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Is Your Lump a Sebaceous Cyst or Something More Serious?

sebaceous cyst

Story at-a-glance -

  • There are many types of cysts; the most prevalent are epidermoid, pilar or sebaceous, which may become problematic if they get infected
  • Carbuncles, faruncles and other skin conditions that may look like any of the above may seem worrisome, as well as be painful and/or unsightly
  • Shaving, skin irritations and sunburn may initiate minor cysts; others are caused by an infected hair follicle, a staph infection or simply a nutritional deficiency

By Dr. Mercola

You may have at one time or other noticed a small, painless bump under your skin, possibly behind your ear or on your chest, shoulders or back. Many people refer to these as sebaceous cysts, but they may be a more common variety called epidermoid. Generally speaking, there are three types of skin cysts:

  • Epidermoid cysts occur when surface skin cells form a fluid-filled sac. They’re generally slow growing, harmless and measure 1 to 5 centimeters across. They aren’t painful unless infection sets in, at which point it turns into an unsightly abscess.
  • Pilar cysts form when the lining of the bump is composed of cells like hair roots, appear most often on the hair follicles of your scalp, and may catch when you comb your hair.
  • Sebaceous cysts, which are much less common, contain oil while regular skin cysts don’t.

A splinter or small cut, sunburn, waxing and shaving, swollen hair follicles, increased skin sebum and acne can cause cysts. Picking them or subjecting them to chafing (such as a bra strap) can aggravate the problem, making them even more uncomfortable and potentially causing infection.

If you have a cyst, most doctors agree that doing nothing is actually better than doing something, as WebMD notes:1

“You might be tempted to try to pop and drain an epidermoid cyst on your own, but this isn't a good idea. First, if the cyst is infected, the infection could spread if the cyst ruptures and drains beneath the skin.

Second, if any of the cyst’s sac is left behind, it could grow back. If the cyst doesn't bother you, it’s fine to leave it alone. If it seems to be infected, is uncomfortable, or you don't like the way it looks, it’s best to have it checked by a doctor.”

If it’s on your face or in an area that’s constantly irritated, a doctor may lance it off. Surgical cyst removal may entail a local anesthesia and removal of the entire sac; otherwise, it may reappear.2 A deep infection may be packed with sterile gauze so it continues to drain.

Blocked sweat glands (hidradenitis suppurativa or HS) may appear as painful, pimple-like bumps. Surgical removal may work for a short time, but the glands may become blocked again and the bumps return. WebMD explains:

“Laser therapy and cryosurgery are promising treatments for HS. They use beams of light or cold gases to destroy the hair follicles that get infected, and remove HS bumps. Some people’s breakouts clear up after a few treatments.”3

What are epidermal or cutaneous cysts made of? According to Medical News Daily:4

“Both epidermoid and pilar cysts are filled with a substance that is like toothpaste in consistency, and cheesy and smelly. However, the substance is not — except for complicated cysts — infected by microbes like bacteria. The pus smells worse when it is infected.”

Gross, right? But experts say nearly everyone gets at least one of these in their lifetime, usually during their 20s and 30s. However, cysts are nearly twice as common in men than in women, according to U.K.-based Patient.5 Most of these cysts go away on their own.

Scientists don’t know why every type of cyst occurs, although they believe it may have something to do with genetics. Case in point: A genetic disorder known as Gardner’s syndrome causes multiple skin cysts.

Sebeceous Cysts Are Different

Sebaceous cysts, on the other hand, appear when the sebaceous gland is blocked by the fibrous protein keratin,6 which is the makeup of hair, as well as hooves, claws and horns.7 Mirriam-Webster describes “sebaceous” as “secreting sebum,” relating to fatty material.

The cysts contain oil from the sebaceous glands surrounding the base of normal hairs. They contain a clear, oily liquid, have a pungent smell and can appear anywhere on your body except for your palms or soles of your feet. On your skin, sebaceous cysts may show redness and soreness, indicating a minor infection.

Boils and abscesses are similar, but sebaceous cysts are not as large and are not inherently cancerous.

Faruncles, Carbuncles and Boils, Oh My!

A boil is a common condition that may begin as a small lump that becomes red and slightly painful, then fills with pus. Carbuncles are more prevalent in men, deeper than boils and take longer to heal. Up To Date8 describes variations:

“A furuncle (or ‘boil’) is an infection of the hair follicle in which purulent material extends through the dermis into the subcutaneous tissue, where a small abscess forms. A carbuncle is a coalescence of several inflamed follicles into a single inflammatory mass with purulent drainage from multiple follicles.”

Similar eruptions are more specific:

  • Folliculitis is an infection caused by an inflamed hair follicle. It may look like tiny pimples around individual hairs, with reddened skin. Not as deep as a boil, it’s still an infection, and a gateway, of sorts, for staph to enter.
  • Boils and abscesses in your groin or armpit areas may be hidradenitis suppurativa, which typically starts in blocked sweat glands and hair follicles.
  • A pilonidal abscess occurs just above the crease of your buttocks and may involve a hair follicle. The “pilonidal dimple” some babies are born with may create a place for this type of boil to form.
  • A sty on the eyelid is usually a puffy, painful infection when an eyelash becomes infected. Styes are sometimes confused with a chalazion, which is painless and not infected.
  • Rose gardener’s disease caused by a fungus is called Sporothrix schenckii.9 Small cuts from handling vegetation eventually form a small nodule on your finger or arm that turns into an ulcer.

Other skin conditions can develop in people with skin or nasal Staphylococcus aureus without causing problems, but infection can come about via community-acquired methicillin-resistant S. aureus (CA-MRSA) and occur more often than abscesses due to other bacteria.

If a staph infection causes a boil, it can spread easily, so skin-to-skin contact should be avoided, and do not share towels, bedding or articles like yoga mats. Keep the boil covered and wash your hands frequently.

Boils are usually treatable at home unless they’re in a vulnerable area or a place you can’t easily get to. While usually smaller than a pea, they can become golf-ball-sized.

If you experience something similar and start feeling tired, feverish or generally unwell, you may want to call your doctor. In an article listing such skin problems, WebMD notes:

“Rarely, the staph bacteria from a boil or carbuncle can get into the bloodstream, which can then affect the heart and other internal organs.”10

Nutritional Deficiencies That Show Up on the Skin

Diabetes and a weakened immune system may exacerbate boils of different types. Nutrient deficiencies sometimes reveal themselves through skin problems and potentially cause cysts, such as:

A red, scaly rash, particularly on your face, might indicate a vitamin B7, or biotin, deficiency. Organic, pastured egg yolks are one of the best sources of biotin to metabolize fats, amino acids and carbohydrates. Biotin strengthens your hair and nails and helps smooth out your skin.

Eating raw, pastured, organic eggs (both the white and the yolk) is an excellent way to combat this skin malady. Avocados, mushrooms, cauliflower, nuts, raspberries and wild-caught Alaskan salmon are more good biotin sources.

Red or white bumps resembling acne may appear on your cheeks, arms, thighs or buttocks, revealing a possible need for more essential fatty acids in your diet, including animal-based omega-3 fats.

Eating sardines, anchovies and wild-caught Alaskan salmon and taking krill oil supplements will introduce more of these nutrients into your system. For more skin-enhancing vitamin A,11 eat more leafy green veggies, sweet potatoes, carrots and red bell peppers.

Sores or cracks at the corners of your mouth may be a sign that you’re not getting adequate iron, zinc, B12 or protein in your diet. Again, organic, free-range poultry and eggs and wild-caught Alaskan salmon are good sources.

Assuming they’re derived from non-polluted waters, oysters and clams are another good way to get more of these vitamins and minerals into your diet, as well as Swiss chard, and tahini because of the sesame.

Home Remedies for Sebaceous Cysts, Boils and Other Skin Problems

At-home treatments for cysts start with keeping them clean — simple soap and water is best, rinsed well and air-dried, especially if a cyst is infected. Many natural topical treatments are very effective and may even cure the problem, such as:

  • A warm, soothing compress a few times a day will stimulate your circulation and hasten the healing process.
  • Epsom salt is an effective treatment when it’s put into your bath water for a 20-minute, allover soak, or just soak the infected area. Follow it up with one of the following treatments for a double whammy of healing.
  • A combination of dandelion and viola herbs placed in an herbal bag and soaked in a teacup for 45 minutes can be squeezed lightly and applied directly to the cyst for several minutes, after which you can drink the tea, three or four times a day for up to two weeks.

Oils, creams and liquid remedies can be applied directly to the cyst, covered with a compress and secured with plastic tape for a few hours or overnight, which also serves to protect the cyst from germs. Repeat the process until the cyst is healed. These remedies include:

Tea tree oil, which is both anti-inflammatory and anti-bacterial, should be mixed with water at a 1:9 ratio

A few drops of potassium iodide, applied two or three times daily to deal with infection

Bee pollen, topical or in pill form, is a natural blood purifier and may be effective for skin cysts

Colloidal silver may stimulate your lymph system and help heal cysts

Castor oil helps bring the cyst to a head quickly, after which it will drain and shrink away

Aloe vera is both pain relieving and healing, because it’s antimicrobial12

Proanthocyanidins in witch hazel help reduce inflamed cold sores, canker sores and wounds13

Raw manuka honey is a natural wound healer and has even destroyed MRSA

Turmeric is another anti-inflammatory healer, as is potassium iodide, according to one study:14

“ … Kills all types of germs, i.e., bacteria, viruses and fungi … (and) is preferred in treating boils, cysts and skin infections. Acne pustules are very responsive, the sebaceous duct discharging easily and permitting prompt healing without scar … Large furuncles, i.e., boils, are equally responsive although they take longer to resolve.

Sebaceous cysts soften within minutes of the application of iodide and the sebum plugged hair follicle usually opens so as to permit easy expression of the contents.”

When Would a Cyst Be Considered Dangerous?

While you may have a boil that looks like many others — painful, red, inflamed and maybe filled with pus — MRSA looks very similar. It’s different in that MRSA is a staph infection that’s often antibiotic resistant, which is why it’s dangerous. Check with your doctor if you’re not sure, as prompt treatment may prevent a more serious infection.

You may also want to call your doctor if the boil is large or painful, is on your spine or face, has red streaks coming from it, keeps coming back or won’t heal, becomes crusty or bleeds easily.