Sebaceous Cyst

What it is

A sebaceous cyst — most often, actually an epidermoid cyst — is a benign lump formed by a capsule under the skin that accumulates keratin and sebum. It arises when the opening of a hair follicle becomes blocked, and is common on the scalp, face, neck, back and genital area. It is usually a round, mobile lump, with a small dark spot at the center, that grows slowly. The problem appears when it becomes inflamed or infected: it turns red, tender, warm and may drain foul-smelling fluid. Inflamed cysts are treated with medication and, if there is an abscess, drainage; definitive removal, together with the capsule, is performed after the inflammation subsides. Diagnosis is clinical, and the removed tissue can be sent for analysis.

Most common symptoms

• Round, mobile, slow-growing lump under the skin
• A small dark spot at the center of the lump
• Redness, pain and warmth when the cyst becomes inflamed
• Whitish, strong-smelling discharge
• Rapid swelling and pus in an abscess
• Commonly located on the scalp, face, neck, back and genitals

Causes and risk factors

• Blockage of a hair follicle opening
• Buildup of keratin and sebum inside a capsule
• Acne and oily skin
• Skin injuries and trauma
• Genetic predisposition, with multiple cysts
• Manipulating or trying to squeeze the lump

How it is diagnosed

Diagnosis is clinical: on exam, the surgeon recognizes the round, mobile lump with its typical central point, and checks for signs of inflammation or abscess. Additional tests are generally not needed. Ultrasound may be ordered when there is doubt in relation to lipomas, cysts of another kind or deeper lesions, especially in the genital area and the breasts. Tissue removed during surgery is sent for pathological analysis whenever any unusual feature is present.

How we treat it at Femi Saúde

Small, asymptomatic cysts can simply be monitored. When they become inflamed, initial treatment includes warm compresses, anti-inflammatory medication and, if there is infection, antibiotics; an abscess is drained under local anesthesia. Complete removal is done once the inflammation has resolved, taking out the entire capsule to reduce the chance of the cyst coming back. The general surgery team at Femi Saúde performs the procedure in the office, under local anesthesia, using a conventional incision or CO₂ laser, which offers greater precision and less bleeding, depending on the location and size of the lesion. The plan is individualized, with attention to the scar outcome in visible areas.

What we offer