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Epidermoid cysts are small masses, which are benign, and are situated underneath the skin. These cysts can develop anywhere on the skin, but most commonly involve the face, the neck and the trunk.

Epidermoid cysts are painless and slow growing lesions that hardly ever cause issues or need to be managed further. 

Causes

Epidermoid cysts develop when the superficial epidermal cells on the skin move deeper down the layers and multiply rather than come off. This is an abnormal growth of these cells, and the cause of this scenario can be due to a damaged oil gland or hair follicle in the skin.

These epidermal cells then form the surrounding structure of the cyst and secrete keratin into the inside of the lesion. Keratin appears as a thick and yellow liquid that sometimes drains from the cyst.

Epidermoid cysts are sometimes mistakenly referred to as sebaceous cysts, but these lesions are different. Genuine sebaceous cysts occur less commonly, and are caused by glands that secrete an oily substance that lubricates the skin and hair, known as sebaceous glands.

Risk factors

Nearly everyone can develop epidermoid cysts, but the following factors make people more susceptible:

  • Previous episodes of acne.
  • Being past puberty.
  • Sustaining injuries to the skin.
  • Being diagnosed with a rare genetic disorder.

Symptoms

Signs and symptoms of an epidermoid cyst include:

  • A tiny blackhead plugging the central opening of the cyst.
  • A small, round bump under the skin involving the face, trunk or neck.
  • A thick, yellow material with an unpleasant odour that sometimes drains from the cyst.
  • Tenderness, swelling and redness in the area if the mass is infected or inflamed.
Most epidermoid cysts don't cause any complications, but it's important to consult with a doctor for further management if the mass grows rapidly, ruptures, becomes painful or infected, occurs in a spot that's constantly being irritated or if it becomes bothersome.

Complications

Possible complications of epidermoid cysts include:

  • A ruptured cyst - which can result in a boil-like infection that requires immediate treatment.
  • Inflammation of the cyst - the mass can become swollen and tender.
  • Infection - an infection of a cyst can develop into an abscess which requires immediate drainage.
  • Genital discomfort - epidermoid cysts involving the genital are can cause painful urination and intercourse.

Management

An epidermoid cyst can be left alone if it doesn't cause any cosmetic issues or discomfort. Although epidermoid cysts can't be prevented from forming, an affected individual can prevent scarring and infection to occur by not squeezing a cyst and by placing a warm, moist cloth over the area to help it drain and heal.

If one wants the epidermoid cyst to be treated, then the following options are available:

  • Injecting the cyst with medication that reduces inflammation and swelling.
  • Making an incision in the cyst to drain its contents. Unfortunately, cysts tend to develop again after this treatment.
  • Minor surgery can be performed to remove the entire cyst. This method is safe and effective enough to prevent cysts from coming back again.
  • A carbon dioxide laser is used to vaporize the cyst, and results in minimal scarring.

 

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