About Epidermoid Cysts

Overview

Epidermoid cysts are common, benign cysts that form under the skin. They consist of a distinct sac wall filled with a cheese-like substance called keratin. These cysts are slow-growing and typically painless. Epidermoid cysts often have a small central opening called a punctum. They are the most common type of cutaneous cyst and are not cancerous. Sebaceous cysts, which are less common, should not be confused with epidermoid cysts. Sebaceous cysts contain a clear, oily liquid produced by the sebaceous glands. Epidermoid cysts, on the other hand, contain keratin. If you have an epidermoid cyst and wish to have it removed for cosmetic reasons or if it becomes infected, consult with a dermatologist who may be able to remove it.

Causes and Risk Factors

Epidermoid cysts are benign growths that form when there is a blockage of the hair follicle or an injury to the skin that allows a keratin-filled cyst to develop. The exact cause of the blockage is not fully understood.

Risk factors for developing epidermoid cysts include:

• Being past puberty
• An injury to the skin
• Gardner Syndrome, a rare inherited condition

Symptoms

The most common early symptom of epidermoid cysts is the presence of a palpable painless lump or mass in the affected area. Epidermoid cysts most often occur on the face, neck, trunk or groin areas of the body. The bump may also:

• Have a blackhead plugging the opening of the cyst
• Leak a thick, cheese-like substance
• Become swollen and tender. This may indicate the epidermoid cyst is infected.

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Diagnosis

To diagnose epidermoid cysts, the following examinations, tests, and procedures are commonly performed:

Physical Exam: The healthcare provider will look at the cyst to examine its appearance and location. They will ask questions about when you first noticed the bump, if it has changed over time, and if it has leaked fluid or become painful.

Lab Tests: Blood draws or other lab tests may be ordered to check for any abnormalities or signs of infection.

Biopsy or skin scraping: The doctor may take a small sample of skin or of the cyst to send to the lab for examination under a microscope. This helps confirm the diagnosis and rule out any other underlying conditions

Imaging Studies: The doctor may recommend an ultrasound to check the size of the cyst below the skin’s surface

Treatment Options

Epidermoid cyst may not require treatment if they are not painful or bothersome. If treatment is needed, the goals of treatment for epidermoid cysts are to alleviate symptoms, prevent infection, and improve cosmetic appearance.

Treatment options include:

• Drainage and cyst wall removal: Inflamed cysts can be treated by draining the fluid and removing the cyst wall. This helps alleviate symptoms and reduces the risk of infection.
• Antibiotics: If the cyst appears infected, antibiotics may be prescribed to treat the infection and prevent further complications.
• Steroid injection: Steroid injection into the cyst may reduce swelling and inflmmation.
• Surgical excision: For cysts that cause irritation or cosmetic difficulties, surgical removal is an option. This procedure involves making a small incision in the skin, emptying the cyst, and removing its entire wall. It aims to improve cosmetic appearance and minimize the risk of recurrence. The surgery usually is performed in a doctor’s office.

Remember, it's important to consult with a healthcare professional for personalized advice and treatment recommendations. Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.