CYSTS


Cutaneous cysts are noncancerous, sac-like growths that can develop just beneath the skin, often arising from hair follicle structures or joint spaces. These cysts typically appear as marble sized, round bumps underneath the skin and can be found on various parts of the body. While they are usually harmless and painless, some individuals may choose to have them removed if they become inflamed, infected, cosmetically bothersome, or painful.

Epidermal Inclusion Cysts:

These cysts arise from the upper portion of the hair follicle called the infundibulum. They can be filled with keratin, a protein that occurs naturally in skin, hair, and nails. They often result from a clogged hair follicle or after an injury to the skin but it is still unknown exactly why they arise in some people. Some cysts have an opening called a punctum where patients might notice drainage of keratinous “cheesy” material from time to time. Many can grow to become quite large, noticeable and bothersome. Rarely, they can rupture leading to a painful infection or inflammation.

Pilar Cysts:

Also known as trichilemmal cysts, pilar cysts originate from the middle part of the hair follicle called the isthmus and are commonly found on the scalp. These rarely become infected or inflamed but they can grow to become cosmetically bothersome and an annoyance during hair care.

Digital Mucoid and Ganglion Cysts:

These cysts are often found overlying joint spaces on the wrists and fingers. They contain a jelly like substance consistent with synovial joint fluid. Though these can be drained or excised, the recurrence rate can be as high as 30%. Thus we work closely with a network of fellowship trained hand surgeons in order to ensure complete removal.

The surgical management of cutaneous cysts is typically straightforward and involves an incision overlying the cyst followed by dissection and removal of the entire cyst sac and its contents. This prevents possible recurrence of the cyst. Cyst excision can be performed safely and efficiently in the outpatient setting sparing you a trip to the hospital and the risks of general anesthesia. After the procedure, the incision site is sutured, and postoperative care instructions are provided to ensure proper healing.

Balakirski G, Loeser C, Baron JM, Dippel E, Schmitt L. Effectiveness and Safety of Surgical Excision in the Treatment of Digital Mucoid Cysts. Dermatol Surg. 2017 Jul;43(7):928-933. doi: 10.1097/DSS.0000000000001096. PMID: 28272086.

Meister H, Taliercio M, Shihab N. A Retrospective Chart Review of Inflamed Epidermal Inclusion Cysts. J Drugs Dermatol. 2021 Feb 1;20(2):199-202. doi: 10.36849/JDD.5014. PMID: 33538555.