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What is a sebaceous cyst?

sebaceous cyst, lumps and bumpsA sebaceous cyst is a small lump or bump on the skin which is non-cancerous. It is most frequently found on the face, neck, upper chest and upper back. However, they can occur anywhere else on the skin.

Usually, a sebaceous cyst grows gradually and does not cause any pain. However, they may become infected or inflamed and the overlying skin turns red, sore and tender. A bad-smelling, cheese-like material can sometimes also drain from your cyst. In these cases, treatment can reduce the discomfort you experience and improve the appearance of your skin.

What Causes a Sebaceous Cyst?

Sebaceous cysts arise from your sebaceous gland. The sebaceous gland secretes sebum, a type of oil that coats your hair and skin. Cysts can develop if the gland or its duct, the location where oil leaves, becomes blocked. This is caused by trauma to the affected skin such as a scratch, a wound from previous surgery or a skin condition such as acne. Cysts are often caused by swollen follicles in the skin as well. Cysts can also be from genetic conditions such as Gardner’s syndrome or basal cell nevus syndrome.

How do I know if I have a sebaceous cyst?

Cysts are commonly found on the face, neck, upper chest and upper back. What you are looking for is a small lump under your skin. The cyst will not be painful in most cases. However, the skin surrounding the skin may be red, warm and tender to the touch. Drainage from the skin will have a foul smell and appear gray-white and cheese-like.

How is a Sebaceous Cyst Diagnosed?

A sebaceous cyst is usually diagnosed by a doctor in a physical examination of your skin. Sometimes, your doctor will perform biopsy to rule out other skin growths. This means a tissue sample of your skin is taken and sent to the laboratory for detailed examination.

Why Surgery to Remove a Sebaceous Cyst?

A sebaceous cyst does not usually disappear by itself, and it is best to remove the cyst before it grows larger or gets infected. Surgery is a practical and safe method of removing cysts.

In certain cases, sebaceous cysts may become cancerous. Surgery to remove the cyst, as well as a biopsy is recommended. This is called excision biopsy. There are also other complications that may arise from the cyst such as infection, pain and discomfort. Should a cyst be infected or inflamed, this can result in a lot of discomfort. The inflammation is usually treated before the cyst can be removed.Sebaceous cysts are most often removed from the face for cosmetic reasons.

What to Expect During Surgery to Remove a Cyst?

Here are some things you can expect from a cyst removal surgery.

Before the procedure

  • Shave hair and clean affected area.
  • Fast as instructed by your doctor.

During the procedure

  • You will be placed under local anaesthesia to numb your skin.
  • Your surgeon will make a tiny cut in the skin and squeeze the cyst out.
  • The resulting scar is usually small and aesthetically pleasing.
  • Six to seven stitches will be in place.
  • A bandage is used to cover the wound.
  • The operation is usually completed within 30 minutes.

After the procedure

  • You may be able to go home on the day of the procedure.
  • Pain is minimal and can be controlled with painkillers if you wish.
  • Change your dressing daily.
  • You may shower with your dressing on or without your dressing.
  • Eat a diet high in fresh fruits, vegetables and other light foods.
  • Avoid spicy food.
  • Cut out alcohol.
  • Schedule a follow-up appointment with your doctor within 1 to 2 weeks time.

When Can You Tell if Your Sebaceous Cyst is Infected?

There are several signs to tell if your sebaceous cyst is infected. A sebaceous cyst is considered infected when it is: 

  • Displaying signs of redness 
  • Tenderness to the touch 
  • Signs of pain 
  • Pus draining (or leaking) from the cysts 

While sebaceous cysts can become infected, should the cyst rupture, it can lead to a boil-like infection that will require immediate treatment. 

Typically, no complications or side effects occur after drainage or surgery. However, even after successful surgery to remove these cysts, they can sometimes recur. 

Is an Infected Sebaceous Cyst an Emergency?

Although they are not usually life-threatening, you should seek medical help if you notice a sebaceous cyst on your body. Take note of lumps or unusual spots on your skin that are sore, red or inflamed and warm to the touch. Seek medical attention and have a doctor examine the affected area. 

Do not attempt to treat the sebaceous cyst on your own, as this could lead to an incorrect diagnosis and treatment. Typically, infections can be easily treated, but immediate medical help may be required if the infection worsens and causes severe symptoms. 

Severe symptoms may include: 

  • A high or prolonged fever 
  • Nausea or vomiting 
  • Dizziness, weakness or trouble walking 
  • Persistent bleeding from the affected area 
  • Issues swallowing 
  • Trouble breathing 
  • A severe pain that is non-responsive to over-the-counter pain medications 
  • Black skin surrounding the cyst

What Happens if an Infected Cyst is Untreated?

While sebaceous cysts are rarely cancerous, the risk of it turning malignant exists as such early treatment is vital as with the case above. If left untreated, benign cysts can cause severe complications, including infection – the cyst fills with bacteria and pus and becomes an abscess. 

If the abscess bursts within the body, it poses a risk of blood poisoning (septicaemia).

Will an Infected Cyst Go Away With Antibiotics?

Antibiotics can treat an infected cyst either through oral medication or application as a cream, or both. If antibiotics prove ineffective in clearing up the infection, the cyst will need to be drained through a small cut (incision). Local anaesthesia will be used to numb the area before the incision and drainage.

What Antibiotic is Best for an Infected Cyst?

Most infected sebaceous cysts are the result of the bacteria Staphylococcus aureus or staph. To fight this infection, our doctor may prescribe oral, topical, or intravenous antibiotics. 

Our doctor will decide which antibiotic is best for you as not every antibiotic is going to work since some varieties of staph have become resistant to particular antibiotics. Our doctor may send a sample of pus from the boil to a lab to determine the antibiotic that would be most effective. 

“If you are considering purchasing over-the-counter medications for your infected sebaceous cysts, my advice is to avoid doing so. Most over-the-counter medications are focused on pain relief. There are no antibiotics suitable when you are purchasing them off the shelves. It is best to seek medical treatment when you are experiencing an infection,” advises Dr Ganesh.

How Long Does an Infected Cyst Take to Heal?

A cyst will not heal until it is saucerised and drained or surgically excised. Without treatment, cysts may eventually rupture and drain partially, and this can take months or years. Once cysts rupture, the painful sebaceous cyst is at risk of returning.

To prevent this, the pocket lining should be completely removed. Surgically removing the sebaceous cyst is the best way to prevent a recurrence.

How is an Infected Sebaceous Cyst Treated?

The most common surgical approach for an infected sebaceous cyst is through cauterisation, and incision and drainage (I&D). When deciding on the course to take for treating your sebaceous cyst, our doctor will first determine the state at which your sebaceous cyst is developing, whether it is normal, inflamed or infected and recommend the right approach to take.

Treatment of a Sebaceous Cyst

Our doctor may treat a cyst by draining it or by surgically removing it. Typically, cysts are removed for cosmetic reasons rather than because they are dangerous. Typically, our doctor will give you the option of choosing which treatment works best for you. 

This is because most cysts are not harmful. However, take note that without surgical removal, a cyst will usually reoccur. Therefore, the best treatment to ensure complete removal is through surgery. Some patients may opt not to have surgery due to cosmetic reasons and potential scarring. 

Our doctor may use one of the following methods to remove your cyst:

  • Conventional wide excision (also known as saucerisation). This is effective in completely removing a cyst. However, it can leave a scar. 
  • Minimal excision. This method causes minimal scarring but comes with the risk that the cyst will return. 
  • Laser with punch biopsy excision. This utilises a laser to create a small hole to drain the cyst of its contents. 

Roughly a month later, the outer walls of the cyst are removed. Once your cyst has been removed, our doctor may prescribe an antibiotic ointment to prevent infection. You should use this until the healing process is complete. A scar cream may also be prescribed to reduce the appearance of any surgical scars.

What Can I Eat to Improve My Condition?

When considering what food to select for promoting the management of your sebaceous cyst, we must first focus on several factors that aid in creating a healthy ecosystem for the body. A robust immune system helps the body promote healing on your road to recovery. 

Eating antioxidant-rich fruits, whole grains, and vegetables such as berries, citrus fruits, and dark leafy greens help to both boost immunity and remove toxins from the body. 

Water plays an important role to help flush toxins outside the body, so increasing your water intake would be ideal as well. Increase your consumption of healthy oils to promote healthy skin and reduce sebum stagnation in the hair shafts. Foods such as nuts and seeds, avocadoes, fish, flaxseed oil, evening primrose oil and fish oil are recommended when it comes to obtaining healthy oils. 

Conversely, particular food promotes inflammation in the body and as a result, may delay the recovery of your skin. Avoid dairy products, red meats, sugary foods, saturated fats and fatty foods if you would like to promote faster healing for your treatment.

Schedule a consult with our doctor Dr Ganesh Ramalingam

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