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The skin is a dynamic organ that is composed of layers of cells, hair follicles, sweat glands, oil glands, blood vessels and lymphatic vessels. As a protective organ, the skin acts as a barrier that prevents foreign bodies, including microbes, from getting into the body and prevents the body from losing too much water and electrolytes to the environment.

Sometimes cysts, or fluid-filled sacs develop beneath the skin. These may be felt as lumps, which may later break open and emit a whitish or yellowish fluid. There are different causes and types of skin cysts:

Sebaceous cysts - these are closed sacs which can be found in various places in the body covered by skin. The term is no longer used because it is not accurate, since these were formerly thought to originate from the sebaceous (oily) glands of the skin. These are more accurately labelled as:

a. Epidermoid cysts - when the cysts develop among the cells in epidermal (topmost) layer of the skin. They may have a tiny blackhead plugging the opening of the cyst.

b. Pilar cysts - when the cysts develop in the hair follicles.

These cysts may be distinguished from each other using the microscope. They usually contain thick whitish fluid that looks like toothpaste or cheese. This fluid is actually made of keratin, a protein produced by cells on the top layer of the skin.

These pea-sized lumps are benign (not cancerous) and are often painless and movable. However, they can become inflamed, swollen and tender, especially when one tries to squeeze them out.

Skin abscesses or boils may also form lumps beneath the skin. These consist of a localized collection of pus (dead skin cells and white blood cells) that is commonly found in the armpit, groin, rectal area, outer vaginal area, and around the tailbone (pilonidal abscess). This is caused by a skin infection and inflammation around the hair follicle or sweat gland, which causes pain, fever and formation of yellowish pus.

Another condition that leads to skin lumps with thick, white to yellowish fluid is called hidradenitis suppurativa. This involves the apocrine glands (sweat glands), which are usually located in areas where hair follicles are found and where skin rubs on skin, such as the armpits. The opening of the glands, which are connected to hair follicles become clogged and inflamed, leading to formation of numerous lumps filled with pus and connected by tunnels under the skin. This is a chronic condition that may become worse with stress, overweight, excessive perspiration and hormonal imbalance. Scarring and keloid formation are common.

Treatment

Small cysts that are not inflamed or infected may heal on their own.

One should not attempt to drain the fluid from these cysts, as they may become infected.

Warm compress may be applied for 20-30 minutes, 3-4 time daily, to relieve inflammation.

Doctors may prescribe antibiotics for boils and hidradenitis suppurativa. Drainage of pus under clinical setting may be done.

To avoid developing these skin problems, doctors advise keeping the skin clean using antibacterial soap. Wear loose clothing to reduce perspiration and skin irritation. A healthy, well balanced diet will also help maintain weight and promote skin health.

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