Sebaceous cysts are sacs just beneath the skin that are filled with an oily, white, semisolid material called sebum. If the sebum becomes infected, the cyst will be red and painful. Sebaceous cysts are commonly seen on the scalp, labia, scrotum, chest, and back, but can be found anywhere on the body.
Epidermal cysts are also known as epithelial or infundibular cysts and present as intradermal or subcutaneous tumours that grow slowly and occur on the face, neck, back and scrotum. Trichilemmal cysts, also referred to as pilar cysts, are clinically indistinguishable from epidermal cysts. They were formerly called sebaceous cysts but do contain keratinous rather than sebaceous material. Trichilemmal cysts are usually multiple. There is often an autosomal dominant inheritance. The cysts generally have a round appearance. A black, dark portion of the cyst is visible on the skin. If squeezed, the cysts exude a stringy, cheesy white material. If the cysts become infected, they will become red and tender. Sebaceous Cysts are primarily a cosmetic problem or a nuisance if they form in body regions that are easily irritated, such as the armpit. These cysts are benign and do not develop into cancer.
The skin has tiny glands under the surface which makes sebum. This is the 'oil' that makes the skin smooth. If a gland's duct (channel) becomes blocked the sebum is still made. This then fills up the blocked pore to form a cyst. The matter inside the cyst has the appearance of toothpaste. Sebaceous cysts tend to develop in teenagers because of an interaction among hormones, sebum, and bacteria. During puberty, the glands in the skin produce excessive sebum. In skin that is prone to acne, the sebum and dead skin cells clog the hair follicles and form comedones, or clogged pores. A comedone may break through the pore wall underneath the skin and release its contents. This causes a pimple or pustule. If this substance is released deep into the skin it will cause a sebaceous cyst.
Virtually every adolescent experiences some comedones, or clogged pores. Generally, acne starts around the age of 10 to 13 years and lasts 5 to 10 years. Around the age of 14 or 15 years, approximately 40% of adolescents have acne that is serious enough to require a visit a healthcare provider. Acne happens in both male and female adolescents, but males are more likely to have a severe form of acne. Some people develop acne for the first time as an adult. Certain forms of acne tend to run in families. If an adolescent's parents or older siblings have severe acne, the adolescent has a higher risk of developing severe acne. Acne is more common in Caucasian Americans than in African Americans or people of Asian descent.
Epidermoid cysts are benign and do not have to be treated. If a patient elects to have a cyst removed, the entire cyst wall and its contents must be removed. If not, recurrence of the cyst is certain. If a cyst becomes infected, treatment may include administering antibiotics and then surgically removing the cyst. The total sac of the Sebaceous Cyst must be removed. If the cheesy material is just squeezed out, the cyst will reform. The removal of the cyst is usually performed by a physician. Sometimes a small incision is required. In the case of infected cysts, antibiotics may be prescribed. Good hygiene may prevent the formation of Sebaceous Cysts. Daily showers or baths with antibacterial soap are recommended. It is important to wash the back. Some individuals are predisposed to development of these cysts, so even careful hygiene does not prevent them.