Epidermoid Cysts

Epidermoid cysts are painless, small lumps under the skin that occur most commonly on face, neck and trunk. They are usually harmless and do not pose a serious health concern. However, problems may arise when the cysts rupture, affect your appearance or become infected and painful. In such case, talk to your doctor about removing the cyst by any suitable method.

Many people use the terms epidermoid cysts and sebaceous cysts synonymously but they are not same. True sebaceous cysts are less common and have a different cause.

The common signs and symptoms of epidermoid cysts include:

• Tiny, round bump beneath the skin, usually on the face, trunk or neck
• Small blackhead at the central opening of the cyst 
• A thick, yellow, foul-smelling discharge from the cyst 
• Painful red swelling may develop if infection occurs 

When to see a Doctor?

Most cases do not pose any serious health concern and hence do not need treatment. Visit your doctor in case the cysts:

• Have rapid growth
• Rupture or become painful or infected 
• Occur at a site causing problems like the one in face 
• Affect your appearance

Epidermoid cysts are caused when the process of skin cell formation is disturbed. In a normal case, the rates of skin formation and shedding are optimally maintained while in this case, the rate of skin formation exceeds that of shedding. It causes accumulation of epidermal cells in the deeper skin layer.

The epidermal cells also secrete a thick, yellow substance that sometimes drains from the cyst, keratin. Damages to hair follicle or oil gland in your skin may lead to such abnormal growth of cells. 

The diagnosis of epidermoid cysts is simply based on physical examination of the affected part. A sample of skin cells can also be removed and sent to lab for further analysis (biopsy). 

Visit your doctor if the signs and symptoms bother you. 

There are various treatment options that you and your doctor may choose from. Some of them are observation, incision and drainage and removal. Sometimes, your doctor may refer you to a specialist in skin disorders (dermatologist).

How to prepare yourself for the visit?

Getting prepared for the visit can optimize the therapy and help make the visit more fruitful.

List out all the symptoms.

Write down your key medical information. Mention if you have had injuries to your skin in recent times.

Write down the names of all your medications, vitamins or supplements.

Make a list of the questions to ask your doctor. Some typical questions can be:

• Do my symptoms indicate epidermoid cyst?
• What are the possible causes of my symptoms? 
• Is the cyst infected? 
• What are my treatment options?
• Will I have a scar after treatment? 
• Can these symptoms return back? 
• How can I prevent such recurrence? 

What your doctor wants to know?

A clear talk with your doctor can optimize the therapy and improve the outcomes. Prepare yourself to answer some essential questions from your doctor. Your doctor might ask you typical questions like: 

• When did you notice this skin growth?
• Have you noticed any other skin growths? 
• Have you had similar growths in the past? If so, on what parts of your body? 
• Did you suffer severe acne in the past? 
• Do the symptoms cause discomfort? 
• Have they affected your appearance?
• Do you remember any event of recent skin injuries, including minor scrapes? 
• Is there a family history of acne or multiple cysts? 

What you can do in the meantime?

Before the actual treatment starts, you have to take care of your condition by not squeezing your cyst. Squeezing can leave blemishes. It’s your doctor’s job to treat the cysts without causing scars or further infections.

You may not need any treatment for epidermoid cysts as long as the symptoms are mild and do not cause discomfort or cosmetic problems.

The treatment options for epidermoid cysts are:

• Injection: Your doctor may administer a medicated injection to reduce swelling and inflammation.
• Incision and drainage: Your doctor may make a small cut in the cyst and squeeze the contents out. With this method, the cysts can come back again.
• Minor surgery: It involves surgical removal of the entire cyst. You may need a follow up visit to see progress of the condition as well as to remove the stitches. It is safe, effective and is associated with decreased rate of cyst recurrences. You might have to wait for surgery if your cysts are swollen. 
• Laser: It uses intense beam of light to destroy the cyst. It has the benefit of causing minimal scarring.

Lifestyle modifications are necessary in order to cope with epidermoid cysts.

You cannot prevent epidermoid cysts but doing these can prevent scarring and infection:

• Resisting the urge to squeeze a cyst on your own
• Applying a warm, moist pad over the area to promote drainage and healing

There are several risks and complications associated with epidermoid cysts.

Risks

• Being past puberty
• History of acne 
• Inherited genetic disorders, in rare cases 
• Skin injuries

Complications

• Inflammation: Even without an infection, epidermoid cyst can become swollen and painful. You have to wait for the inflammation to subside before removing it.
• Rupture: If the cyst ruptures, it may lead to an infection similar to boils, which requires immediate medical care.
• Infection: Infections can develop in the cysts and form pus filled sac (abscessed). 
• Genital discomfort: If cysts are present in the genitals, they may cause painful intercourse and urination. 
• Skin cancer: Very rarely, skin cancer may develop from epidermoid cysts.