Sebaceous cysts on back of neck: Sebaceous Cyst: Causes, Diagnosis, and Treatment
Sebaceous Cyst: Causes, Diagnosis, and Treatment
Sebaceous Cyst: Causes, Diagnosis, and Treatment
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Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — By Lydia Krause — Updated on February 7, 2023
A sebaceous cyst is typically benign.
But you may choose to have a doctor remove it for cosmetic reasons.
Sebaceous cysts are common, noncancerous cysts of the skin. Cysts are atypical growths in your body that may contain liquid or semiliquid material.
Sebaceous cysts are mostly found on your face, neck, or torso. They grow slowly and aren’t life threatening, but they may become uncomfortable if they go unchecked.
Doctors usually diagnose a cyst with only a physical examination and your medical history.
In some cases, a cyst will be examined more thoroughly for signs of cancer.
Share on PinterestSebaceous Cyst at the upper back. Casa nayafana/Shutterstock
Sebaceous cysts form out of your sebaceous gland. The sebaceous gland produces the oil (called sebum) that coats your hair and skin.
Cysts can develop if the gland or its duct (the passage from which the oil is able to leave) becomes damaged or blocked. This usually occurs due to trauma to the area.
The trauma may be a scratch, a surgical wound, or a skin condition, such as acne.
Sebaceous cysts grow slowly, so the trauma may have occurred weeks or months before you notice the cyst.
Other causes of a sebaceous cyst may include:
- misshapen or deformed ducts
- damage to the cells during surgery
- genetic conditions, such as Gardner’s syndrome or basal cell nevus syndrome
Small cysts are typically not painful. Large cysts can range from uncomfortable to considerably painful. Large cysts on the face and neck may cause pressure and pain.
This type of cyst is typically filled with white flakes of keratin, which is also a key element that makes up your skin and nails. Most cysts are soft to the touch.
Areas on the body where cysts are usually found include:
- scalp
- face
- neck
- back
A sebaceous cyst is considered atypical — and possibly cancerous — if it has the following characteristics:
- a diameter that’s larger than 5 centimeters
- a fast rate of reoccurrence after being removed
- signs of infection, such as redness, pain, or pus drainage
Your doctor can treat a cyst by draining it or by surgically removing it.
Usually, cysts are removed. This doesn’t mean they’re dangerous — it may be for cosmetic reasons.
Since most cysts aren’t harmful to your health, your doctor will allow you to choose the treatment option that works for you.
It’s important to remember that without surgical removal, your cyst will usually come back. The best treatment to ensure complete removal is surgery. However, some people may decide against surgery because it can cause scarring.
Your doctor may use one of the following methods to remove your cyst:
- Conventional wide excision. This completely removes a cyst but can leave a long scar.
- Minimal excision. A method that causes minimal scarring but carries a risk that the cyst will return.
- Laser with punch biopsy excision. This uses a laser to make a small hole to drain the cyst of its contents (the outer walls of the cyst are removed about a month later).
After your cyst is removed, your doctor may give you an antibiotic ointment to prevent infection.
You should use this until the healing process is complete. You may also be given a scar cream to reduce the appearance of any surgical scars.
Doctors often diagnose a sebaceous cyst after a simple physical examination. If your cyst is atypical, your doctor may order additional tests to rule out possible cancers. You may also need these tests if you wish to have the cyst surgically removed.
Common tests used for a sebaceous cyst include:
- CT scans, which help your doctor spot atypical characteristics and find the best route for surgery
- ultrasounds, which identify the contents of the cyst
- punch biopsy, which involves removal of a small amount of tissue from the cyst to be examined in a laboratory for signs of cancer
Sebaceous cysts are generally not cancerous. Cysts left untreated can become very large and may eventually require surgical removal if they become uncomfortable.
If you have a complete surgical removal, the cyst will most likely not return in the future.
In rare cases, the removal site may become infected. Contact your doctor if your skin shows any signs of infection, such as redness and pain, or if you develop a fever. Most infections will go away with antibiotics, but some can be deadly if untreated.
Last medically reviewed on December 6, 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.
- Hoover E, et al. (2020). Physiology, sebaceous glands.
ncbi.nlm.nih.gov/books/NBK499819/ - Zito PM, et al. (2021). 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 7, 2023
Written By
Lydia Krause
Edited By
Shannon Ullman
Copy Edited By
Helena Hoayun
Dec 6, 2021
Medically Reviewed By
Cynthia Cobb, DNP, APRN
VIEW ALL HISTORY
Share this article
Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — By Lydia Krause — Updated on February 7, 2023
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Sebaceous Cyst: Causes, Diagnosis, and Treatment
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Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — By Lydia Krause — Updated on February 7, 2023
A sebaceous cyst is typically benign.
But you may choose to have a doctor remove it for cosmetic reasons.
Sebaceous cysts are common, noncancerous cysts of the skin. Cysts are atypical growths in your body that may contain liquid or semiliquid material.
Sebaceous cysts are mostly found on your face, neck, or torso. They grow slowly and aren’t life threatening, but they may become uncomfortable if they go unchecked.
Doctors usually diagnose a cyst with only a physical examination and your medical history.
In some cases, a cyst will be examined more thoroughly for signs of cancer.
Share on PinterestSebaceous Cyst at the upper back. Casa nayafana/Shutterstock
Sebaceous cysts form out of your sebaceous gland. The sebaceous gland produces the oil (called sebum) that coats your hair and skin.
Cysts can develop if the gland or its duct (the passage from which the oil is able to leave) becomes damaged or blocked. This usually occurs due to trauma to the area.
The trauma may be a scratch, a surgical wound, or a skin condition, such as acne.
Sebaceous cysts grow slowly, so the trauma may have occurred weeks or months before you notice the cyst.
Other causes of a sebaceous cyst may include:
- misshapen or deformed ducts
- damage to the cells during surgery
- genetic conditions, such as Gardner’s syndrome or basal cell nevus syndrome
Small cysts are typically not painful. Large cysts can range from uncomfortable to considerably painful. Large cysts on the face and neck may cause pressure and pain.
This type of cyst is typically filled with white flakes of keratin, which is also a key element that makes up your skin and nails. Most cysts are soft to the touch.
Areas on the body where cysts are usually found include:
- scalp
- face
- neck
- back
A sebaceous cyst is considered atypical — and possibly cancerous — if it has the following characteristics:
- a diameter that’s larger than 5 centimeters
- a fast rate of reoccurrence after being removed
- signs of infection, such as redness, pain, or pus drainage
Your doctor can treat a cyst by draining it or by surgically removing it.
Usually, cysts are removed. This doesn’t mean they’re dangerous — it may be for cosmetic reasons.
Since most cysts aren’t harmful to your health, your doctor will allow you to choose the treatment option that works for you.
It’s important to remember that without surgical removal, your cyst will usually come back. The best treatment to ensure complete removal is surgery. However, some people may decide against surgery because it can cause scarring.
Your doctor may use one of the following methods to remove your cyst:
- Conventional wide excision. This completely removes a cyst but can leave a long scar.
- Minimal excision. A method that causes minimal scarring but carries a risk that the cyst will return.
- Laser with punch biopsy excision. This uses a laser to make a small hole to drain the cyst of its contents (the outer walls of the cyst are removed about a month later).
After your cyst is removed, your doctor may give you an antibiotic ointment to prevent infection.
You should use this until the healing process is complete. You may also be given a scar cream to reduce the appearance of any surgical scars.
Doctors often diagnose a sebaceous cyst after a simple physical examination. If your cyst is atypical, your doctor may order additional tests to rule out possible cancers. You may also need these tests if you wish to have the cyst surgically removed.
Common tests used for a sebaceous cyst include:
- CT scans, which help your doctor spot atypical characteristics and find the best route for surgery
- ultrasounds, which identify the contents of the cyst
- punch biopsy, which involves removal of a small amount of tissue from the cyst to be examined in a laboratory for signs of cancer
Sebaceous cysts are generally not cancerous. Cysts left untreated can become very large and may eventually require surgical removal if they become uncomfortable.
If you have a complete surgical removal, the cyst will most likely not return in the future.
In rare cases, the removal site may become infected. Contact your doctor if your skin shows any signs of infection, such as redness and pain, or if you develop a fever. Most infections will go away with antibiotics, but some can be deadly if untreated.
Last medically reviewed on December 6, 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.
- Hoover E, et al. (2020). Physiology, sebaceous glands.
ncbi.nlm.nih.gov/books/NBK499819/ - Zito PM, et al. (2021). 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 7, 2023
Written By
Lydia Krause
Edited By
Shannon Ullman
Copy Edited By
Helena Hoayun
Dec 6, 2021
Medically Reviewed By
Cynthia Cobb, DNP, APRN
VIEW ALL HISTORY
Share this article
Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP — By Lydia Krause — Updated on February 7, 2023
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If it’s a cyst…READ MORE
- Epidermoid Cysts
Medically reviewed by Owen Kramer, MD
Epidermoid cysts, also called sebaceous, keratin, or epithelial cysts, are small, hard lumps that develop under the skin.
READ MORE
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Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP
It’s common to develop painful bumps, called cysts, on and around your earlobes. Cysts can look like pimples, but they’re different. Read on to learn…
READ MORE
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READ MORE
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A skin lesion biopsy is a simple medical procedure in which a sample of your skin is removed and tested in a laboratory.
READ MORE
- Hard Pimples: Causes, Treatment, and More
Medically reviewed by Katie Mena, MD
Chances are you’ve experience a pimple or acne here and there.
Knowing the type of pimple you have can be important for treating it. We explain what a…READ MORE
- Milium Cysts in Adults and Babies
Medically reviewed by Cynthia Cobb, DNP, APRN, WHNP-BC, FAANP
A milium cyst is a small, white bump that typically appears on the nose and cheeks. Multiple cysts are referred to as milia. Milia is most common in…
READ MORE
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A skin lesion is a part of the skin that has an abnormal appearance compared to the skin around it. Discover 21 types of skin lesions, like acne and…
READ MORE
- Healing Cystic Acne From the Inside Out
Most acne treatment is an after-thought, so what happens when you treat acne from the inside out? Read how this woman changed her life (and skin) by…
READ MORE
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READ MORE
If it’s a cyst…
Knowing the type of pimple you have can be important for treating it. We explain what a…treatment, symptoms and causes of the disease, diagnostics in the “SM-Clinic”
The surgeon deals with the treatment of this disease
- What is atheroma?
- Atheroma symptoms
- Causes of atheroma
- Atheroma diagnostics
- Atheroma treatment
- Doctors
Atheroma can develop on the excretory duct of any sebaceous gland.
The sebaceous glands are everywhere except the soles and palms. There are especially many glands on the face, scalp, back between the shoulder blades, chest, and groin. In some areas of the skin, the number of sebaceous glands reaches 900. Therefore, atheroma can have a variety of localization.
Atheroma – a small cavity, not soldered to the skin, easily moves under the skin. Contains a mushy mass, palpable as an elastic, painless ball. This is the result of blockage of the sebaceous gland. Although the excretory duct is blocked, sebum continues to be produced, gradually expanding the duct.
Atheroma increases in size slowly over several years. Patients apply only because of a cosmetic defect, since there are no painful manifestations. Sizes can reach 10 cm or more.
Symptoms of atheroma
A cyst is defined as a soft, round formation that protrudes slightly under the skin. If the contents of the cyst are liquid, then fluctuation (oscillatory movement) is felt.
The skin over the atheroma is stretched so much that it cannot be folded. At the top point, a blocked duct can be seen in the form of a black dot. Atheroma is easy to displace relative to neighboring tissues. Education does not give any unpleasant sensations.
If the atheroma is located in a place of close contact with clothing, then scuffs and signs of inflammation may be present.
When located on the scalp, the hair over the atheroma thins and almost always falls out. Due to constant trauma, necrosis (necrosis) often occurs, ulcers form, and slight bleeding occurs. In some patients, the skin over the atheromas on the head becomes dense, cyanotic and painful to the touch.
Causes of atheroma
Blockage of the sebaceous gland occurs for the following reasons:
- genetic – structural features of the sebaceous glands are such that in some glands there is no excretory duct. In this case, the accumulation of sebum begins even in utero, and the born child is covered with atheromas;
- acne, when the mouth of the excretory duct becomes keratinized, and the secretion of the gland becomes more viscous;
- oily seborrhea, when a large amount of sebum forms on the scalp;
- mechanical damage to the gland – boils, cuts, abrasions, scars, permanent hair removal;
- exposure to ionizing radiation;
- ultraviolet irradiation;
- burns and frostbite;
- various hormonal factors resulting from stress.
Usually several pathological mechanisms work simultaneously in one person.
Thus, a blockage can occur for any reason. The resulting secret stretches the duct, and a cavity is obtained. Vessels and nerves are not affected, and the person does not feel anything. However, over time, a dense capsule of connective tissue forms around the swollen cavity. Attempts to puncture and empty the cyst do nothing, as the contents are recruited again and again.
Complicated atheroma is rare, and complications include suppuration. This happens with mechanical pressure or irritation, as well as after independent attempts to empty the cyst. A connective tissue capsule separates the cavity with its contents from the rest of the tissues, and when you try to squeeze it out, it can collapse, and suppuration passes to neighboring areas.
Get advice
If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.
You can find out more about the disease, prices for treatment and sign up for a consultation with a specialist by phone:
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Treatment is carried out in accordance with clinical guidelines
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Diagnosis of atheroma
Diagnosis is carried out by a dermatologist or surgical oncologist. During the examination, the doctor detects characteristic changes, paying attention to the location, mobility and size. The speed at which the cyst formed matters.
In a difficult case, an ultrasound of the soft tissues is performed at the site of the cyst. On ultrasound, a capsule is visible, inside it is a thin cyst and contents.
During ultrasound, atheroma is delimited from other similar formations – hygromas (sweat gland cyst), fibromas (connective tissue), lipomas (benign tumor of adipose tissue).
If there is still doubt about the nature of the cyst, a histological analysis (study of the cellular composition) is performed during surgical removal.
Treatment of atheroma
The treatment is complex, since it is necessary not only to remove the cyst with the capsule, but also to choose skin care products to prevent the formation of new cysts.
If the cyst is inflamed, then before surgical treatment, all measures are taken to stop the inflammation. Antibacterial and disinfectants, agents to reduce the formation of sebum are prescribed.
Operative treatment is possible in two variants:
- classical cystectomy — exfoliation of the capsule with a scalpel with a cosmetic suture;
- radio wave removal – high frequency waves evaporate the liquid from the capsule, as a result, the formation is eliminated. This method is preferable because it is not accompanied by bleeding and scarring, but cannot be used in patients with a pacemaker and the presence of metal structures in the body.
- With festering atheroma, pus is first evacuated and the inflammation subsides, and only then the capsule is husked.
This method is preferable because it is not accompanied by bleeding and scarring, but cannot be used in patients with a pacemaker and the presence of metal structures in the body.The best prevention of atheroma is to see a dermatologist for any skin changes. After the examination, the doctor selects skin care medications that normalize the production of sebum. The entire range of medical services for the diagnosis, treatment and prevention of atheroma is available at the SM-Clinic.
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The surgeon is treating this disease
- About the disease
- Species
- Neck cyst symptoms
- Causes of neck cysts
- Neck cyst diagnosis
- Neck cyst treatment
- Prophylaxis
- Rehabilitation
- Questions and answers
- Doctors
About disease
Recently, congenital malformations of the neck and face have become more common, which may be due to poor environmental conditions (primarily worsening background radiation).
Lateral soft tissue cysts are usually diagnosed immediately after birth (often combined with the presence of a fistulous tract), median cysts are diagnosed several years later.
Cervical cysts are not only an aesthetic defect. The inconvenience is also associated with the presence of pathological discharge from the fistula, painful sensations when swallowing. In some cases, neck cysts are accompanied by the development of inflammation. In 1-2% of patients there is also a risk of malignant degeneration.
Treatment involves surgery. Puncture and introduction of sclerosants into the cyst cavity is not very effective.
Species
According to the classification, the following types of neck cysts are distinguished:
- median (central) – located along the central vertical of the neck;
- lateral (lateral) – localized on the right or left.
Congenital cysts of the neck are often accompanied by fistulas. If the fistulous canal has 2 openings (one opens on the skin of the anterior surface of the neck, and the other on the mucous membrane of the oral cavity), then it is complete.
A fistula is considered incomplete when there is only 1 fistula.
Neck cyst symptoms
Lateral neck cysts are more common than median cysts. Often they are asymptomatic for a long time. The tumor-like formation usually becomes well visualized when the head is turned to the side contralateral to the cyst. Cystic formation is usually elastic to the touch, not soldered to the surrounding tissues. Subjective symptoms of neck cysts with lateral localization usually appear when the contents are suppurated or when the formation is large, when there is compression of the large vessels and nerves of the neck.
Central cysts are usually located in the space between the superior surface of the thyroid cartilage and the hyoid bone. The position of the cyst can vary, being somewhat away from the midline, above the hyoid bone, below the upper edge of the thyroid cartilage.
Median cysts of the neck are usually round, elastic to the touch and little mobile. They move a little when swallowing.
In the absence of complications, the skin over the cyst is not changed, while the skin can be taken in a fold. When feeling the formation of pain is absent. As a rule, the size of the central cysts is usually 20-40 mm. With suppuration of the median cyst, the likelihood of the formation of a fistulous tunnel increases. Fistulas are formed when pus finds a way out (the fistulous opening is located on the front surface of the neck. The fistulous discharge can periodically irritate the skin and lead to its maceration.
Causes of a cyst in the neck
Causes of a cyst in the neck are associated with a deviation from the normal course of the embryonic period.
- Lateral cysts. It is believed that their formation is due to the non-closure of the gill furrows. As a rule, this pathological process is associated with the action of unfavorable factors on the embryo at the 4-6th week of development.
- Median cysts. It is believed that they develop as a result of a delay in the reverse development (reduction) of the prenatal existing thyroid duct (it extends from the blind opening of the tongue to the thyroid gland). If this duct does not undergo reverse development, then it can transform into derivatives such as the pyramidal process of the thyroid gland, accessory thyroid glands, cysts and fistulas. The impact of unfavorable factors on the embryo at the 6-7th week of development creates prerequisites for the formation of median cysts.
If this duct does not undergo reverse development, then it can transform into derivatives such as the pyramidal process of the thyroid gland, accessory thyroid glands, cysts and fistulas. The impact of unfavorable factors on the embryo at the 6-7th week of development creates prerequisites for the formation of median cysts.Get advice
If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.
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Neck cyst diagnosis
In order to diagnose and differential diagnosis of cysts and fistulas of the neck, paraclinical studies are carried out to exclude the specific nature of the pathological formations of the anterior surface of the neck.
- Contrast radiography – allows you to determine the size of the cyst, the nature of its structure, the presence of lateral branches, connection with the hyoid bone.
- Ultrasound scanning – ultrasound shows the size of the formation, its structure and connection with nearby organs.
- Computed (CT) or magnetic resonance imaging (MRI) – performed in complex clinical cases and allows you to assess in detail what the cyst looks like and what signs are characteristic of it.
- Puncture and cytological examination of the contents.
The final diagnosis of neck cysts is based on imaging data. And sometimes a morphological assessment of the cellular composition is also required.
Expert opinion
Although central cysts and fistulas of the neck are prenatal anomalies, they are rarely detected immediately after birth. As a rule, they are diagnosed in childhood or adolescence, sometimes even in adulthood. This feature is due to the fact that the central cysts increase in size very slowly, usually within 8-10 years.
As practice shows, most often the time interval from the onset of the first symptoms to the visit to the doctor is from 6 months to 3 years.
Shikhaleva Natalya Gennadievna
Traumatologist-orthopedist, plastic surgeon, doctor of the highest category, MD
Treatment of neck cysts
Treatment of neck cysts is performed surgically.
Conservative treatment
The introduction of sclerosing agents into the cyst cavity is not very effective, so this method is practically not used at present.
Surgical treatment
Recently, in operations to remove median cysts and fistulas of the neck, doctors have begun to use microsurgical technology. The method allows you to consider in more detail all possible branches of the fistulous tract or strand and radically excise them, isolate the fistula or cyst from soldered and scar tissue.
Prevention
Pregravid preparation and creation of optimal conditions for prolonging pregnancy (reducing the risk of infectious diseases in a pregnant woman, protection from radiation, providing the body of a pregnant woman with vitamins and minerals, avoiding the unreasonable use of drugs) can reduce the likelihood of formation of neck cysts.
Rehabilitation
After surgery, the patient is recommended to come for dressings and antiseptic treatment of the surgical wound. This helps to create optimal conditions for tissue repair and wound healing.
Questions and Answers
Diagnosis and treatment of this condition is done by a general surgeon, orthopedic traumatologist, and in some cases the assistance of an oral and maxillofacial surgeon is also required.
The contents of the cysts are viscous, opaque with a yellowish tint. The inflammatory process to which cysts are subject leads to the formation of persistent fistulas. Very often, the inflammatory process in cysts is provoked by viral colds and foci of chronic infection of the pharynx (chronic tonsillitis, chronic pharyngitis, hypertrophy of the lingual tonsil). Neck cysts can also suppurate and undergo malignant transformation.
Bogdanov K.P. About median cysts and fistulas of the neck. Anatomical and topographic characteristics: author.
dis. … cand. honey. Sciences. – M., 1963. – 14 p.
Kiselev A.S., Pazhetnev A.N. Branchiogenic brushes and fistulas of the neck and face // Ros. otorhinolaryngitis – 2007. – No. 5. – P. 91–94.
Shulga I. A., Zheleznov A. M., Shulga A. I. Median cysts and fistulas of the neck, their surgical treatment. – Orenburg, 2007. – 116 p.
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