Why do cysts smell: What Is an Epidermoid Cyst (Sebaceous Cyst)? Symptoms, Causes, Diagnosis, Treatment, and Prevention
What Is an Epidermoid Cyst (Sebaceous Cyst)? Symptoms, Causes, Diagnosis, Treatment, and Prevention
It’s easy to panic when you notice a lump on your skin. You may wonder if it’s melanoma or another type of skin cancer.
But sebaceous cysts — slow-growing bumps under the skin that can appear on the ears, scalp, face, torso, back, or groin area — are typically harmless. And while they can be irritating (or unsightly), they are not cancerous. Here’s what you need to know — and do — if you have a sebaceous cyst.
The first thing to know is that the term “sebaceous cyst” is often used to describe what is actually an epidermoid cyst. The terms are used interchangeably, but there’s a difference, notes the Cleveland Clinic.
True sebaceous cysts are caused by the glands that secrete the oily matter (sebum) that helps lubricate your skin and the hair, per the Mayo Clinic.
They are not as common as epidermoid cysts, which occur when skin cells accrue under the skin instead of being shed from its surface.
This article will mainly focus on epidermoid cysts.
Signs and Symptoms of an Epidermoid Cyst
These dome-shaped cysts can be pea-sized, or grow to a few inches or larger. They grow very slowly, and they’re not painful. If you touch them, you should be able to move them around. They often have a central small black dot, or punctum, through which sebum accumulates.
Sometimes, however, they can become inflamed, infected, or suddenly rupture, which can increase the risk of infection (more on that later). Occasionally, they occur on a site that is constantly irritated, such as a cyst on your neck that rubs against your collar, or one on your back under a bra strap.
Whatever the cause, if you notice redness, tenderness or warmth, that can indicate that the cyst has become infected. You may also notice that the cyst excretes a cheese-like liquid that has a foul smell.
Unpleasant as that may seem, cysts can disappear on their own without treatment, according to Harvard Health.
But if a cyst is bothering you, or becomes painful, it makes sense to see your doctor.
Common Questions & Answers
What is the cause of sebaceous cysts?
Usually when people use the term sebaceous cyst, they’re actually referring to epidermoid cysts. These occur when skin cells accrue under the skin. Sebaceous cysts, which are less common, are caused by the glands that help lubricate skin and hair.
What is a sebaceous cyst filled with?
Sebaceous cysts are filled with sebum, which is the liquid that helps lubricate skin and hair. Epidermal cysts contain dead skin cells that did not get shed from the skin’s surface.
Can you squeeze out a sebaceous cyst?
Do not pop or squeeze the cyst like a pimple. A ruptured cyst could lead to infection. Instead try applying a warm moist compress, which may help the cyst drain.
Do sebaceous cysts go away on their own?
Some sebaceous cysts go away on their own, but, as with epidermal cysts, which don’t tend to go away on their own, they’ll need to be removed if they become infected.
How do you get rid of a sebaceous cyst?
If a sebaceous or epidermal cyst doesn’t cause problems, you probably don’t need any treatment. If a cyst becomes inflamed, it can be injected with a steroid to reduce swelling. Cysts that become infected may need to be surgically removed.
Causes and Risk Factors of an Epidermoid Cyst
The surface of your skin, known as the epidermis, consists of thin layers of cells that are constantly shedding. Sometimes, though, when the cells move deeper into the skin, instead of shedding, they can multiply, leading to cyst formation.
Acne can contribute to their development, as can damaged or swollen hair follicles.
Sometimes, injury to the skin may cause a sebaceous cyst.
And as for that secretion that can emerge from the cyst? It comes from the cells that form the walls of the cysts. Those cells secrete a protein, known as keratin. These cysts are also made of fat, and it’s often that substance, or infection, that makes the smell, according to American Family Physician.
How Is an Epidermoid Cyst Diagnosed?
Usually, your doctor can diagnose a sebaceous cyst by examining your skin, though sometimes he or she may perform a biopsy to make sure it’s not a symptom of another condition. Before your exam, it’s a good idea to note any recent skin injuries, when you first noticed the cyst, if you’ve had any other cysts, and if you have a family history of cysts. Your general practitioner will usually be the one to examine you, and then after that you may be referred to a dermatologist.
Prognosis of Epidermoid Cysts
Most sebaceous cysts can be ignored, since they are not dangerous. Some go away on their own; others grow slowly, but unless they are bothering you, or get infected, you don’t need to do anything about them.
To rule out cancer, your doctor may send a cyst specimen to be examined under a microscope. These will turn out to be basal cell carcinoma — the most common form of skin cancer — or squamous cell carcinoma in less than 1 percent of cases, notes StatPearls.
RELATED: What Is Pilonidal Cyst?
Treatment and Medication Options for Epidermoid Cysts
If a sebaceous cyst does not cause problems and its appearance doesn’t bother you, you probably don’t need any treatment, as mentioned above.
Medication and Surgical Options
If a cyst becomes inflamed, a doctor can inject it with a steroid to reduce swelling. Cysts that become infected, on the other hand, may need to be surgically removed. Dermatologists and plastic surgeons can perform this procedure. To do this, your doctor will make a small puncture and remove the contents. But cysts frequently return after removal and will ultimately need to be surgically removed again. If a cyst becomes swollen or infected, antibiotics may be called for before surgery. Larger cysts may also need to be removed if they cause hair loss on the scalp, interfere with clothing (for instance, if a piece of clothing routinely rubs the cyst, causes irritation), or if the cyst is in an obvious place, like the face.
In some cases, your doctor may use a laser to remove the cyst. A study published in April 2019 in Archives of Craniofacial Surgery found that this approach works well with smaller cysts, leaves smaller scars, and may be a suitable replacement for surgery in an area of cosmetic concern, such as the face.
After the treatment, be sure to follow your doctor’s instructions for keeping the wound clean once you get home, and ask if you should return for a follow up visit.
Alternative and Complementary Therapies
If a sebaceous cyst becomes swollen or tender, home treatments may also help. One easy thing to try: applying a warm moist compress, which can help the cyst drain. What not to do: Resist the urge to pop or squeeze the cyst, like a pimple. It won’t end well.
Prevention of Epidermoid Cysts
Unfortunately, there’s no known way to prevent them from developing.
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How does medicine describe the worst smells humans can make?
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The worst part of a minor surgery was not what I was expecting
By Elizabeth Lopatto, a reporter who writes about tech, money, and human behavior. She joined The Verge in 2014 as science editor. Previously, she was a reporter at Bloomberg.
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An epidermoid cyst, stained and under the microscopeEd Uthman
I did not truly know what a foul odor was until a doctor cut into my right breast with a scalpel to remove a growth. I am a new woman, now.
If you talk about a lump on your breast, people get twitchy; they always assume it’s potentially cancerous. Sometimes it is! But this was just a cyst, a pea-sized lump that has been chilling on my right breast, near the midline of my body, for years.
Most of the time cysts are pretty harmless, unless they’re in a bad location or infected. I’d gone in to a doctor when I first noticed it, in 2012. As long as the cyst wasn’t hurting me, removing it was more trouble than it was worth, my doctor said. This seemed reasonable. So I just thought of it as, like, a not-very-demanding pet.
We’re skin bags filled with blood and all sorts of other nonsense
That is, until last weekend, when I discovered it had more than doubled in size, was red and hot to the touch, and smelled weird, like dirty socks. This seemed bad, probably. So Monday I called the doctor.
The disgusting truth is that we’re skin bags filled with blood and all sorts of other nonsense. Cysts fall in the category of “other nonsense”; they’re little sacs of fluid — usually the protein keratin, plus some rotting skin cells and maybe some fat — that just kind of hang out on the body. There are a couple kinds, but the most common one is epidermoid cysts, which are the result of cells from your skin’s surface migrating too far down into the skin’s layers.
(These are sometimes called sebaceous cysts.) They multiply, forming the walls of the cyst; the fluid inside is excreted by these cells.
Most descriptions of fluid from a cyst say it has a “foul” odor. This is a remarkable understatement
I have read a fair amount of medical literature about cysts by now, though I will not say I understand it all. I checked in with a variety of sources (Mayo Clinic; Merck Manual; Medline; etc.) before my appointment. Most descriptions of this fluid from a cyst say that it has a “foul” odor. This is, it turns out, a remarkable understatement. I would say “foul odor” is a fair description of what the cyst smelled like before it was drained and removed, when it was still under my skin.
My doctor numbed me up and cut me open, and the stench was immediately overwhelming. The smell was far and away the worst part; not the incision nor the stitches afterward. How do I say this? It smelled like death. There was, immediately, the sweetish stink of rotting meat, with a top note of dirty gym socks; the scent opened up, after a minute or so, to what I’d describe as a strangely sulfurous wet dog, wearing those gym socks, which have been stuffed with rotting meat.
I have smelled many foul odors over the years: manure, slaughterhouses, chicken coops, New York’s garbage / urine / auto exhaust killer combo, floating god-knows-what from New Jersey, sewage, garbage dumps, chemical spills, teenage boys. This was the foulest, no question. I didn’t vomit but it was a near thing; apparently I turned quite green. Someone — I am not sure who, as I was busy staring at the ceiling and trying not to puke — opened a window to at least get me air.
“Foul” doesn’t even begin to describe it
In no way had my amateur research prepared me for the so-called foul odor, either. “Cheesy” is a favorite description, appearing in the American Academy of Family Physicians’ copy, as well as that of Medline Plus, and the British Association of Dermatologists; the Cleveland Clinic prefers “cheese-like.” Other descriptions: foul, malodorous, smelly. Doctors are fairly used to ghastly smells, I’d reckon. But I think something else is driving the faux-neutral word choices here.
“Foul, cheesy odor” sounds distant; it’s not descriptive but it’s authoritative. It’s vague and official-sounding at the same time. It doesn’t make you imagine the doctor ever experiencing the stench first-hand, that’s for sure. From experience: “foul” does not even begin to describe that stink, which I hope never to smell again in my life. As a word choice, “foul” is inadequate to the task. “Cheesy” doesn’t really cover it either — try “Limberger from hell” and we’re getting somewhere.
I certainly understand not wanting to alarm patients — my perfectly accurate descriptions are possibly alarming — but I would have liked a chance to prepare myself, perhaps by drenching a bandanna in Shalimar and wearing it over my nose and mouth the entire time. In the interest of offering future patients some kind of guidance on cysts, I have put together some suggested descriptions for the smell: putrescent, noxious, shocking, repugnant, fetid, rancid, stinking, revolting, sent from hell itself… Or to keep it clinical, you could try this: nausea-inducing.
Really, though: the surgery itself was quick and mostly painless — I only needed aspirin for the soreness after. I’m done with my antibiotics, the skin now lies flat again, and my stitches come out Monday. The procedure itself was so minor that the smell is really what stands out.
My doctor, at least, tried to warn me. She told me she’d once seen a nurse faint at the smell. Nurses are among medicine’s hardiest creatures; if the stench can fell a nurse, you know it’s hellacious indeed. I realized what she was trying to tell me too late, I’m afraid.
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Atheroma – what is it and how to treat it?
Atheroma is an epidermal or follicular cyst filled with a pasty substance or the cyst’s own secretions.
That is, it is a subcutaneous capsule containing curd mass. This curdled mass is the accumulated secretions of the sebaceous gland, which often have an unpleasant odor. Sometimes there is a hole in the middle of the formation, from which the contents of an unpleasant color and smell are released. Sometimes atheromas are multiple.
Causes of atheroma?
There are many reasons for the appearance of atheromas. Most often, atheroma occurs due to blockage of the excreted duct of the duct of the sebaceous gland or swelling of the hair follicle (sac). swelling of the follicle may occur due to damage. As a rule, one hair grows from one follicle (hair follicle), and after injury and hair removal, the exit from the follicle can be blocked, especially against the background of high testosterone levels. The remaining part of the sebaceous gland continues to secrete sebaceous secretions and, as a result, the former follicle increases in size and turns into a large atheroma.
Injury or rupture of the sebaceous glands themselves. Part of such a gland after an injury or inflammatory process (furuncle or carbuncle) may be under the skin, and since the gland continues to work and secrete a sebaceous secret, atheroma appears. The appearance of atheromas can also be influenced by hereditary and hormonal factors, such as increased testosterone levels.
What is inside an atheroma?
Contents of atheroma are filled with secretions, usually sebaceous glands. As a rule, these are fatty and keratinized substances of a fibrous structure. Outwardly, this mixture resembles cottage cheese. If an infection has penetrated into the atheroma, then the contents turn into a purulent mass of various colors from white to brown and mixed with blood.
Who gets atheromas more often?
Atheromas are very common and in most people throughout life, at least one appears. They appear for no apparent reason. True, it is believed that men appear twice as often.
By age – the peak of the appearance of atheromas occurs at 20-30 years, but people go to the doctor more often at a later age, when atheromas grow to an impressive size.
On which part of the body do atheromas appear more often?
Atheromas are most often found on the scalp, face, ears, neck, shoulders, back and chest. In men, atheromas occur on the scrotum. On the scalp, if the atheroma is for a long time, this can lead to hair loss in this area, directly above the atheroma.
What is the danger of atheroma?
Atheromas are benign neoplasms (not cancerous), but they can become a chronic source of infection, which leads to other complications. Atheroma, even if not infected with a bacterial infection, can become inflamed and swollen. During inflammation, atheroma is very difficult to remove, so the operation during such a period may be postponed. Serious complications of atheroma are its rupture and infection, which can lead to an abscess and even phlegmon.
Very rarely, atheromas can lead to basal and squamous cell skin cancer, but since this rarely occurs, atheroma histological examination is not performed.
How do you know if atheroma is inflamed and infected?
Signs and symptoms indicating inflammation of atheroma: it is reddening of the skin over the atheroma, swelling, increase in size, pain, aggravated by touch, fever, discharge of a white-gray substance over the atheroma with an unpleasant odor. If a person has at least one of the listed signs, then an urgent need to consult a surgeon.
When contacting a surgeon
The doctor will conduct a survey, examination, make an accurate diagnosis. For the diagnosis of atheroma, ultrasound, consultation with an oncologist or dermatologist is sometimes required. After the diagnosis is made, the doctor will prescribe the appropriate treatment. If it is a surgical treatment, he will tell you how it will be carried out: to what extent, by what method, under what anesthesia.
Be sure to ask about the tolerance of drugs, allergies, the presence of concomitant diseases, such as diabetes, taking drugs that affect the blood coagulation system. The latter may be a contraindication to surgery. In accordance with generally accepted treatment protocols, he will prescribe a preoperative laboratory examination. After that, he will set the date of the operation or hold it on the day of the appeal, if possible.
How many days to stay in the hospital
The operation is usually performed on an outpatient basis and usually does not require hospitalization in most cases.
How long will the atheroma removal operation take? The operation to remove atheroma is usually performed on an outpatient basis, under local anesthesia. The duration of the actual surgical intervention is 15-25 minutes, but the total time taken together with preparation, followed by dressing, paperwork is 45-70 minutes.
What kind of anesthesia is used to remove atheroma?
Removal of atheroma in most cases is performed under local anesthesia.
The use of anesthesia is irrational. Local anesthesia is the introduction of an anesthetic using a syringe with a needle into the skin and subcutaneous tissue surrounding and covering the atheroma, or more simply, an anesthetic injection is made. General anesthesia, that is, anesthesia or regional conduction anesthesia, is carried out if there are indications, for example, with a giant atheroma.
Before the operation
On the day of the operation, 4 hours before the actual operation, it is advisable not to eat or drink anything. Before the operation itself, consent to the surgical intervention is signed and the place where the atheroma is located is photographed.
Emergency surgical treatment for atheroma inflammation
If an atheroma is infected, inflamed and an abscess has formed, then it is not possible to remove the atheroma. In this case, under sterile conditions under local anesthesia, the atheroma is opened, the purulent contents are evacuated, washed and drained.
In the postoperative period, antibiotics are often required. Further, the wound is tightened according to the laws of purulent surgery, the so-called secondary intention. In this case, the atheroma will need to be removed after 3 months to avoid recurrence of inflammation.
Planned surgical treatment
Planned surgery, as a rule, takes place according to the following algorithm:
- Preparation and treatment of the surgical field with disinfectants.
- Anesthetize the area around the atheroma with local anesthetics.
- An incision is made over the atheroma An incision in modern medical institutions can be made both with a scalpel and with a Surgitron radio wave knife (Surgitron) or a laser.
- Next, the atheroma is isolated and husked. Atheroma can be removed in two different ways: without violating the membranes as a whole, or with the extraction of the contents of the atheroma in the first place and the membranes in the second.
The latter method is used if a small skin incision is made or the atheroma is fragmented. - Next, hemostasis is carried out – that is, they stop bleeding from damaged vessels, if any.
- Treat the wound with disinfectants.
- Stitch the wound if required. Depending on where the atheroma was located, absorbable, cosmetic, ordinary or reinforced sutures are applied (especially on parts of the body that are actively involved in the movement of the body, for example, in the armpits and on the lower back).
- Apply an aseptic bandage to the wound or a sticker, depending on the location of the former atheroma. For small incisions or on the scalp, do not apply a bandage.
The latter method is used if a small skin incision is made or the atheroma is fragmented.Will there be a scar after the operation?
In the incision area, immediately after the operation, a small scar remains, which should disappear with time. How long it will disappear – it depends on the individual characteristics of the organism.
What complications can occur after the operation?
After removal of atheroma, tissue fluid with blood clots may accumulate in the resulting cavity.
The danger of the accumulation of this fluid is that this fluid is a potentially ideal environment for the development of infection. To prevent this fluid from accumulating, a pressure bandage or drains are applied, through which this fluid flows out over the next day and thereby prevents the formation of an infectious focus.
After removal of atheroma during the first day, there may be a slight increase in body temperature. But if the temperature rises to a high level (38 g), swelling and pain occur in the area of the postoperative wound, then you should urgently contact the surgeon who performed the operation to exclude infection from entering the postoperative wound, even though the inflammation and infection of the postoperative wound is rare. In this case, after examination, the doctor may prescribe the use of antibiotics.
What should be done to prevent atheromas from appearing?
To prevent and prevent the appearance of atheromas, it is recommended to clean the skin of the face at the beautician and thoroughly wash the face at home, especially in the presence of acne and oily skin.
Many doctors recommend reducing the intake of fatty foods and high amounts of carbohydrates.
Make an appointment with a surgeon, dermatologist
Be sure to consult a qualified specialist in the field of skin diseases at the Semeynaya clinic.
To find out prices for a dermatologist’s appointment or other questions, follow the link below
Treatment and diagnosis of epididymal cysts in the El.N. in Moscow
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Rating: 5/5
Olga
All attempts to have sex with my boyfriend ended in failure due to severe pain. In desperation, I turned to the El. En” and asked to recommend some effective remedy. After the examination, I was offered a surgical defloration. Already a week after the operation, we had our first real sexual contact, and it was almost painless. I don’t know what I would do without medical help. Thank you!
Score: 5/5
Karina
After the coil was removed at the laser technology clinic, I was recommended to use a vaginal hormonal ring.
I am delighted! Firstly, the menstrual cycle has become regular (hour by hour), and secondly, menstruation has become less painful and less plentiful. The hormonal ring does not cause any discomfort and does not interfere with sexual intercourse. True, I had to spend money, but how many benefits!
Rating: 5/5
Olga
I want to say thank you to the dentist Inessa. Did bio-whitening which does not damage the enamel of the teeth. The doctor explained everything, did everything very carefully and was attentive. I was satisfied with both the attitude and the effect after the procedure. Rating: 5/5 I have lived all my life with lop-earedness, wherever I go, I attract everyone’s attention. That’s why I decided to do otoplasty. The procedure is actually the simplest, and now I only regret that I did not do it earlier. The doctor was a caring and pleasant woman. I was satisfied
Rating: 5/5
Yana Emelina
Even at the time of registration, the administrators consulted in detail, all questions were answered.