Regarding Skin Cysts and What To Do About Them?: Matthew Mittelbronn, MD: Dermatologist

If you happen to feel a lump on or beneath your skin, you may have a cyst. These abnormal growths vary in size and shape, and can be due to multiple causes, but quite commonly they develop from the skin.

It is important to note that most skin cysts are not dangerous. However, it is best you have the lump evaluated by a dermatologist, or other expert, to make sure it looks benign and to receive treatment if necessary – especially if it is painful or symptomatic in some way.  A dermatologist can help determine if the lump is just a benign cyst or if it is something more serious that needs further evaluation or even biopsy.  Let’s talk about what a skin cyst is and what can happen if the cyst is left untreated.

What Is a Cyst?

Cysts, in general, can occur in many places throughout the body, and can be due to numerous causes, but we are focusing on skin cysts here.  The most common type of skin cyst is medically called an ‘epidermoid cyst’, or commonly called a ‘sebaceous cyst’ by most people.   These are usually soft to moderately firm nodules beneath the skin filled with dead skin cells and generally often found on the trunk (especially the back), scalp, face, or other areas.

Most commonly, sebaceous cysts develop due to blocked hair follicles which form outpouchings beneath the skin, creating sacs that are lined inside by active skin cells.  These sacs can remain quiet and stay small, but generally they slowly enlarge over months or years.  Sometimes however, they can enlarge quickly for unknown reasons.

Can a Skin Cyst Be Dangerous?

As discussed, most skin cysts are harmless benign lesions, and often not problematic.  That said, however, some cysts become painful as they enlarge, and others become inflamed or even infected.  Additionally, while it is extremely rare, there is some possibility that a skin cyst could be malignant.  As noted, it is important that if a skin cyst is symptomatic, it should be evaluated by a doctor.

One of the worst things you can do is to ‘mess’ with a cyst by trying yourself to pop or express its contents.   Although sometimes the contents are removed easily, more often they are not, and the pressure placed on the cyst can cause it to rupture beneath the skin.  When this happens, the contents are released into the tissues and the body treats this as a foreign invader, which can cause a huge inflammatory reaction.  In addition, many cysts contain bacteria which can overgrow at times, causing a cyst to become ‘infected’.  Both inflamed and infected cysts behave similarly, and present as red, swollen, painful nodules.  If an infected cyst is left untreated, it can spread infection to the surrounding areas causing cellulitis and even infect the bloodstream in the worst cases.

Treating Skin Cysts

The treatment for a cyst will depend on the type of cyst, location, size, presence of symptoms, current condition (?inflamed or infected), and other factors.  For most epidermoid cysts not causing any problems, it is ok to leave it alone, as these are generally benign lesions.  However, if a cyst is enlarging rapidly, painful, swollen, or inflamed or infected, treatment is warranted and recommended.   If a cyst is inflamed or infected, first-line treatment involves oral antibiotics and sometimes steroid injections to calm it down.  Additionally, it may need to be opened and drained, allowing the contents to be released, so that the excess pressure and any infection can be removed.  Once the cyst has calmed down, it can then be re-assessed for possible removal.  The only true treatment for sebaceous cysts is to remove it completely, including the skin ‘sac’ lining that created it – otherwise there is a high likelihood it will return.  In most cases, this requires a minor surgical procedure that can be done in clinic under local anesthesia.  Your doctor can explain the situation and all of your options in detail during your visit.

Cyst Diagnosis and Treatment in Lake Worth, Texas

At Lakeview Dermatology in Lake Worth TX, our team strives to deliver quality, state-of-the-art medical and surgical care to all our patients. We provide a wide range of services to our patients with skin problems such as skin cancer, eczema, acne, psoriasis, and skin cysts, not to mention a number of cosmetic services.

From simple to complex skin issues, we have the training and experience necessary to treat you. Our goal is to care for the health of your skin and keep it in great condition – because healthy skin contributes to a healthy body.

To schedule an appointment with our caring dermatologist at Lakeview Dermatology, you may reach us by calling us at (817) 752-5256 or request an appointment online. Our friendly team looks forward to serving you.

Cyst Treatment | Palos Verdes

A cyst is a closed sac under the skin filled with material. That material may be liquid, soft or hard (calcified and scarred). They can be found anywhere on the body. They are usually slow-growing, painless, freely movable lumps beneath the skin. Occasionally, however, a cyst will become inflamed and tender.

When treatment is desired, cysts are usually easily treated as an in-office procedure with local anesthesia. Treatment options include (1) injection of a steroid medication into the cyst in order to reduce inflammation (2) drainage and (3) complete surgical removal.

There are literally hundreds of different kinds of lumps, bumps and cysts associated with the skin. Fortunately, the vast majority of these are harmless and painless. The chart below provides a guide for some of the most common forms of skin lumps, bumps and cysts.

Dermatofibromas

Dermatofibromas are firm bumps, or nodules, that form in the deep layers of the skin. Dermatofibromas are harmless and common. They tend to occur in response to an injury, even minor events like an insect bite. This makes them more likely to appear on the arms and legs. Dermatofibromas may persist for years or indefinitely.

They can appear pink or dull red, or can resemble a mole (nevus). They are usually small (about a quarter- to a half-inch wide) but can grow to be over an inch in diameter. When pinched, dermatofibromas tend to create a dimple on the skin where the nodule attaches to the upper layers of the skin.

There is no prevention if the skin responds to injury by producing a dermatofibroma growth. They are benign lesions so can be left alone without treatment. If they are painful or their presence is bothersome (for example – easily traumatized by shaving) they can be removed with minor surgery.

Epidermoid Cysts (Sebaceous Cysts)

Cysts are growths in the deeper layers of the skin. They are small closed sacs containing fluid or solid material composed of dead skin cells. There are many types of cysts of different sizes that appear on various parts of the body. Ruptured cysts can become inflamed (red and painful) and discharge pus. Occasionally cysts become infected and resemble a boil. Cysts may require minor surgery to be removed.

Treatment

• Antibiotics might be prescribed if there is an underlying infection
• Dermatologist removes the discharge and the sac (capsule) that make up the walls of the cyst to prevent recurrence

Folliculitis

Folliculitis is an inflammation of one or more hair follicles. It appears as a rash or white-headed pimples or pustules near a hair follicle. It can occur anywhere on the body, but typically affects hairy areas, such as the neck or groin. Follicles can be damaged from repeated friction (such as rubbing of too tight clothes) or blockage of the hair follicle (for instance, from shaving). In most cases, follicles become infected with Staphylococcus bacteria.

There are two types of folliculitis:

Superficial Folliculitis affects the upper area of the hair follicle and may cause red, inflamed skin, small clusters of red bumps, blisters that break open and crust over and/or itchiness and tenderness. When the infection occurs in men’s’ beards, it is called Barber’s Itch.. When it is caused by a fungal infection, it is known as Tinea Barbae (ringworm).

Deep Folliculitis affects the entire follicle from its deepest parts under the skin to the surface of the skin. This less-common form of folliculitis is seen in people who are undergoing chronic acne antibiotic treatment, people with HIV or people with boils and carbuncles.

Treatment

• Antifungal medications
• Oral antibiotics
• Topical medications
• Eliminating the cause

Keratosis Pilaris

Keratosis pilaris is a very common condition in which there are numerous rough follicular spots, which may be skin-coloured, red or brown. Most often they arise on the outer aspect of the upper arms. They may also occur on the thighs and cheeks, and less often on the forearms and upper back. Keratosis pilaris is most obvious during the teenage years and may also be present in babies and persist into adult life. However, it is uncommon in elderly people. It is particularly prevalent in those who are overweight, or have atopic dermatitis or ichthyosis. Keratosis pilaris tends to be more severe during the winter months or other times of low humidity when skin dries out. Although unsightly at times, it is completely harmless.

Treatment

• Usually does not require treatment
• In most cases disappears on its own by age 30
• Intensive moisturizing is the first line of treatment
• For more difficult cases, use of medicated creams with urea or alpha-hydroxy acids

Lipomas

Lipoma is a fatty lump or tumor that is typically located between the skin and the underlying layer of muscle. These growths are slow-growing and easy to identify since they are palpable to touch. Fatty tumors of lipoma can occur at any age, but are most commonly detected during middle age. It is important to note that lipomas are not cancerous and do not usually indicate future harm. However, if the growth is bothersome, continues to grow, or becomes painful, lipomas can be removed with in-office surgery.

Neurofibromas

Neurofibromatosis is a genetically inherited disorder of the nervous system (brain and spinal cord) which mainly affects the development of nerve cell tissues, causing tumors (neurofibromas) to develop on nerves, and may cause other abnormalities.

Characteristics

• Soft fleshy growths under the skin
• Slow growing and generally benign and painless
• Pain may indicate a need for medical attention
• May experience an electrical shock at the touch

Treatment

• Usually does not require treatment, particularly if it does not cause any symptoms
• If it affects a nerve, it may be removed surgically

Epidermal Inclusion Cyst – StatPearls

Continuing Education Activity

Epidermal inclusion cysts are the most common cutaneous cysts and can occur anywhere on the body. These cysts typically present as fluctuant nodules under the surface of the skin, often with visible central puncta. These cysts often become painful to the patient and may present as a fluctuant filled nodule below the patient’s skin. This activity reviews the evaluation and management of epidermal inclusion cysts and highlights the importance of an interprofessional approach to caring for affected patients.

Objectives:

• Identify the etiology of epidermal inclusion cysts.

• Describe the evaluation of epidermal inclusion cysts.

• Describe the treatment and management options available for epidermal inclusion cysts.

• Explain interprofessional team strategies for improving care coordination and communication to advance the management of epidermal inclusion cysts and improve outcomes.

Access free multiple choice questions on this topic.

Introduction

Epidermal inclusion cysts are the most common cutaneous cysts. Numerous synonyms for epidermal inclusion cysts exist, including epidermoid cyst, epidermal cyst, infundibular cyst, inclusion cyst, and keratin cyst. These cysts can occur anywhere on the body, typically present as nodules directly underneath the patient’s skin, and often have a visible central punctum. They are usually freely moveable. The size of these cysts can range from a few millimeters to several centimeters in diameter. Lesions may remain stable or progressively enlarge over time. There are no reliable predictive factors to tell if an epidermal inclusion cyst will enlarge, become inflamed, or remain quiescent. Infected and/or fluctuant cysts tend to be larger, erythematous, and more noticeable to the patient. Due to the inflammatory response, the cyst will often become painful to the patient and may present as a fluctuant filled nodule below the patient’s skin. The center of epidermoid cysts almost always contains keratin and not sebum. This keratin often has a “cheesy” appearance. They also do not originate from sebaceous glands; therefore, epidermal inclusion cysts are not sebaceous cysts. The term “sebaceous” cyst should not be used when describing an “epidermoid” cyst. Unfortunately, in practice, the terms are often used interchangeably.[1]

Etiology

The majority of epidermoid cysts are sporadic. Epidermal inclusion cysts are extremely common, benign, not contagious, and can appear to resolve on their own. Without definitive treatment, they can reoccur. They often occur in areas where hair follicles have been inflamed and are usually common in conjunction with acne.[1][2][3]

Epidemiology

They are more common in men than women, with a ration of 2:1. They occur more frequently in patients in their 20s to 40s. Epidermal inclusion cysts by themselves are usually not genetically linked. They can be hereditary in rare syndromes such as Gardner syndrome, nodular elastosis with cysts and comedones (Favre-Racouchot syndrome), and basal cell nevus syndrome (Gorlin syndrome). Elderly patients with chronic sun-damaged skin areas have a higher likelihood of developing epidermoid cysts. Patients on BRAF inhibitors such as imiquimod and cyclosporine have a higher incidence of epidermoid cysts of the face. They often occur in areas where hair follicles have been inflamed or repeatedly irritated.  They are more frequent in patients with acne vulgaris. They can be seen during the neonatal period known as milia.[1]

Pathophysiology

The epidermal inclusion cyst can be primary or secondary. Primary epidermal cysts arise directly from the infundibulum of the hair follicle. Plugging of the follicular orifice allows for cyst formation. The cyst often communicates with the surface of the skin through a small orifice or visible central punctum. Patients suffering from acne vulgaris have a higher rate of hair follicle disruption and pore blockages leading to a higher rate of epidermal inclusion cyst formation from preexisting comedones. Secondary epidermoid cysts can arise after the implantation of the follicular epithelium in the dermis due to trauma or comedone formation. Epidermoid cysts are lined with stratified squamous epithelium with the accumulation of keratin in the core. Recently, Human papillomavirus and chronic ultraviolet light exposure have been seen to allow epidermal cysts to form.

Additionally, the epidermal inclusion cysts can occur in any area of the body. Most often, they are found on the face, scalp, neck, back, and scrotum. Inclusion cysts found in unusual numbers or locations like the extremities, trunk, or the back of the ears may be seen in the setting of Gardner syndrome. Gardner syndrome or familial adenomatous polyposis (FAP) with extracolonic manifestations is an autosomal dominant inherited disease due to a mutation in the APC gene on chromosome 5. The cardinal clinical feature is innumerable, widespread colonic polyps in conjunction with extracolonic lesions. In this disease process, the epidermal cysts will often appear before the onset of puberty and may even precede the onset of colonic polyposis.[1]

Histopathology

Epidermoid inclusion cysts can be confirmed by histologic examination. Epidermal inclusion cysts, more specifically, demonstrate the implantation of epidermal elements into the dermis layer of the skin. The cyst wall is usually derived from the infundibular portion of the hair follicle. Thus, the majority of epidermal inclusion cysts may be referred to as an infundibular cyst. However, a cyst’s wall can be derived from another etiology, explaining the interchangeable yet inaccurate use of the two names. The cystic cavity is filled with laminated keratinous material. Often, a granular layer is present that is filled with keratohyalin granules. In the event a cyst ruptures, a keratin granuloma can be seen during the examination. Infected cysts microscopically can show disruption of the cyst wall, acute inflammation or neutrophil invasion, or intense foreign body giant cell reaction. Approximately less than 1% of epidermal inclusion cysts have a malignant transformation to basal cell carcinoma or squamous cell carcinoma.[4][5]

History and Physical

The diagnosis of epidermoid cysts is usually clinical. It is based upon the clinical appearance of a discrete, freely moveable cyst, often with a visible central punctum. These cysts can occur anywhere on the body and typically present as nodules directly underneath the patient’s skin. The size of a cyst can range from a few millimeters to several centimeters in diameter. Lesions may remain stable or progressively enlarge. There is no predictive modality to tell if an epidermal inclusion cyst will enlarge, become inflamed, or remain quiescent. An infected cyst tends to be large with increased erythema, and it is more noticeable to the patient.

Furthermore, if inflammation is present, it usually results in cyst rupture and extrusion of cyst contents into the surrounding cutaneous and/or subcutaneous tissues, which may or may not be the result of an active infection. The source of infection for cysts usually comes from normal skin flora organisms, such as Staphylococcus aureus and Staphylococcus epidermidis. Generally, epidermal inclusion cysts are asymptomatic until they rupture.

Evaluation

Epidermoid inclusion cysts are evaluated by the history and physical exam often in an office setting. The need for pathology or histological examination before the operating room is usually not warranted. Radiographic and laboratory exams, such as ultrasound studies, are unnecessary and not typically ordered unless the evaluation leads the practitioner to suspect a genetic condition.

Treatment / Management

Inflamed, uninfected epidermal inclusion cysts rarely resolve spontaneously without therapy or surgical intervention. Treatment is not emergent unless desired by the patient electively before an increase in symptom severity (pain and/or infection). Definitive treatment is the surgical excision of the cyst. Some sources describe an alternative, yet not definitive, minimally invasive therapy for treatment, such as injecting triamcinolone at the dosage of 10 mg/mL for the trunk and 3 mg/mL for the face. The injection should be introduced into the inflamed epidermoid cyst, and it can help resolve the inflammation, prevent infection, and potentially reduce the need for surgical incision and drainage.

The definitive treatment is the complete surgical excision of the cyst with its walls intact; this will prevent reoccurrence. Excision is best accomplished when the lesion is not acutely inflamed. During this period, the cyst wall is friable, and the planes of dissection are more difficult to appreciate, making complete excision less likely and increasing the rate of reoccurrence.

For surgical excision, a local anesthetic, such as lidocaine with epinephrine, can be used. The anesthetic should be injected around the cyst, with care to avoid direct injection into the cyst, injection into the central pore, or rupture of the cyst wall. A small incision is made with a #11 blade on the skin overlying the cyst. The cyst contents are then expressed by exerting lateral pressure on either side of the cyst. With this technique, the cyst wall is often freed from the adjacent tissues and can be completely extracted through the small incision. The minimal incision surgical option provides better cosmetic results than the standard excision technique. Maintaining the incision within the minimal skin tension lines is important for cosmetic results. Reoccurrence rates from 1% to 8% have been shown with the minimal incision technique. A multiple layer subcuticular closure with an additional epidermal closure will yield better cosmetic outcomes.[6]

An alternate surgical option is to utilize a 4 mm punch biopsy with the expulsion of the intact cyst through the defect created in mass. Regardless of the option chosen, removal of the entire cystic wall is paramount to decrease reoccurrence.

In the event of a fluctuant lesion, incision and drainage are often needed with the mechanical destruction of intracavitary loculations. The presence of surrounding cellulitis may necessitate the use of oral antibiotic therapy. Empiric antibiotic therapy can be done with oral agents active against methicillin-sensitive S aureus or oral agents active against methicillin-resistant S aureus in areas of high prevalence. For patients who wish to have a more conservative treatment in the setting of acute infection, the cyst can be drained, and the patient started on oral antibiotics with a plan of surgical excision of remaining contents at a later date for definitive management. This is recommended due to a higher likelihood of reoccurrence without definitive surgical management.[4]

Differential Diagnosis

Depending on the anatomical area of the suspected epidermoid inclusion cysts, the differential diagnosis includes pilar cyst, lipoma, abscess, neuroma, benign growths, skin carcinomas, metastatic cutaneous lesions, pilomatrixoma, ganglion cyst, neurofibroma, dermoid cyst, brachial cleft cyst, pilonidal cyst, calcinosis cutis, pachyonychia congenita, steatocystoma simplex, and steatocystoma multiplex.

Prognosis

Epidermal inclusion cysts have an excellent prognosis after complete excision of all contents and the cystic wall.

Complications

Complications of epidermal inclusion cysts before definitive management can occur due to rupture and may result in symptoms such as erythema, pain, swelling, localized cellulitis. The main complication seen in clinical practice is reoccurrence due to incomplete excision. Any time surgery is done, there is a small inherent risk of complications. Complications of epidermal inclusion cyst excisions may include but are not limited to infection, bleeding, damage to surrounding structures and tissues, scarring, and wound dehiscence. There is a risk of the cyst reoccurring if the capsule is not completely excised during the surgical procedure.

Pearls and Other Issues

Differential diagnosis of epidermal inclusion cysts also include lipomas, neuromas, benign cutaneous growths, metastatic skin lesions, squamous cell carcinoma of the skin, basal cell carcinoma of the skin.

Enhancing Healthcare Team Outcomes

An interprofessional team that provides a holistic and integrated approach to patient care can help achieve the best possible outcomes. Cutaneous lesions and cysts are often found by a primary care provider or the emergency room provider on the initial presentation. The primary care provider or emergency department provider will often identify an epidermoid inclusion cyst or other cutaneous lesions. Given the provider’s comfort level, they will then attempt to drain or remove the cutaneous lesion in the office. Often, this lesion turns out to be an epidermal inclusion cyst during the procedure, and there is not a complete excision of the cyst capsule. This incomplete removal can lead to complications such as infection, localized pain, and recurrence.

Additionally, the providers might order imaging of the lesion, such as an ultrasound, to further evaluate the lesion. If better communication can take place between healthcare providers, they could refer the patient to general surgery before any intervention. The surgeon may then offer definitive operative management and complete removal of the cyst capsule. Seeing a surgeon early in the care of a prospective epidermal cyst may also lead to a decrease in unnecessary imaging, which can also contribute to decreasing the overall cost of healthcare. Nurses should instruct patients about postoperative care and notify the surgeon if there are complications. This, in turn, provides the patient with a decreased chance of complications. From an overall healthcare system perspective, early referral and definitive treatment by a general surgeon for epidermoid inclusion cysts would lead to a single procedure for the patient, a higher level of patient satisfaction, decreased overall healthcare costs, and better patient outcomes.

Figure

Epidermal Cyst. Contributed by DermNetNZ

References

1.

Zito PM, Scharf R. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Sep 29, 2020. Epidermoid Cyst. [PubMed: 29763149]

2.

Boussemart L, Routier E, Mateus C, Opletalova K, Sebille G, Kamsu-Kom N, Thomas M, Vagner S, Favre M, Tomasic G, Wechsler J, Lacroix L, Robert C. Prospective study of cutaneous side-effects associated with the BRAF inhibitor vemurafenib: a study of 42 patients. Ann Oncol. 2013 Jun;24(6):1691-7. [PubMed: 23406731]

3.

Urabe K, Xia J, Masuda T, Moroi Y, Furue M, Matsumoto T. Pilomatricoma-like changes in the epidermoid cysts of Gardner syndrome with an APC gene mutation. J Dermatol. 2004 Mar;31(3):255-7. [PubMed: 15187352]

4.

Zuber TJ. Minimal excision technique for epidermoid (sebaceous) cysts. Am Fam Physician. 2002 Apr 01;65(7):1409-12, 1417-8, 1420. [PubMed: 11996426]

5.

Apollos JR, Ekatah GE, Ng GS, McFadyen AK, Whitelaw SC. Routine histological examination of epidermoid cysts; to send or not to send? Ann Med Surg (Lond). 2017 Jan;13:24-28. [PMC free article: PMC5198733] [PubMed: 28053700]

6.

Lee HE, Yang CH, Chen CH, Hong HS, Kuan YZ. Comparison of the surgical outcomes of punch incision and elliptical excision in treating epidermal inclusion cysts: a prospective, randomized study. Dermatol Surg. 2006 Apr;32(4):520-5. [PubMed: 16681659]

3 easy steps to treat a red, painful cystic pimple

Most of us know how to deal with the odd spot, but those deep, often painful cystic pimples that emerge under the surface of the skin need to be approached with caution. Acne can appear in several shapes, sizes and forms—factors such as poor hygiene, hormone imbalances, diet and genetics can exacerbate them. “Sporadic surface spots such as blackheads and whiteheads can be easily removed with exfoliation, deep cleansing and extractions,” explains Dr Howard Murad, a board-certified dermatologist based in Los Angeles.

“If the skin does not heal normally, the follicle wall may rupture, and the skin surface becomes red and swollen. Pustules are the next stage of the process when a severe inflammatory reaction can result in large, tender pus-filled lesions in the deeper layers of the skin, which are called cysts,” he adds. Dermatologists class these spots as the most severe and difficult to treat, but there is plenty you can do to tackle and tame the occasional cystic spot at home. 

1. First, cleanse

However tempting it may be to squeeze or pick a cystic spot—don’t do it. “The absolute worst thing you can do is attempt to pop a cystic spot,” warns Mumbai-based celebrity dermatologist Dr Rashmi Shetty. “Since this type of spot lies beneath the skin, it isn’t easy to squeeze and doing so can spread the infection, leading to painful inflammation, scarring and hyperpigmentation,” she says.

Cystic spots are formed when a combination of sebum, bacteria and dry skin cells get trapped in the pores. If you are afflicted with severe and persistent cystic acne, consult a dermatologist, who can asses your skin and put together a tailored regime. You can usually feel a cystic spot forming, so cleansing with the right zit-zapping ingredients may help shrink it before it develops.

“Salicylic acid is a brilliant anti-inflammatory and antibacterial ingredient found in many blemish-fighting cleansers, but when we are dealing with a single cystic spot, you don’t want to upset the delicate balance of the rest of the skin, so look for a cleanser that can clean the skin without leaving it feeling dry,” advises Dr Murad.

He recommends a gel to oil based cleanser that emulsifies with water. “The oil breaks down sebum and helps flush out blocked pores, while keeping a healthy balance of hydration,” he explains. “Then apply an astringent toner containing witch hazel, precisely to the oil prone and affected areas of skin. This will dry out excess sebum and calm redness,” he adds.

2.

Then, stop the swelling

If the bump is swollen, using a cold compress can constrict the blood vessels helping to reduce the size of the spot. “Use an ice cube wrapped in a clean cloth to to help reduce inflammation,” advises Dr Shetty. “Hold this onto the skin for a few minutes, every few hours. But, if the spot has already developed and is ready to burst, apply a warm compress to consolidate the pus,” she adds.

3. Treat it fast

Using the wrong active ingredients can leave the spot looking dry, irritated and difficult to conceal. Dr Murad recommends spot treating emerging pimples with salicylic acid. “It is a great anti-inflammatory ingredient, which is able to penetrate the pores, calm redness, reduce swelling, it also kills bacteria and exfoliates the skin’s surface to speed up healing,” shares Dr Murad.

Cysts vs. Tumors: 7 Things You Need to Know | Fox Chase Cancer Center

Updated: February 11, 2020

Whenever we have a new lump, bump, or an unusual mass, it can be easy to assume the worst—cancer. But oftentimes the diagnosis is a benign cyst or tumor. The following seven points can help you understand some key facts about cysts and tumors, including how they differ, how they develop, and how they are treated.

1. Tumors and cysts aren’t the same thing

A cyst is a sac or capsule that’s filled with tissue, fluid, air, or other material. A tumor is usually a solid mass of tissue.

2. A tumor doesn’t automatically mean cancer

It’s easy to jump to the worst-case scenario, but that’s not the right move. “Tumors aren’t necessarily cancer,” said Christina Chu, MD, a gynecologic oncologist at Fox Chase Cancer Center. “You can have benign cysts and benign tumors.”

Benign tumors don’t grow or invade other parts of the body.

3. Tumors develop as a result of abnormal cell growth

Normally, the body grows new cells as needed. When old cells die, new ones form to take their place. But with abnormal cell growth, old cells stick around and new cells are created when they shouldn’t be. When the usual rules of cell growth aren’t followed, these extra cells may form a tumor.

4. Cysts come in hundreds of varieties and have many causes

They range in size from tiny to very large. Some develop because of infections, blockages in ducts, or even damaged hair follicles. And, although less likely, cysts can also develop from cancer.

5. Both tumors and cysts can show up anywhere

They can show up from your face to your feet. Bones, organs, and soft tissue can all play host to these lumps and bumps.

6. You should have any lump or bump checked out

“Most cysts and most lumps, statistically speaking, are benign,” Chu said. “They just need the appropriate follow-up.” It’s important to have these cysts or tumors evaluated by a specialist, like those at Fox Chase.

See your doctor sooner, rather than later, if you have a mass that grows quickly, changes color, looks red or swollen, or if it bleeds, is painful, or interferes with your daily activities.

It’s possible that the nature of a mass can be determined with a scan. Ultrasounds and CT scans are often used for this purpose. If the lump is filled with fluid, a needle may be used to aspirate some of the liquid for testing. Sometimes, part of a lump must be biopsied or the entire mass must be surgically removed for diagnosis. A pathologist will examine the cells and determine what type they are and if they are benign, malignant, or even precancerous.

7. Treatment for cysts and tumors depends on several factors

Location, cause, and whether it’s cancerous all help determine next steps.

Most cysts don’t require treatment. They typically don’t cause any symptoms and may go away on their own. But this can depend on where the cyst is located. If a cyst hurts or you don’t like the way it looks, some options are removing it or draining its fluid.

You can usually let a benign tumor be, unless it is pressing on a vital organ and is interrupting its function—then it may need to be removed. Cancerous tumors generally require treatment with surgery, radiation therapy, chemotherapy, or a combination of these and other therapies.

Turn to the experts

At Fox Chase, our highly experienced teams of physicians can help determine whether a lump or mass is a cyst or a tumor—and whether either one requires treatment. When treatment is necessary, they will create a personalized plan just for you. Request an appointment online or call 888-369-2427.

Learn more about screening services offered at Fox Chase.

Epidermoid and Pilar Cysts (Sebaceous Cysts) | Causes and Removal

Epidermoid and pilar cysts are commonly referred to as ‘sebaceous cysts’ (pronounced ‘seb-ay-shuss’).  They are overgrowths of skin cells (called keratin) held together in a little capsule, or sac.

They are harmless smooth lumps just under the surface of the skin. They are not cancerous and do not require removal unless they are bothering you by the look or the feel of them.

They can occur almost anywhere in the body, but are commonly found on the back or scalp.

What are epidermoid and pilar cysts?

A cyst is a sac that is filled with a fluid or semi-fluid material. Cysts develop in various places in the body and arise from different tissues in the body. Two of the most common types of cyst that occur under the skin surface are epidermoid and pilar cysts. These cysts used to be called sebaceous cysts but this term is no longer correct, as the origin of these cysts is not from the sebaceous glands in the skin, as was once thought.

However, many doctors still call them sebaceous cysts and so you will probably hear them using this term.

• An epidermoid cyst is a cyst where the cyst sac forms from cells that normally occur on the top layer of the skin (the epidermis).
• A pilar cyst is a cyst where the cyst sac forms from cells similar to those that are in the bottom of hair follicles (where hairs grow from).

In both cases, the semi-fluid content of the cyst looks a bit like cottage cheese. This substance is soggy keratin. Keratin is made by skin cells and is the substance that hairs are made from and the substance that covers the top layer of the skin.

What do these cysts look like and what are their symptoms?

Epidermoid and pilar cysts are smooth round lumps which you can see and feel just beneath the skin surface. They are very common.

Often they are small, like a pea, but sometimes they slowly get bigger over many months to become a few centimetres in diameter. They look very similar to each other but can be distinguished from each other if the cells that form the cyst sac are looked at under the microscope.

• Epidermoid cysts can affect anyone but are most common in young and middle-aged adults. They can appear anywhere on the skin but develop most commonly on the face, neck, chest, upper back and sometimes on the scrotum.
• Pilar cysts can affect anyone but are most common in middle-aged women. They can appear anywhere on the skin but develop most commonly on the scalp. It is common for several to develop at the same time on the scalp.

Epidermoid and pilar cysts usually cause no symptoms. Occasionally:

• They become infected, when they may become red, inflamed and painful. A course of antibiotics will usually clear an infection if it occurs. Sometimes they settle down even without antibiotics.
• The cyst may leak the cheese-like material on to the skin if the cyst is punctured or damaged.
• A little horn may grow on the skin over the cyst.
• A cyst may form in an uncomfortable place such as in the genital skin or beside a nail.  

This photo shows the typical appearance of an epidermoid cyst on someone’s neck:

Epidermoid cyst on the neck

Steven Fruitsmaak (Own work) – close-up view, CC BY-SA 3.0, via Wikimedia Commons

By Steven Fruitsmaak (Own work) – close-up view, CC BY-SA 3.0, via Wikimedia Commons

What causes epidermoid and pilar cysts?

It seems that some cells that are normally near to the surface of the skin (cells of the epidermis or cells in hair follicles) get into deeper parts of the skin and continue to multiply. The cells that multiply form into a sac and produce the keratin that they would normally make on the top layer of the skin. The keratin becomes soggy and forms into a cheese-like substance.

Usually epidermoid cysts pop up for no particular reason: there is nothing you can do to prevent them. They are not related to cleanliness, nor will exfoliating stop them occurring. 

Pilar cysts on the scalp can be hereditary and run in families, although this is rare.

Are epidermoid and pilar cysts harmful?

Not usually. If they do not bother you then it is best just to leave them alone. If one has grown recently it’s worth asking your doctor to check that it is a harmless cyst. Sometimes a person with an epidermoid or pilar cyst requests that it be removed. This is usually for one of three reasons:

• Cosmetic reasons. For example, the cyst is in an obvious site on the skin and looks unsightly.
• They are sometimes easy to catch and traumatise. This typically occurs on the scalp when combing hair.
• If the cyst has become infected or irritating.

Epidermoid and pilar cysts are non-cancerous (benign). They do not spread to other parts of the body or cause any serious problems.

Removal of epidermoid and pilar cysts

If required, the cyst can usually be easily removed by a simple operation under local anaesthetic. The surrounding skin is numbed by injecting some local anaesthetic. A small cut is made over the cyst. It can then be gradually teased out by the doctor. The wound is then stitched up. A small scar will result. Sometimes, after the removal of a cyst, it gradually regrows in the same site under the scar.

Bear in mind you then exchange a small cyst for a scar: some people would rather have been left with the cyst, once they see the results of the surgery.

Gulf of Maine Cyst Sampling Cruise Sets Stage for 2020 Red Tide Forecast

A Carib Corer collects bottom sediment samples containing the HAB cysts. The samples are processed onboard and the cysts preserved for counting at a shore-based lab. Credit Mary Rider, NOAA.

In the Gulf of Maine, seasonal forecasts of harmful algal bloom (HAB) severity depend on the numbers of seed-like HAB cells in the sediments, frequently called cysts. Cyst abundances are measured in the fall or early winter prior to the forecast release in the spring. In October 2019, a NCCOS-sponsored cyst cruise, in partnership with the Woods Hole Oceanographic Institution (WHOI), sailed aboard the NOAA Ship Gordon Gunter to document cyst abundance across the Gulf of Maine.

Gulf of Maine red tide, caused by Alexandrium catenella, produces a toxin that can accumulate in shellfish. Human consumers of toxin-contaminated shellfish can experience paralytic shellfish poisoning, a serious or even fatal illness. To protect human health, state agencies conduct rigorous monitoring and ban harvesting of toxic shellfish. NCCOS provides forecasts of Gulf of Maine red tide events that enable proactive responses to protect coastal economies, making the region more resilient to red tide outbreaks.

A conductivity, temperature, and depth (CTD) instrument is used to collect water column physical parameters such as salinity, depth, turbidity, and dissolved oxygen concentrations. These parameters are included in the model. Credit Mary Rider, NOAA

Alexandrium catenella seasonal forecasts depend on measurements of the abundance of the cysts in bottom sediments within the Gulf of Maine. From October 2-10, 2019, a NCCOS/WHOI crew sailed from Newport, RI, on the Gordon Gunter collecting and mapping  A. catenella cyst abundance. Fifty-seven stations were sampled for sediment cyst abundance using a Carib Corer. Water column physical parameters were determined using a conductivity, temperature, and depth (CTD) instrument.

NCCOS participants in the 2019 cruise included Chief Scientist Teresa (Terry) McTigue, NCCOS Deputy Director Margo Schulze-Haugen, CRP Director David Kidwell, Steve Kibler, Yizhen Li, Andrew Meredith, Todd Neison, Mary Rider, Mary Kate Rogener, and NCCOS 2019 Knauss Sea Grant Fellow Alessandra (Ali) Burgos. WHOI participants included David Kulis. Students sponsored by the NOAA Educational Partnership Program included Elyse Bonner (Tuskegee University) and Prian Vidal (Florida A&M University).

For more information, contact [email protected].

90,000 ✔ addresses of clinics, ✔ prices, ✔ online registration – Meds.ru

Clinic network Medicine and beauty

Medicine and Beauty on Paveletskaya

Medicine and Beauty on Paveletskaya

6th Monetchikovsky per., d. 19

Paveletskaya

Serpukhovskaya

Dobryninskaya

Oktyabrskaya

Proletarian

09: 00-21: 00

Mon-Fri 09: 00-21: 00

Sat 09: 00-21: 00

Sun 09: 00-21: 00

Make an appointment

To enroll in any branch of the clinic, call: +7 (499) 685-18-13

Clinic network Medicine and beauty

Make an appointment

To enroll in any branch of the clinic, call: +7 (499) 685-18-13

Naran Clinic Network

The Naran Specialized Clinic at the Red Gate has been opened since 2014 and carries out diagnostic and treatment procedures using the methods of Tibetan medicine.This is one of the branches of a network of medical institutions. Doctors with extensive work experience conduct appointments here.

Make an appointment

To enroll in any branch of the clinic, call: +7 (499) 685-18-13

Multidisciplinary clinic SOYUZ

Multidisciplinary clinic SOYUZ

st.Matrosskaya Tishina, 14 A

Sokolniki

Electrozavodskaya

Preobrazhenskaya square

09: 00-21: 00

Mon-Fri 09: 00-21: 00

Sat 09: 00-21: 00

Sun 09: 00-21: 00

The Soyuz multidisciplinary clinic provides polyclinic services and inpatient treatment.

Make an appointment

To make an appointment at the clinic, call: +7 (499) 685-18-13

GMS Clinic network

Surgical Center GMS Hospital on Kalanchevskaya is a multidisciplinary modern medical institution that provides various services in the field of planned and emergency surgery, traumatology, gynecology and many other areas of surgical interventions.This surgical center also provides ambulance services, hospital admissions, etc.

Make an appointment

To enroll in any branch of the clinic, call: +7 (499) 685-18-13

Clinic network K + 31 Clinic

International Medical Center K + 31 “Petrovskie Vorota” is engaged in diagnostics and treatment and consulting services in the most popular specializations.The staff of the medical institution has experienced specialists, including highly qualified doctors, candidates of sciences in the field of medicine.

• 18200 Puncture and aspiration from the cyst of the kidney or renal pelvis
• 96800 Excision of the kidney cyst
• 108900 Excision of renal cyst laparoscopic
• View clinic price list →

Make an appointment

To enroll in any branch of the clinic, call: +7 (499) 685-18-13

International Health Center

International Health Center

st.Oktyabrskaya, 2

Dostoevskaya

Novoslobodskaya

Mendeleevskaya

Prospect Mira

09: 00-21: 00

Mon-Fri 09: 00-21: 00

Sat 09: 00-20: 00

Sun 10: 00-20: 00

The multidisciplinary medical center “International Center for Health Protection” provides a wide range of medical services in various fields.The clinic offers effective treatment, quick diagnosis, effective prevention of pathologies and acute conditions.

Make an appointment

To make an appointment at the clinic, call: +7 (499) 685-18-13

Dentistry “Novostom” on Kalanchevskaya

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Dentistry on Kalanchevskaya

Contact information

Address:

107078, Moscow st.Kalanchevskaya, 17

Phones:

8 (495) 694-79-06
8 (929) 597-24-02

Reception hours:

Mon-Fri: 9.00-21.00
Sat-Sun: 9.00-20.00

Clinic staff

All employees …

Appointment schedule …

Clinic room

The Dentistry Center in CAO “Novostom” is a modern clinic in which the patient is offered a wide range of services for dental treatment and prevention of various diseases.Convenient transport links and flexible working hours make professional dental care available to all residents of the Central Administrative District. For a long experience of work, dentistry on the Komsomolskaya metro has grown to a center, which has a rich list of procedures for orthopedic treatment, orthodontics, periodontology, and implantology.

Before carrying out a particular procedure and choosing the appropriate type of treatment in dentistry on the Krasnye Vorota metro station, the patient is provided with a consultation, as well as a medical examination and the necessary diagnostics.In their work, dentists use high-quality materials, modern medical equipment and safe anesthetic drugs. Examination of patients in the dentistry center on the Krasnye Vorota metro station is carried out using the latest computer technologies, which allows us to reduce to a minimum the discomfort of our clients.

Dentists of the Novostom clinic are qualified specialists whose professional level is constantly improving. Specialists working in dentistry on the Komsomolskaya metro attend conferences, master innovative medical technologies, and undergo multilevel testing upon hiring to determine the required level of theoretical and practical training.

Schedule of appointments for doctors

* Reception is carried out by appointment only.

Next 7 days

Next 7 days

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Modern dentistry near Krasnye Vorota metro station

Dental clinic “Doctor Smile” is located in the Central Administrative District of Moscow, a 10-minute walk from the station “Krasnye Vorota”.

The range of services provided in the clinic includes all types of dental services:

• Oral hygiene;
• Therapy;
• Orthopedics;
• Orthodontics;
• Periodontics;
• Surgery;
• Implantation

Constant promotions in the clinic near the Red Gate are an excellent opportunity to receive high quality dental services at an affordable price.

We accept bank installment cards for payment:

• Sovcombank;
• Kiwi;
• HomeCredit;

We arrange loans for dental treatment on favorable terms and interest-free installments in partner banks:

• Alpha;
• Europe Credit;
• Orient Express;
• Tinkoff;
• Renaissance;

Dentistry service modern standards

In the Doctor Smile dentistry at the Red Gate station, highly specialized dentists work: orthodontists, therapists, orthopedists, surgeons, and implantologists.

The specialists were selected to the team according to a strict competition held by the owner of the clinic, orthopedic doctor Kagan M.L.

They regularly attend seminars, master classes and refresher courses in Russia and Europe.

Equipment of our clinic

• Orthopantomograph GENDEX;
• Tomograph GENDEX;
• ZOOM-3 and ZOOM-4 devices;
• Apex Locators;
• 3d-shape scanner;
• “Vector” apparatus;
• Autoclaves Assistina and Mocom;
• Radiovisiograph.

We pay great attention to the infectious safety of the manipulations carried out in the clinic. We make the most of disposable instruments and various hygiene products. If the instrument is reused, then it undergoes a special multilevel cleaning, sterilization and processing on modern advanced equipment.

OGBUZ “Clinical Emergency Hospital” :: Information for patients