require treatment. However, patients may prefer to have these removed for cosmetic reasons.

Treatment: The best method of removal is to carefully nick the milia cyst surface with a sterile blade and gently express the contents. This procedure is best done in the office by a trained professional to reduce the risk of scarring and infection.

Milia Cyst - Pilar Cysts

Pilar Cysts

Pilar cysts, often referred to as trichilemmal cysts, are common cysts found on the scalp. These cysts are formed from the hair follicle when dead skin cells become trapped under the skin. This cyst sac is thicker than epidermal cysts and is less likely to become inflamed and rupture. There is no black central punctum located on pilar cysts. They are benign and do not require treatment unless they are symptomatic. Given their common location on the scalp, these may become painful for patients when brushing their hair or laying down with pressure on the cyst. There is a genetic predisposition for the formation of these cysts which exhibit an autosomal dominant pattern of inheritance.

Treatment: The treatment for symptomatic pilar cysts is local excision with suture placement. These cysts are easier to remove than epidermal cysts as they often protrude from the excision site with the sac fully intact.

Pilonidal Cyst

A pilonidal cyst is located near the tailbone region above the gluteal cleft. The formation of these cysts is thought to be related to trapped hair follicles below the skin’s surface. This cyst is found more commonly in men than women. Inflammation and irritation may result from pressure placed on the cyst while sitting down. Obesity, coarse body hair, and prolonged sitting have all been identified as risk factors for this condition.

Treatment: Typically patients are referred to general surgery for surgical removal of pilonidal cysts since these lesions tend to form sinus tracts deeper into the skin causing treatment to be more complex.

At REJUVA Dermatology and Vein Center, our board-certified physicians offer excision of various cysts that are symptomatic. The procedure is quick and done right here in our office in Venice, FL. The skin is first numbed with a local anesthetic. The rest of the procedure is painless. The cyst is excised with the smallest scar possible to remove the entire cyst wall and contents. Pain relief from symptomatic cysts is often right away. As we are a cosmetic office as well, we focus on suturing techniques to minimize scarring. We also offer a variety of laser procedures to treat scars if desired. Schedule your consultation for expert treatment and care today!

Dr. Golta Rasouli

Dr. Golta Rasouli is a double board-certified and fellowship-trained vein specialist and physician. Patients are consistently pleased with her comprehensive treatment for venous diseases and other skin conditions. Dr. Rasouli’s extensive publication record complements her outstanding Google Reviews, reflecting her expertise and patient-centered approach.

Dr. Sean Mazloom

Dr. Sean Mazloom is a board-certified dermatologist and dermatologic surgeon with stellar Google Reviews. He is also one of few Mohs surgeons in Sarasota County where he provides exceptional treatment and care to thousands of patients struggling with complex skin cancers, skin conditions, and cosmetic concerns.

© 2023 REJUVA. All Rights Reserved. Digital Marketing by Webtools | Privacy Policy | Terms and Conditions | Sitemap

Skip to content
Text Us Now

Enter your information, and we will text you shortly.
First Name(Required)
Last Name(Required)