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Bursting a sebaceous cyst. Sebaceous Cysts: Causes, Treatment, and Why You Shouldn’t Pop Them at Home

What are sebaceous cysts and how do they form. Can sebaceous cysts be dangerous. How are sebaceous cysts diagnosed and treated. Is it safe to burst a sebaceous cyst at home. What are the risks of popping a sebaceous cyst yourself. How can you prevent sebaceous cysts from developing.

Understanding Sebaceous Cysts: What They Are and How They Form

Sebaceous cysts are round, fluid-filled lumps that develop beneath the skin. These benign growths typically appear on the face, scalp, neck, chest, and back. They are characterized by their yellow or white color, distinct from the surrounding skin, and a small opening on the surface called a punctum.

How do sebaceous cysts form? These growths occur when sebaceous glands, responsible for producing sebum (an oily substance that moisturizes the skin), become damaged. This damage can result from various factors:

  • Skin injuries
  • Scratches
  • Rashes
  • Skin conditions like acne

When a sebaceous gland is damaged, it leaks sebum, which becomes trapped under the skin, leading to cyst formation. People with a history of acne or recent skin injuries are more prone to developing sebaceous cysts.

Identifying Sebaceous Cysts: Symptoms and Characteristics

Recognizing a sebaceous cyst is crucial for proper management. These cysts have several distinctive features:

  • Soft to the touch
  • May slide slightly under the skin when gentle pressure is applied
  • Grow slowly, reaching a maximum diameter of about 5 centimeters
  • Usually painless, unless ruptured or infected
  • Can become painful if they form in awkward locations and apply pressure to surrounding areas

Are sebaceous cysts painful? Generally, these cysts are not painful. However, they can cause discomfort or pain in certain situations:

  1. If the cyst ruptures
  2. When infection occurs (the cyst may turn red and feel tender)
  3. If the cyst forms in an awkward location and grows large enough to pressure surrounding tissues

The Safety of Sebaceous Cysts: Assessing the Risks

Do sebaceous cysts pose a health risk? Sebaceous cysts are benign, non-cancerous growths that do not typically threaten overall health. However, they can cause several issues:

  • Discomfort or pain as they grow larger
  • Interference with clothing if they develop in certain areas
  • Cosmetic concerns, especially when appearing in visible areas like the face
  • Risk of infection if left untreated

While sebaceous cysts are not inherently dangerous, it’s essential to monitor them for any changes and consult a healthcare professional if concerns arise.

Diagnosing Sebaceous Cysts: Professional Methods and Techniques

How are sebaceous cysts diagnosed? In most cases, a dermatologist can identify a sebaceous cyst through visual examination. The distinct appearance and characteristics of these cysts often make diagnosis straightforward. However, in some instances, additional steps may be necessary:

  • Biopsy: A small skin sample is taken from the lump and sent to a laboratory for examination
  • Imaging tests: In rare cases, an ultrasound or MRI might be used to confirm the diagnosis or rule out other conditions

Why might a biopsy be necessary? While sebaceous cysts are typically benign, a biopsy can help rule out other skin conditions or rare instances of malignancy. This procedure ensures an accurate diagnosis and appropriate treatment plan.

Prevention Strategies: Minimizing the Risk of Sebaceous Cysts

Can sebaceous cysts be prevented? While it’s not always possible to prevent sebaceous cysts entirely, there are steps you can take to minimize your risk:

  1. Implement a regular skincare routine
  2. Treat acne effectively to reduce skin damage
  3. Protect your skin from injuries and irritation
  4. Maintain good overall hygiene
  5. Avoid picking or squeezing existing blemishes

Why is skincare important in preventing sebaceous cysts? A consistent skincare routine helps maintain healthy skin, reducing the likelihood of damage to sebaceous glands. This, in turn, decreases the chances of sebum leakage and subsequent cyst formation.

Key Components of an Effective Skincare Routine

  • Gentle cleansing
  • Regular exfoliation
  • Moisturizing
  • Sun protection
  • Treating existing skin conditions promptly

The Myth of Contagion: Understanding Sebaceous Cyst Transmission

Are sebaceous cysts contagious? No, sebaceous cysts are not contagious. They result from internal factors related to sebaceous gland function and cannot be transmitted from person to person through contact or any other means.

Why is this misconception common? The visible nature of sebaceous cysts and their occasional similarity to other skin conditions can lead to misunderstandings about their transmissibility. However, it’s important to understand that these growths are entirely non-contagious.

The Natural Course of Sebaceous Cysts: To Treat or Not to Treat?

Do sebaceous cysts go away on their own? While some sebaceous cysts may eventually disappear without intervention, this is not always the case. Many cysts continue to grow larger over time and may require surgical removal for resolution.

When should a sebaceous cyst be removed? As sebaceous cysts are generally harmless, removal is not always necessary. However, there are situations where removal might be recommended:

  • The cyst is causing pain or discomfort
  • It interferes with daily activities or clothing
  • There are cosmetic concerns, especially for visible cysts
  • The cyst shows signs of infection
  • There’s a need to rule out other skin conditions

Treatment Options for Sebaceous Cysts

What are the available treatments for sebaceous cysts? While leaving small, asymptomatic cysts alone is often an option, there are several treatment methods for those that require intervention:

  1. Surgical excision: Complete removal of the cyst and its wall
  2. Incision and drainage: Cutting open the cyst and draining its contents
  3. Laser therapy: Using laser technology to remove the cyst
  4. Intralesional corticosteroid injection: Reducing inflammation and cyst size

Which treatment is most effective for sebaceous cysts? Surgical excision is generally considered the most effective treatment, as it removes the entire cyst, including its wall, reducing the likelihood of recurrence.

The Dangers of DIY: Why You Should Never Pop a Sebaceous Cyst at Home

Is it safe to burst a sebaceous cyst at home? Attempting to pop or drain a sebaceous cyst at home is strongly discouraged by medical professionals. While it may seem like a quick solution, this action can lead to several serious complications:

  • Infection: Introducing bacteria into the wound
  • Scarring: Improper drainage can result in permanent skin damage
  • Cyst recurrence: Incomplete removal often leads to cyst regrowth
  • Pain and inflammation: Improper technique can cause unnecessary discomfort
  • Spread of cyst contents: Risk of spreading the cyst material to surrounding areas

Why is professional treatment preferred for sebaceous cysts? Healthcare providers have the necessary skills, tools, and sterile environment to safely and effectively treat sebaceous cysts, minimizing risks and ensuring the best possible outcome.

Risks of Self-Treatment

What specific risks are associated with attempting to pop a sebaceous cyst at home?

  1. Incomplete removal: Failing to remove the entire cyst wall can lead to recurrence
  2. Infection: Non-sterile conditions increase the risk of bacterial infection
  3. Scarring: Improper technique can result in unsightly scars
  4. Pain: Self-treatment can be more painful than professional procedures
  5. Delayed healing: Improper care can prolong the healing process

How can you care for a sebaceous cyst while awaiting professional treatment? If you have a sebaceous cyst and are waiting to see a healthcare provider, follow these guidelines:

  • Keep the area clean and dry
  • Avoid picking or squeezing the cyst
  • Apply a warm compress to relieve discomfort
  • Watch for signs of infection, such as redness, warmth, or increased pain
  • Seek immediate medical attention if you notice any concerning changes

In conclusion, while sebaceous cysts are generally harmless, they require proper care and professional treatment when necessary. Resist the urge to pop or drain these cysts at home, as doing so can lead to complications and worsen the condition. By understanding the nature of sebaceous cysts, implementing preventive measures, and seeking appropriate medical care, you can effectively manage these common skin growths and maintain overall skin health.

Popping a Sebaceous Cyst – Can I Burst a Sebaceous Cyst at Home?

It can be very tempting to pop a sebaceous cyst yourself at home. Although these common skin growths are ultimately harmless, they can be uncomfortable, unattractive, and – in some instances – even painful. As a result, squeezing the cyst with your fingers or sticking a needle into its shell can seem like a quick and easy solution to rid yourself of the unwanted lump. 

Nevertheless, popping a sebaceous cyst at home is a dangerous mistake. Although bursting a cyst yourself may remove the bothersome lump in the short-term, it will inevitably cause problems down the line, such as infection, deep scarring, or even the emergence of more cysts. 

In this article, we will discuss everything that there is to know about sebaceous cysts – from their symptoms to possible treatment options – and explain why you should never pop them at home. 

What is a Sebaceous Cyst?

Sebaceous cysts are round, fluid-filled lumps that grow beneath the skin. Although they can appear anywhere on the body, they are most commonly found on the face, scalp, neck, chest and back. 

Typically, a sebaceous cyst is yellow or white, and looks distinct from the skin that surrounds it. It has a small hole on its dome-like surface, called a punctum, through which its internal fluid can be squeezed out. It is soft to touch, and – when you apply gentle pressure to its shell with your finger – it may slide a little under the skin. 

Sebaceous cysts grow slowly over time, until they reach a maximum diameter of roughly 5 centimetres. They are not usually painful, though they can hurt if they rupture or become infected (in which case the cyst will turn red and feel tender to touch). Additionally, sebaceous cysts can be painful if they form in an awkward location and begin to apply pressure to the surrounding areas as they grow larger. 

What Causes a Sebaceous Cyst to Grow?

Sebaceous cysts form when your sebaceous glands undergo damage. These glands are responsible for secreting an oily substance called sebum, which moisturises the skin and helps the body to retain water.

The sebaceous glands are located in the skin and are found across the entire surface of the body, except the palms of your hands and the soles of your feet. The skin on the face and scalp contains the most sebaceous glands, which is why sebaceous cysts often form in these areas. 

When the skin is damaged (which can happen as a result of a scratch, rash, injury, or a skin condition, such as acne), a sebaceous gland within it may get damaged, too. In these cases, the gland will leak sebum, which then becomes trapped under the skin, causing a sebaceous cyst to form. 

For this reason, patients who have recently experienced an injury, or who have a history of acne, are more likely to have a sebaceous cyst.

Are Sebaceous Cysts Dangerous?

No, sebaceous cysts are not dangerous. They are benign, non-cancerous skin growths, so they do not pose any serious threat to your health. However, sebaceous cysts grow larger with time, and, if they appear in an uncomfortable place, they can cause discomfort or pain as they grow. Sometimes, when they grow very big, they can even interfere with the way in which patients wear clothes.

Sebaceous cysts can also cause cosmetic concerns, especially when they grow in very visible areas, such as the face. Furthermore, leaving a sebaceous cyst untreated risks the possibility of infection in the future, which will be painful and may require antibiotics to treat. 

How Are Sebaceous Cysts Diagnosed? 

Usually, a dermatologist can diagnose a lump on the skin as a sebaceous cyst simply by examining it with the naked eye. In some cases, however, a biopsy may have to be performed. This involves taking a small skin sample from the lump, which is then sent to a laboratory for examination. 

How Do I Prevent Sebaceous Cysts from Growing?

A sebaceous cyst will grow when sebum has leaked from a sebaceous gland, which happens when the gland has experienced some damage. This damage can be caused by an injury to the skin, or by a skin condition such as acne.

Therefore, the only way to prevent a sebaceous cyst from forming is to take good care of your skin. Implement a skincare routine and follow it regularly, and, if you suffer from acne, try to clear your skin with an effective treatment. 

 

We Can Solve Your Problem

 

Are Sebaceous Cysts Contagious?

No, sebaceous cysts are not contagious. 

Do Sebaceous Cysts Go Away on Their Own?

Although some sebaceous cysts eventually disappear on their own, this is not always the case, as some cysts will continue to grow bigger until they are surgically removed. 

When Does a Sebaceous Cyst have to be Removed?

As sebaceous cysts are harmless, it is never necessary for them to be removed. If a cyst is small and not a cause of frustration for you, then it is perfectly fine to simply ignore it. However, if a sebaceous cyst is causing you to feel discomfort, pain or embarrassment, then it is advisable to have it treated.  

In these cases, it can be tempting to burst your sebaceous cyst at home, but – as we will discuss below – this is dangerous and likely to lead to further problems in the future. 

Is it Safe to Pop a Sebaceous Cyst Myself?

No, you should never remove a sebaceous cyst yourself at home. If you wish to have a cyst of any kind removed, then it must be treated by a medical professional at a clinic. Popping a sebaceous cyst yourself, or asking someone else to burst it for you at home, is unsafe, and will likely require further dermatological treatment in the future. 

Why is it unsafe to burst a sebaceous cyst at home?

Here are six reasons why you should never attempt to pop, burst or cut out a sebaceous cyst at home:

The risk of infection is greater

When a sebaceous cyst is removed in a reputable clinic, the highest hygiene standards are maintained. Consequently, the cyst is removed by a medical professional in a sanitary environment and using sterile equipment, which ensures that the risk of infection is as minimal as possible.  

When a sebaceous cyst is removed at home, however, the risk of infection is much higher. Even after they are cleaned in the kitchen sink, the instruments that are used to remove a cyst at home are likely to carry germs, which could then enter the body and cause an infection. 

This is particularly important if the sebaceous cyst is very large. This is because the removal of a large cyst will create a large wound in the skin. If the cyst has been removed by a medical professional, this hole will be stitched closed using dissolvable stitches. However, if the cyst is removed at home, it is likely that the wound will not be closed appropriately, which leaves the body open and vulnerable to invading pathogens. 

Equally, if you attempt to close the wound with stitches at home, it is unlikely that the stitches will be sanitary, which will almost certainly lead to an infection and make you very unwell. 

The risk of scarring is greater

Experienced surgeons know how to perform surgical excision in such a way that reduces the risk of scarring as much as possible. As a result, they can remove a sebaceous cyst without creating a large scar, or – in some cases – without creating a scar at all. 

When a sebaceous cyst is removed by someone without surgical training, the risk of scarring is very high. This means that popping a sebaceous cyst at home may simply replace the bothersome (but ultimately not irremovable) cyst with a large, permanent scar. 

It is likely that the cyst will grow back again

When a sebaceous cyst is treated in a clinic, it is removed in its entirety. Your surgeon will cut out the cyst’s base and capsule, which ensures that it will not appear again. 

It requires surgical training and experience to know how to do this, because not all of the cells that make up a sebaceous cyst will be visible to the naked eye. This means that, when you try to remove a sebaceous cyst at home, it is likely that you will think that you have removed the entirety of the cyst, when there are actually still some of its cells remaining. As a result, the sebaceous cyst will simply grow back again (and the act of trying to remove it may also have created a scar). 

The cyst may grow back thicker and stronger

As we discussed above, if a sebaceous cyst is not removed in its entirety, it is probable that it will simply grow back. When this happens, the shell of the cyst is usually thicker and stronger than it was before, making it more difficult to remove later on. Consequently, popping a sebaceous cyst at home may lead to the formation of an even tougher lump.

Because a medical professional will always remove a sebaceous cyst fully, there is no risk of a stronger, harder cyst forming when a cyst is removed in a clinic. 

The removal of the cyst will be painful

When a sebaceous cyst is excised in a clinic, it is unlikely that the process will be painful. If the cyst is very large or wide, your surgeon will use a local anaesthetic to numb the treatment area prior to the surgery, in order to prevent pain.

Anaesthetic is not available at home, and so popping or bursting a sebaceous cyst yourself will be quite painful. 

The risk of cancer cannot be eliminated conclusively

When you discover any kind of lump, bump or abnormal growth on your skin, you must have it examined by a doctor. This will ensure that the lump is diagnosed professionally and eliminate the risk of cancer. 

If you find a growth on your body and try to remove it at home (under the assumption that it is only a sebaceous cyst), there is a risk that the lump is actually more dangerous, and requires serious treatment. 

What Are the Treatment Options for Removing a Sebaceous Cyst?

So, the safest way to remove a sebaceous cyst is to arrange to have it treated at a reputable clinic – but how does the treatment work? There are four treatment options for removing a sebaceous cyst: surgical excision, punch excision, incision and drainage, or a laser treatment. 

 

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Surgical Excision

The most straightforward and effective method for removing a sebaceous cyst is to cut it out surgically. Prior to this treatment, the area in which the cyst is located will be numbed using a local anaesthetic. Then, your surgeon will mark out the area around the cyst where incisions need to be made. Using a scalpel, the surgeon will then make the necessary incisions and remove the cyst from beneath the skin. This will create a wound, which will be sealed closed using stitches. 

After approximately two weeks, the patient will return to the clinic for a check-up, during which the stitches will be removed. This will create a slim linear scar, which will fade with time. 

Punch Excision

Punch excision is a form of surgical excision. The only difference is that this procedure uses an instrument called a dermal punch, instead of a scalpel, to remove the sebaceous cyst. This device circles the cyst and removes it from the skin like a cookie cutter. 

Like surgical excision, a local anaesthetic is used prior to the treatment in order to reduce discomfort. Stitches may be required to seal the wound that is created during the procedure, which will be removed during a check-up appointment two weeks after the surgery.  

Generally speaking, punch excision is an effective method for treating small sebaceous cysts, because it causes less scarring. However, a dermal punch cannot be used to treat very large cysts. One of our specialists will determine the right treatment for you during your pre-surgical consultation. 

Incision and Drainage

Sebaceous cysts can also be treated via a procedure known as incision and drainage. During this treatment, a dermatologist will use a very fine needle to puncture a small hole in the shell of the cyst. The liquid inside will then be squeezed out through the hole, until the cyst has been drained entirely. 

This method is less invasive than surgical excision, which is why some patients prefer it. However, it is likely that a sebaceous cyst will eventually reappear after it has been drained. By contrast, surgical removal will ensure that the cyst disappears forever. 

Laser Treatment

Depending on the patient’s preferences, sebaceous cysts can be drained using a laser, instead of a fine needle. During a laser treatment, a dermatologist will direct a powerful beam of light at the cyst, which will create a small hole in its shell. Then, the liquid inside will be drained from the cyst through this hole. 

As we mentioned above, draining a cyst of its internal content will make it disappear, but it does not prevent it from reappearing again. Thus, though a laser treatment is an effective (and scar-free) method for removing a sebaceous cyst in the short-term, surgical excision is the only way to erase the growth for good. 

Although sebaceous cysts can be frustrating and unflattering, they are ultimately non-cancerous, and do not pose any serious risk to your health – but attempting to remove them yourself could. Popping a sebaceous cyst at home puts you at risk of developing an infection that could make you very unwell, or cause permanent damage to your skin. Consequently, the only way to ensure that a sebaceous cyst is removed both safely and permanently is to have it treated by a professional at a clinic.  

References:

Brian Moore et al., ‘What’s the Best Treatment for Sebaceous Cysts?’, The Journal of Family Practice, 56 (2007), 315-316.

Lydia Krause, ‘Sebaceous Cyst: Causes, Symptoms, Treatments, and More’, Healthline

‘Skin Cyst’, NHS

Motonobu Nakamura, ‘Treating a Sebaceous Cyst: An Incisional Technique’, Aesthetic Plastic Surgery, 25 (2001), 52-56.

About the Author

Dr Suhail Alam

Dr Alam is devoted to providing high quality, holistic, patient centred care designed to make patients look and feel their best. He has a specialist interest in Hair Restoration Surgery and Regenerative Medicine.

See author’s posts

Can I Stick a Needle in a Sebaceous Cyst? No — and Here’s Why

Can I Stick a Needle in a Sebaceous Cyst? No — and Here’s Why

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Medically reviewed by Kristen M. Moyer, MD, Internal Medicine, Pediatrics, Hospice and Palliative Medicine — By Rachel Nall, MSN, CRNA on February 17, 2021

A sebaceous cyst is almost as tempting to pop as a pimple — but hold that thought before you do.

Popping a sebaceous cyst at home by yourself could increase your risk for inflammation, infection, and discomfort. In short, this is a cyst your doctor is better off removing.

Keep reading to find out more about sebaceous cysts and how you should and shouldn’t treat them.

The term sebaceous cyst can be misleading. These cysts don’t arise from sebaceous (sweat) glands, but instead from cells above a hair follicle known as the infundibulum.

For this reason, doctors now commonly call them epidermoid cysts. Some ways to recognize these cysts include:

  • Location. These cysts are most commonly found on the face, neck, abdomen, and back.
  • Compressibility. You can usually press on the cyst, and it’ll move toward the skin.
  • Center appearance. The cyst may have a visible opening in its center that’s usually black in color. Doctors call this area a punctum.
  • Contents. If a sebaceous cyst accidentally ruptures, it’ll likely release a foul-smelling, thick, yellow substance that’s a combination of fats and proteins.

Men are twice as likely to have sebaceous cysts than women. Those ages 30 to 40 are also most likely to have this type of cyst.

Share on PinterestInflamed sebaceous cyst. Photography courtesy of Steven Fruitsmaak/Wikimedia

Epidermoid or sebaceous cysts are inclusion cysts. This means they have a capsule around the cyst.

If you don’t remove the capsule or cell wall in its entirety, it’s likely that the cyst will grow back. Also, the cell wall tends to grow back thicker after an attempted partial removal or rupture, making the cyst harder to remove at a later time.

Removing the cyst at home also increases your risk of scarring. Doctors will use special techniques to try to reduce this likelihood.

Risk of infection

But the possibility the cyst could return is just one of the reasons you shouldn’t remove one yourself. Another reason is the risk of infection.

Doctors use sterile instruments and clean techniques to prevent infections, and attempting to remove the cyst at home can make you more vulnerable to them.

If you have a sebaceous cyst, there is some risk that you can disturb it through everyday activities. This includes your clothes rubbing against the cyst or accidentally hitting the cyst on a hard surface. This often depends on where your cyst is located.

If you have a cyst that appears inflamed, some of your at-home treatment options include:

  • Warm compresses. Applying a warm compress to the cyst may help to reduce redness and discomfort.
  • Cleaning the affected area. Cleaning the affected area with mild soap and water can help minimize the risk of bacteria entering the cyst. You don’t necessarily have to apply a bandage to the area — just keeping it clean and dry can help.
  • Over-the-counter (OTC) pain relievers. If the cyst is painful, taking OTC pain relievers such as ibuprofen can help reduce symptoms.

The most common method a doctor will use to remove the cyst is surgical excision, or complete removal.

Typically, your doctor will only remove a cyst if it’s not infected. Otherwise, it can be difficult for them to determine the cyst’s edges.

If the cyst is infected, your doctor may inject antibiotics into the cyst and recommend waiting to remove it until the infection has subsided.

The removal process

Unless the sebaceous cyst is very large in size, your doctor can usually remove it in their office. To remove the cyst, they typically follow this process:

  1. Inject the cyst with a local anesthetic to reduce pain and minimize bleeding.
  2. Use a cutting device, such as a scalpel, to remove the cyst. What’s most important is to remove the cyst with its wall intact (not ruptured). This approach will reduce the likelihood that the cyst will return.
  3. Sew the incision closed with stitches to minimize scarring and promote healing.

Some doctors will use a different approach to remove the sebaceous cyst, which involves using a special device that creates a punch biopsy. This tool has a circular cutting end where your doctor can remove the cyst evenly.

You should see your doctor if you experience the following symptoms related to a sebaceous cyst:

  • pain
  • redness
  • swelling
  • warmth to the touch

These symptoms may indicate that your cyst has become infected and requires treatment. Although it’s tempting, remember to avoid manipulating or squeezing the cyst.

If you’ve had a sebaceous cyst removed, follow your doctor’s instructions to keep the area clean and dry. If you have infection symptoms, contact your doctor immediately.

Cancer risk

For the most part, sebaceous cysts are benign (noncancerous). In very rare instances, they can become cancerous.

For example, squamous cell carcinoma, a rare type of skin cancer that often begins on the eyelid, can arise in a sebaceous cyst.

If you notice changes in the cyst’s appearance, including any of the following, talk with your doctor:

  • bleeding
  • oozing
  • color changes
  • swelling

Sebaceous cysts are rarely a medical concern, but they can be a cosmetic one and are sometimes uncomfortable.

If you have a sebaceous cyst that you’re concerned about, speak with your doctor about potential removal options. To minimize your infection risk, don’t try to do it yourself at home.

Leaving sebaceous cyst removal to your doctor will increase the likelihood that the cyst will not return.

Last medically reviewed on February 17, 2021

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

  • Hoang VT, et al. (2019). Overview of epidermoid cyst.
    sciencedirect.com/science/article/pii/S2352047719300401
  • Lam M, et al. (2020). Epidermoid cyst.
    dermnetnz.org/topics/epidermoid-cyst/
  • Zico PM, et al. (2020). Epidermoid cyst.
    ncbi.nlm.nih.gov/books/NBK499974/

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Feb 17, 2021

Written By

Rachel Nall, MSN, CRNA

Edited By

Connor Rice

Medically Reviewed By

Kristen M. Moyer, MD

Copy Edited By

Anne Arntson

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Medically reviewed by Kristen M. Moyer, MD, Internal Medicine, Pediatrics, Hospice and Palliative Medicine — By Rachel Nall, MSN, CRNA on February 17, 2021

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causes, symptoms, diagnosis and treatment

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Sebaceous gland

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Atheroma: causes, symptoms, diagnosis and treatment.

Definition

Atheroma is a cyst (pathological cavity) of the sebaceous gland, resulting from difficulty or complete cessation of the outflow of secretion (sebum) from the gland. The sebaceous glands are external secretion glands and are located in almost all parts of the skin, with the exception of the palms, soles and back of the feet. The secret produced by them is part of the water-lipid mantle of the skin. If the duct of the gland is clogged, then the secret begins to accumulate in it, stretches it with the formation of a cavity lined with the epidermis and containing the secretion products of the sebaceous gland, cholesterol crystals, keratinized epidermal cells and detritus (decay products) – this is atheroma.

Atheromas occur in 5-10% of the population, mainly formed at the age of 20-30 years, with the same frequency in men and women.


Causes of atheroma

Atheroma occurs as a result of disruption of the sebaceous glands, which is manifested by increased production of sebum and blockage of the duct. A number of factors predispose to this: increased sweating, insufficient hygiene, narrowness of the ducts of the sebaceous glands, individually determined high viscosity of sebum, chronic skin trauma, hormonal disorders, frostbite and burns. Affects the development of atheroma and hereditary factor.

The use of antiperspirants can contribute to blockage of the duct.

Disease classification

Allocate true and false cysts. True sebaceous cysts are a hereditary disease and are extremely rare. They develop as a result of a genetic defect that affects the formation of the gland. Typically, such cysts are found in newborns and are small in size. False cysts are actually atheromas that have arisen due to a violation of the outflow of the secretion of the sebaceous gland.

Symptoms of atheroma

Atheromas most often occur in areas of the body where there are many sebaceous glands, for example, on the scalp, face, neck, in the interscapular space.

Atheroma is a mobile formation of a round or slightly elongated shape, dense or elastic consistency, covered with unchanged skin. A characteristic sign of atheroma, which distinguishes it from other formations, is the presence of a point retraction of the skin (crater) in the area of ​​​​the excretory duct of the gland and adhesion of the skin to the cyst membrane in the same place. Sometimes in the middle of the atheroma there is a hole through which its contents are released – curdled masses with an unpleasant odor.

The size of atheroma can vary from a pea to a chicken egg and even more, reaching 10 cm. Atheroma always rises above the level of the skin, increases slowly, usually painless.

Diagnosis of atheroma

To make a diagnosis, the doctor performs a clinical examination, in some cases an ultrasound examination may be required.

Ultrasound of soft tissues

Examination of soft tissues to detect pathological changes and diagnose neoplasms.

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A biopsy of the formation is rarely performed, since the risk of degeneration of atheroma into a malignant neoplasm is extremely low.


Which doctors to contact

Diagnosis can be made by a dermatologist,
general practitioner or
therapist. Surgical treatment is performed
surgeon.

In order to prevent the appearance of new foci, patients turn to a cosmetologist for a consultation.

Treatment of atheroma

Surgical removal of atheroma together with the capsule gives the best results – this reduces the risk of recurrence. The operation is performed under local anesthesia, usually on an outpatient basis. If the atheroma is located on the face, then sparing methods can be used for aesthetic purposes, such as cystotomy, which involves cutting the skin, opening the atheroma capsule and evacuating the contents of its cavity.

Laser destruction of atheroma is an alternative to surgical removal. There are three methods of laser intervention – laser photocoagulation, laser excision of atheroma together with the shell and laser evaporation of the atheroma shell from the inside. The type of intervention is determined by the surgeon, choosing the most optimal for each individual patient.

Complications

Atheroma may suppurate. This process is accompanied by pain, redness and swelling of the skin. As a rule, the inflammatory process develops slowly. Education is delimited by a capsule, so local and general inflammatory changes during suppuration are poorly expressed. Festering atheroma can spontaneously open with the release of pus with an unpleasant odor.

Prevention of atheroma

For prevention, it is recommended to thoroughly cleanse the skin, preventing its pollution and removing excess sebum. If there is a predisposition to the formation of atheromas, it is better to abandon the use of antiperspirants. Beauticians recommend limiting the intake of foods containing a large amount of animal fats and quickly digestible carbohydrates.

Sources:

  1. Clinical guidelines “Cysts of the maxillofacial region and neck”. Society of specialists in the field of maxillofacial surgery. 2020.
  2. Tarasenko G.N. et al. Atheroma: a problem for a cosmetologist or a dermatologist? // Hospital medicine: science and practice. – T. 4. – No. 1. – 2021. – S. 41-44.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Atheroma of the skin (trichodermal cyst) in Kyiv – private clinic Oberig. Skin atheroma (trichodermal cyst)

Atheroma (from the Greek atheroma, athera – gruel and oma – tumor) is a tumor-like formation related to epithelial skin cysts, which are divided into several types depending on their histological structure (retention cyst of the sebaceous glands of the skin (formed as a result of blockage of the excretory duct of the gland), epidermal cyst, trichilemmal cyst, multiple steatocystoma). According to their clinical manifestations and treatment, they are almost equivalent, therefore in clinical practice they are called atheromas.

Atheroma is a round, encapsulated mass filled with thick, white or yellowish masses, often foul-smelling. The content of atheroma is the protein keratin, which is produced by its walls.

Atheromas occur in 5-10% of the population. They can be sporadic or hereditary (however, despite research, it has not yet been possible to identify the genes responsible for the occurrence of atheromas). They are more common in women than in men, and also in middle-aged people compared to young people.

SYMPTOMS, COURSE

It can occur in any part of the body, but the predominant localization is the scalp, face, back, neck, genital area.

On the head, single atheromas occur in 30% of cases, multiple in 70%, and 10% of patients may have more than 10 atheromas.

Patients complain of a tumor-like formation, superficially located, densely elastic, usually well mobile (partially displaced by finger pressure), painless. The skin over the formation is most often not changed, but with inflammation it may be red, and sometimes, with rapid growth, the skin over the atheroma may ulcerate. In some cases, an enlarged obstructed excretory duct of the sebaceous gland is visible on the skin near the center of the formation. The tumor may remain small for many years or grow larger. Sometimes atheroma communicates with the surface of the skin through a small hole, through which cheesy white or yellowish masses can be separated, usually with an unpleasant odor.

Differential diagnosis is carried out with soft tissue tumors (fibromas, lipomas, dermoid cysts, osteomas).

COMPLICATIONS

Atheromas often suppurate, with reddening of the skin, pain in the area of ​​the tumor, swelling or increase in size. A festering atheroma, if left untreated, can spontaneously break out, while pus is released with greasy contents and an unpleasant odor. It is also possible to spread the infection to surrounding tissues with the development of phlegmon. With suppuration, urgent surgical intervention is required, which consists in opening and draining the abscess. The cosmetic results of such an intervention are much worse than planned operations, since the skin incision is not sutured in this case, but heals by secondary intention with the formation of a rough scar. In addition, under conditions of purulent fusion, it is not always possible to completely remove the atheroma capsule, which can lead to tumor recurrence in the future. In some cases, antibiotics have to be used.

A rare complication of atheroma is its injury, in which the cyst may rupture into the subcutaneous tissue or outward, which also requires urgent surgical treatment. Very rarely, atheroma can transform into a malignant neoplasm.

TREATMENT

The method of treatment for atheromas is only surgical removal of the entire tumor together with the capsule. None of the international guidelines describe other methods of treatment.

The operation is usually performed under local anesthesia (lidocaine or novocaine). There are several ways to remove atheromas, a mandatory element of each of them is the removal of the skin area associated with the tumor and the complete removal of the entire tumor capsule. Most often, atheroma is removed by making an incision over the tumor and either the tumor is excised without opening its lumen, or the capsule is removed after removal of the contents of the tumor (in order to reduce the size of the skin incision). The minimum incision from which atheroma can be removed is 3-4 mm. In the West, it is common to remove atheromas with the help of biopsy instruments, with the help of which a round area of ​​skin over an atheroma with a diameter of 3-5 mm is removed, followed by removal of the capsule. The wound is then sutured. The sutures are removed 7-10 days after the intervention. The patient is forbidden to wet the operation area for 48 hours, the wound should be treated daily with betadine or other antiseptic. On the head, a bandage on the wound is not needed in most cases; on other parts of the body, bandages are usually required, as the wound rubs against clothing. When the tumor is localized in the scalp, a small amount of hair is cut off, usually no more than the size of the tumor, so in most cases the fact that the operation has been done is not noticeable to others.

I would like to dispel the existing misconceptions regarding the removal of atheromas without surgical intervention. Removal of atheroma with a laser or radio wave (what we do in our clinic) scalpel is a surgical intervention, the same as a traditional operation with a conventional scalpel and other surgical instruments. Indeed, during the intervention, it is necessary to remove the atheroma capsule, and this cannot be done without a skin incision. In addition, atheroma is associated with the skin, so when removing the tumor, it is necessary to separate it from the skin. A neat and minimally short skin incision made in the right direction (along the lines of force of the skin) and then closed with a cosmetic suture or a special plaster heals equally well whether it is made with a sharp scalpel or a radio wave knife.