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Cysts

 
What is a cyst?

   A cyst is a pocket or saclike structure of the body, which usually contains fluid or semi-solid material. The sebaceous or epidermoid cyst is the common oil gland cyst that usually occurs on the trunk or face of oily- skinned individuals, and less frequently on the arms and legs. Another common cyst is the pilar cyst, which usually occurs on the scalp as multiple firm, round, enlarging nodules and is thought to derive from hair shaft cells. Most cysts do not present problems, but some cysts may become inflamed, red, and swollen or infected.

 How do cysts occur?

   Most cysts arise spontaneously. There is often a familial tendency to develop either sebaceous (epidermoid) or pilar cysts.

   Inflammatory cysts may occur when a cyst leaks or ruptures under the skin. The cystic contents irritate the tissue outside of the cyst wall, causing the swelling, redness, and pain that are the hallmarks of an inflammatory cyst. Additionally, inflammatory cysts may develop from an acne pimple (papule) that enlarges excessively, or after trauma to the skin such as ear or other body piercing.

 Are cysts medical problems?

   Most cysts are benign, remaining stable for years without any measurable change in appearance or symptoms. Some cysts, however, enlarge either slowly or rapidly and may become painful, inflamed or cosmetically distressing. Cysts may become infected and/or rupture, typically becoming red and exquisitely painful within days. Prompt medical attention is required.

   Although most cysts are benign, some lesions that appear to be cysts may instead be tumors, and they should be thoroughly evaluated. Signs of possible abnormal development include rapid growth and any appearance or behavior that seems unusual.

 How are cysts treated?

   Benign and unchanging cysts may not require any treatment, although careful and complete surgical excision may limit the possibility of future problems with the cyst, such as rupture or infection (see above). Excision can remove painful pilar cysts of the scalp. If the cyst is protuberant and unsightly, then removal for cosmetic reasons can be performed (see Surgery). Incision and drainage (I &D, lancing) may be required if the cyst is painfully enlarged, inflamed or infected. A culture may identify bacteria that require treatment with oral antibiotics. Some inflammatory cysts respond well to the injection of steroid solution into the cyst through a needle. This can shrink the cyst promptly, and is most effective for large inflammatory acne cysts of less than 1 week's duration.

 What can Cary Dermatology Center do for me?

   Our doctors are experienced in the diagnosis and treatment of cystic masses. Appropriate treatment depends upon a correct diagnosis, and this requires both an accurate history and skilled physical examination. Whether the cyst is stable or inflamed, schedule a consultation so that a treatment plan can be initiated.

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