What is an epidermal cyst?

Epidermoid cysts are small, noncancerous lumps under the skin. They can appear anywhere on the skin, but are more common on the face, neck, and trunk. Epidermoid cysts grow slowly and are often painless, so they rarely cause problems or need treatment.

Many people call epidermoid cysts “sebaceous cysts,” but they are different. True sebaceous cysts are less common. They arise from the glands that secrete fatty matter that lubricates the hair and skin (sebaceous glands).

What symptoms does it cause?

Signs and symptoms of epidermoid cysts include the following:

  • A small, round lump under the skin; usually on the face, neck, or trunk.
  • A small black dot that plugs the central opening of the cyst.
  • A thick, yellow, foul-smelling substance that sometimes drains from the cyst.
  • Redness, swelling, and tenderness in the area, if the cyst is inflamed or infected

How is it diagnosed?

Doctors usually make the diagnosis by looking at the cyst. Epidermoid cysts look like sebaceous cysts, but they are different. True epidermoid cysts result from damage to hair follicles or the outer layer of skin (epidermis).

What treatment options exist?

Generally, it is possible not to treat a cyst if it does not cause discomfort or cosmetic problems. If you seek treatment, talk to your doctor about these options:

  • Incision and drainage. With this method, the doctor makes a small cut in the cyst and gently squeezes it to remove the contents. This is a fairly quick and easy method, but the cysts usually come back after this treatment. It is usually used when the cyst is complicated and the infection must be evacuated.
  • Minor surgery. The doctor removes the entire cyst. Minor surgery is safe and effective and usually prevents the cysts from coming back. If the cyst is inflamed, the doctor may delay surgery.


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