A lump in your genital area doesn't necessarily mean you're infected with a sexually transmitted disease (STD), or you have a cancerous tumor. The lump may just be a sebaceous cyst or epidermoid cyst, which is oftentimes harmless. Doctors generally don't recommend treating sebaceous cysts, but you may still get rid of them if they get infected or grow too big.
What is a Sebaceous Cyst?
The epidermis, the top layer of your skin, is made up of a thin protective layer of cells that you continuously shed. Most sebaceous cysts form when these surface cells, instead of shedding normally, move deeper into your skin and multiply. This often happens in areas where there are small hair follicles and large sebaceous glands, such as your genitals, upper back, neck, and face.
The multiplying cells form the walls of the sebaceous cyst, and secrete keratin into the interior. Keratin makes up the thick “cheesy” substance that sometimes drains from the cyst. Several factors contribute to the abnormal proliferation of cells, including:
- Impaired sebaceous glands: Sebaceous glands are located just above hair follicles. They produce sebum, the oily substance that coats your skin and hair. Your sebaceous glands can easily be impaired by inflammatory skin conditions like acne. Ruptured sebaceous glands are likely sites for sebaceous cysts.
- Hair follicle damage: A follicle is a small pocket of modified skin that grows hair in the dermis, the layer of skin below the epidermis. Follicles damaged by injuries such as surgical wounds and abrasions can become clogged by cells, forming a sebaceous cyst.
- Genetic factors: People afflicted with Gardner's syndrome, a rare genetic disorder that causes growths in the colon, are likely to develop sebaceous cysts. Also, people with basal cell nevus syndrome have a higher risk of developing sebaceous cysts. Basal cell nevus syndrome is an inherited disease that causes several serious defects.
- Birth defect: Sebaceous cysts can begin early in a developing fetus when stem cells, instead of forming hair and skin, become trapped in cells that form other tissues.
Symptoms of Sebaceous Cysts
Sebaceous cysts may look like acne or trichilemmal cysts, which have different characteristics. The following is a list of common symptoms of sebaceous cysts to help you determine your condition:
- Round, freely moving sacs ranging in size from a few millimeters to five centimeters in diameter.
- Yellow or white lumps on your face, neck, or torso.
- Thick, cheesy, and foul-smelling material that drains from the cyst.
- Miniature cysts on the surface of your skin called “milia.”
- Redness, swelling, and tenderness around the lump, which are indications of infection.
Consult your doctor to confirm your skin condition. In most cases, doctors can diagnose sebaceous cysts based on their appearance alone. If your doctor suspects another skin condition though, he may refer you to a dermatologist for examination and treatment.
Medical Treatment for Sebaceous Cysts
After diagnosis, your doctor will most likely recommend leaving the cyst alone if it's not painful. You may choose to remove the cyst however, if it's infected or if it's unpleasant to look at. The following is a list of medical treatments for sebaceous cysts:
- Corticosteroids: If you have an inflamed sebaceous cyst that's not infected, your doctor may inject it with corticosteroids to reduce the inflammation.
- Clinical lancing: In this procedure, your doctor makes a small incision in the cyst and drains its contents. Clinical lancing is quick and easy, but cysts often recur after treatment.
- Carbon dioxide laser: Surgical procedures to remove sebaceous cysts typically leave scars. Vaporizing the cyst with a carbon dioxide laser may minimize scarring.
- Minimal excision: Like lasers, minimal excision reduces the risk of scar formation. In this procedure, the doctor makes a small incision in the cyst, drains its contents, and removes the whole cyst through the incision. The tiny wound is then left to heal naturally.
- Total excision: Total excision guarantees a 100% cure rate if the cyst can be removed in one piece. Cysts will not grow in the exact same place, but may recur in nearby areas. The biggest drawback of total excision is that it usually causes scarring. Here is the typical course of the procedure:
Step 2: He uses a scalpel to open the cyst, making either a single cut down the center of the lump, or an oval cut on both sides. A lancet may be used if the cyst is relatively small.
Step 3: Once the cut is made, the doctor squeezes out the cheesy contents made of keratin, sebum, and dead skin cells. He may use blunt-headed scissors or other instruments to hold the cut wide open, while his fingers or forceps remove the entire cyst.
Step 4: If the cyst can't be recovered in one piece, he may scrape the remaining exposed fragments to get rid of the cyst.
Step 5:. The incision is then disinfected; and in some cases, the wound is stitched back together.
Step 6: The doctor may also fill the hole with an antiseptic ribbon after washing it with an iodine solution. If you go for this procedure, make sure to change the ribbon once or twice daily for seven to 10 days, and then have the incision stitched.
Home Treatments for Sebaceous Cysts
Treating your sebaceous cyst at home is not as effective as surgery, but it's less expensive and easier. Here are some tips to reduce the size or completely remove your cyst at home:
- Use a heating pad: Apply a heating pad directly on the cyst for 20 to 30 minutes three to four times a day. Do this for up to 10 days and see if the cyst gets smaller. Some cysts contain sebum, which melts under high temperatures, and gets reabsorbed and processed by the body. Take note that this method will not work if your cyst doesn't contain hardened sebum. Have your doctor examine your cyst to determine its contents.
- Clean the cyst daily: Wash the cyst and the surrounding skin with an antibacterial soap every day to prevent infection.
- Never squeeze the cyst: Never squeeze, puncture, drain, or scratch a lump because this can cause infection or severe bleeding. This may also push the infection deeper into the skin if the lump is already infected.
- Bandage an infected cyst: Draining pus from an infected cyst can cause infection in surrounding areas. To avoid further complications, apply a bandage on the infected cyst, and change the bandage daily. Consult your doctor immediately if the cyst becomes more swollen and painful.
- Avoid using oily skin care products: Oily skin care products may cause complications to your sebaceous cyst, since they may further clog your pores with sebum and dead skin cells. As much as possible, avoid these products, and choose ones that are oil-free.
- Avoid too much sun exposure: “Milia” are miniature sebaceous cysts composed of deep-seated whiteheads that don't come to the surface of your skin. They are common in older women and in men with too much sun damage on their temples and cheeks. Avoid excessive sun exposure to prevent the formation of milia on your skin.
It's best to leave your sebaceous cyst alone if it doesn't hurt and it's not too visible. Sebaceous cysts that become cancerous tumors are rare, but they do occur in some cases. If you want to get rid of your sebaceous cyst for cosmetic reasons, follow the instructions of your doctor to prevent infection after the procedure. Experts have not yet determined how to prevent sebaceous cysts from forming, but maintaining personal hygiene might help reduce your risk of developing sebaceous cysts and other skin diseases.
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