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Epidermoid cysts are small bumps that develop just beneath the skin on your face, neck, trunk and sometimes your genital area. They are slow-growing and often painless. Although many people refer to epidermoid cysts as sebaceous cysts, true sebaceous cysts are much less common than epidermoid cysts are. Most epidermoid cysts don't cause problems or need treatment. But if they're a cosmetic concern or they rupture or become infected, they're usually surgically removed. Epidermoid cysts are almost always noncancerous, but in rare cases, they can give rise to skin cancers. Because this occurs so seldom, epidermoid cysts usually aren't biopsied unless they have unusual characteristics that suggest a more serious problem.
Complications of Sebaceous Cysts
In rare cases, epidermoid cysts can give rise to basal and squamous cell skin cancers. Because this occurs so seldom, epidermoid cysts usually aren't biopsied unless they're solid, immobile, infected or have other unusual characteristics that suggest a more serious problem. Besides cancer, other complications include:
Causes of Sebaceous Cysts
The surface of your skin (epidermis) is made up of an extremely thin, protective layer of cells that your body continuously sheds. Most epidermoid cysts form when these surface cells, instead of exfoliating normally, move deeper into your skin and multiply. Most often, this occurs in areas where there are small hair follicles and larger oil glands (sebaceous glands), such as your face, neck, upper back and groin. The epidermal cells form the walls of the cyst, and then secrete the protein keratin into the interior. The keratin is the thick yellow substance that sometimes drains from the cyst.
Several factors can lead to this abnormal proliferation of cells, including:
Signs & Symptoms of Sebaceous Cysts
Sometimes an epidermoid cyst has a central opening — the remnant of a hair follicle from which the cyst originally formed — that's plugged by a tiny blackhead. You may be able to squeeze out a thick, cheesy material through this opening, but because of the risk of infection and scarring, it's best to leave this to your dermatologist.
Milia — tiny, deep-seated whiteheads that never seem to come to the surface of your skin — are miniature epidermoid cysts. They're especially common in older women and in men with significant sun damage on their cheeks and temples. They can also be caused or aggravated by long-term use of oil-based creams or cosmetics.
Signs and symptoms of infection, which can occasionally occur, include:
A similar looking condition
Sometimes you may develop a small bump on your scalp that looks like an epidermoid cyst. These are almost always pilar or trichilemmal cysts, which usually have thicker walls than epidermoid cysts do and almost always move freely under your skin. The lining of this type of cyst differs slightly from that of an epidermoid cyst.
Diagnosis of Sebaceous Cysts
In most cases, your doctor can diagnose an epidermoid cyst based on its appearance alone, though you may be referred to a dermatologist for treatment.
Treatments of Sebaceous Cysts
Cysts that don't cause cosmetic or functional problems are usually left alone. When a cyst is inflamed, ruptured or infected, these treatment options exist:
Prevention of Sebaceous Cysts
There's no real way to stop epidermoid cysts from forming, but avoiding excessive sun exposure and using oil-free skin care products can help prevent milia. To prevent scarring and infection, don't try to squeeze cysts yourself.
When to seek Medical Advice
Most epidermoid cysts aren't harmful, but you may want to have them removed for cosmetic reasons. See your doctor if you have a cyst that:
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