Why Does My Sebaceous Cyst Keep Coming Back?

I frequently see patients who complain that they had a sebaceous cyst drained, but that it came back.  Why does this happen? To answer this question, let’s discuss what a cyst actually is.  The medical definition of a cyst is a sac lined with cells.  Cysts can occur within organs such as the ovaries, kidneys and liver, or can occur on the skin.  Cysts of the skin are commonly referred to as sebaceous cysts, but there are actually several different types of skin cysts, depending on the cell type of origin:

  • A sebaceous cyst arises from the oil glands
  • An epidermal inclusion cyst arises from the epidermal skin cells
  • A pilar cyst arises from the hair follicles

All three types cysts appear identical on exam; they appear as a large lump.  Squeezing this lump may produce a thick, white, cheesy substance (you may have seen videos of this uploaded to You Tube, or posted on Facebook.)  This thick white substance is composed of oil and dead skin cells made by the cells lining the cyst.  As the lining cells make more oil and skin cells, the cyst slowly becomes larger.  Cysts can also become infected.   In this instance, the cyst becomes red, hot to the touch, swollen, and painful as in the photo below.

"Inflamed epidermal inclusion cyst" by Steven Fruitsmaak - Own work. Licensed under Creative Commons Attribution-Share Alike 3.0 via Wikimedia Commons

“Inflamed epidermal inclusion cyst” by Steven Fruitsmaak – Own work. Licensed under Creative Commons Attribution-Share Alike 3.0 via Wikimedia Commons

To treat an inflamed or infected cyst your doctor may drain the infection and place you on antibiotics.  But draining the contents of the cyst does not remove the cyst cavity itself.  So the cyst “comes back” when it fills back up with oil and dead skin cells. Actually removing a cyst involves making an incision in the skin.  The cyst is removed, and the incision is sutured closed.

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Disclaimer: This webpage is for general information only. It is not intended to diagnose or treat any medical illness, or give any specific medical advice. Because medical knowlege is constantly evolving, I cannot guarantee the accuracy or timeliness of any information in this blog.

48 thoughts on “Why Does My Sebaceous Cyst Keep Coming Back?

  1. Hi i don’t know if you can help –
    i had an infected and inflamed cyst drained about 7 years ago .
    2 weeks ago this same cyst got inflamed and infected again and after a course of antibiotics i had the cyst removed. the surgeon cut and removed the cyst using laser and prescribed an other form of antibiotics .
    5 days after the operation i had to have it reopened as it was yet again inflamed and a small piece of the cyst wall was found and removed, before stitching me back up the surgeon was convinced that the wound was clear of the cyst and cyst walls. today i have removed the stitches but the cavity in which the cyst was removed from is still filling up with a clear liquid thus resulting in a ongoing inflammation the doc informed me that it was sebum.
    any insight you can give would be greatly appreciated
    thanks
    ben

    • Thanks for your question. It’s difficult to comment on your specific case without seeing you in person. As you know, cysts can recur if part of the capsule remains. But generally this process takes a minimum of a few weeks. Also, I’m a little bit confused by the description of the drainage from your cyst. Clear fluid is normal in wounds- it is called serum, and it’s the body’s way of providing nutrients and antibodies to a healing wound. Sebum is the thick, white, cheesy drainage that is found in cysts or pimples. If you have followed up with your doctor and still haven’t resolved the problem, I would recommend following up with a plastic surgeon in your area. http://www.plasticsurgery.org can provide a list of board certified surgeons. Best of luck to you!

  2. My husband had a cyst show up on his chest cavity(under breast) and had a fever off for 2 weeks. He was rushed to hospital for “Stat-blood work”. He was sent home with another antibiotic. It has now receded. But in the mean time, a cyst that was on his back from 6 years ago has reoccurred. Red & inflamed @ this time. Should he seek out a plastic surgeon or a dermatologist?

    • Most dermatologists are not comfortable excising cysts. These are usually treated by either a general surgeon or a plastic surgeon, both of which can excise a skin cyst. Thank you for your question, and best of luck to your and your husband!

  3. I have had several surgeries to have cysts removed. I had a ganglion cust removed that grew back in 6 months. I had four cysts removed from my pubic area because I kept getting abscess and two months after the surgery I got four abscess in that area. I also had a cyst removed from my tailbone 5 years ago because it kept getting abscess and just last week it abscessed again! What is happening to me??? Please help!

    • Thank you for your question. Although I can’t offer specific medical advide without seeing you in person, I can tell you that sebaceous cysts, ganglion cysts, and cysts over the tailbone area (known as pilonidal cysts) are completely separate disease entities. So having all these types of cysts is bad luck, but they’re not related. There is also a condition called hidradenitis suppurativa which is characterized by the development of recurrent infections and abscess in areas with sweat glands, including under the breasts, the thighs and pubic area, and the axillae (armpits). This is certainly something to consider in a person who frequently develops infections in these areas.

  4. I have a daughter that had a cyst from she was 6 weeks old now she is 7 and had two surgerys and it is till coming back behind the right ear

    • Thank you for your comment. Cysts commonly occur in babies, but are usually present on the forehead, either just above the eyebrow or between the eyebrows. The location of your daughter’s cyst behind the ear suggests to me this may be something different than a simple skin cyst. You might consider seeking out a second opinion if you are frustrated with you daughter’s care so far, or even if you just need a different person to explain what is going on. You can find a board certified plastic surgeon at http://www1.plasticsurgery.org/find_a_surgeon/. Best of luck to you!

  5. I had a sebaceous cyst on chest and removed by surgically. After 2 weeks again it come back on same area where operated and this cyst is painful and reddish in nature.why it happens. Is it curable?. Why it spreading again

    • Thank you for your question. Without examining you, I cannot tell if the actual cyst is back, or if you are feeling scar tissue from the incision. I would recommend following up with doctor who did the surgery, or scheduling a consultation with a board-certified Plastic Surgeon in your area.

  6. i had operation with my doctors last 6 months, but then it back, re hot and inflamed. do i need to take the operation again?? is there any medical alternative to remove the cyst again??

    • Thank you for your question. Without seeing you in person, I can’t comment on your particular situation. I would recommend you see your surgeon for more information. Cysts can come back, although this isn’t particularly common. If the cyst was drained, but not actually removed, then it will come back within a few months.

  7. Hi! Im aware without seeing me in person you cant make an exact diagnosis, but im unsure of how serious my cyst may be.
    About 17/18 years ago i had what doctors called a sebaceous cyst the size of a softball on my neck (it grew overnight) and i went through surgery to have it removed/drained. Less than a year later i went under the kife again because it had came back.
    Now, in the exact same place across my surgery scar is a very sore lump about an inch in diameter -at its biggest – and its causing pain as i move my neck. Is it possible that its the SAME thing i had removed so many years ago?

    • Thank you for your question. Did your doctor actually remove the cyst the first time, or simply drain the infection? Even if the cyst was completely removed, it is possible to develop another one in the same area, so I would recommend seeing a surgeon in your area for a consultation.

  8. Hello,

    I have a recurring infection on my nose that refills with clear fluid. Would a doctor ever biopsy it? I’ve had it 10 months and the derm and meds, including antibiotics, don’t help. Would it be appropriate to see a dermatological surgeon for this type of problem?

    • I cannot evaluate you without seeing you in person, but if you haven’t seen a dermatologist yet regarding this issue, it would certainly be worthwhile to find out what is going on.
      Thank you for the question!

  9. I have what my Doctor Said a epidermal inclusion cyst – where my leverets my glut – I get this every year usually go pant less or granny pants then. Elastic band aggravated it. I am delaying surgery as I was toldThanks sitting would be a no-no , and I have to be able to drive daughter to Dr. I keep it clean a dermatologist told me to use moist heat. I use a Kotex pad to protect it, unfortunately a sticky part attached itself to area. I am on blood thinner and told there maybe spotting. A few days ago it was flat and I felt great – do you have any suggestions as to making life a little more comfortable

    • Thank you for your question. What you’re describing sounds like a pilonidal cyst. These commonly occur in the gluteal cleft (i.e. at the top of the crack where the two buttocks meet). Using sitz baths or a squirt bottle to cleanse the area several times a day with warm water can help. I don’t routinely restrict sitting in patients who have had surgery to remove a pilonidal cyst, so it may be worth getting a second opinion.
      Best of luck to you!

  10. Hi I had a cyst removed last year , I now have a horrible scar/indent from it and a new cyct is growing right above it also overnight I have one on my lower back and its painful to the touch. Why am I getting these and should I be concerned?

    • Thank you for your question. Some people unfortunately are prone to forming cysts. I would recommend seeing your doctor to ensure that these are, in fact, cysts. But if you are someone who is prone to forming cysts, there really isn’t a way to prevent it. Best of luck to you.

  11. Hi, I keep getting what seems to be a pilar cyst in the same place on the top of my scalp. I used to not pay any attention until the last time I had two right next to each other and they were giving me a lot of pain. My mom drained both of them but I keep getting one in the same spot. People say it looks like a pimple on my head. What’s the reason I keep getting them?

    • Thank you for your question Ashlen. When a cyst is drained, the contents are removed. But the cyst itself is still there, and will fill back up eventually. Actually removing the cyst requires making an incision and removing the entire cyst capsule. This type of procedure is usually done by a general surgeon or plastic surgeon. Hope that information helps- best of luck to you!

  12. I had a cyst removed from the scalp of my head right above my neckline. It didnt heal up all the way before another knot grew back . Nw I hav an open cyst from previous surgery and another growing under it. What advisr can,u give me on what I should do?

    Thanking you in advance for all advice and support

  13. Is it recommended to keep going back to the ER for a reoccurring cyst or should I contact a surgeon. Any advise will help. Last visit to the ER was nearly $1000. Don’t want to keep repeating that.

    • The ER is great for emergency situations, but a recurring cyst is not an emergency. If the cyst is infected, the ER can treat the infection, possibly by lancing the cyst. But this will not actually remove the cyst. I would recommend seeing your primary care physician for any type of chronic recurring problem.

  14. Hi..abcess on the site (nearly above the elbow)of my sebaceous cyst was removed by incision & drainage..after 2months secretions start to appear again,my doctor said a TB (Tuberculosis)test for the skin is needed to know the cause of its recurrence..is there such a test?..how is it done?..is it reliable?..what other tests can be done?..thank you

    • As I explained in my blog post, incising and draining does not actually remove a cyst. Without knowing your entire medical history I can’t comment on why your doctor would recommend a TB test for an inclusion cyst. This is a question best reserved for your doctor.

  15. I had a fine needle biopsy on a cyst that was both cystic and solid. He drained it at 3:30 p.m. and by 10 p.m. it was already fill again. Im so bummed. Specimen sent to pathology lab so we will see if there are any suspicious cells. It is just to the right of my thyroid. He said most cyst are benign but I’m sure worried. This lump came up after delivering my son 1 yr ago. Praying for good results!

    • Thank you for your comment. This blog post was about epithelial inclusion cysts (aka sebaceous cysts), which occur in the skin. Cysts can also form in other organs in the body, such as the pancreas, kidneys, and thyroid. Those are a completely different disease entity, with different treatments.

  16. I had a cyst on my back that got infected was rushed to hospital as I blacked out the doctor removed it but said there was 2 cavities she removed the infected cyst and told me when it heals up see your doctor about getting the other cavitiy removed what did she mean by this thank you

  17. Hi, I have a small cyst located on my cheek. My doctor actually removed it (didn’t drain it) and after a couple of months it came back. My doctor actually made an incision and physically removed it. Waiting for your reply, thanks.

  18. My 13 year old grandson has developed a cyst behind his ear, quite large I might add, he’s gone several times and had it drained, it’s also formed behind the opposite ear as well. He’s type 1 diabetic so is quite alarming. Could this be something other then a sebasous cyst? It keeps refilling, he’s also been on iv antibiotics as well as oral. Help….

    • Thank you for your question. Unfortunately, without seeing your grandson in person it is impossible to tell what might be going on. I would first ask his current doctor what he/she thinks might be going on. And don’t be afraid to seek out a second opinion if you’re still frustrated. Best of luck to you!

  19. I had a cyst removed from my inner thigh a few years ago and now the scar has opened up a little bit and is draining. It keeps doing that on and off. It will leak for a few days then stop then start up again. I also keep getting cysts in the thigh area and I’m on dialysis. I was told I’m more prone to them because of being on dialysis. Is this true?

  20. Hi, I understand you can’t answer specifics of a case without seeing the person in question, so I have a general question regarding my son’s cyst since it seems to be returning. Somewhere around age 15 he developed a small knot on the inside of his forearm. It remained unchanged until late last yr (age 22) when it grew and became infected overnight. He went to an ER where the dr made an incision and removed it . The scar is a cosmetic disaster, which is only relevant as it raises some question as to the competence of the dr in this area. There also is a very hard knot reforming under the scar. Shortly after removal, he went to change the bandage and when he pulled it off a clump of white gel like almost like a hard mucus came from inside the unstitched, open wound. My concern is how likely is it for the site to have possibly left in worse shape by not closing the wound after removal at all and the possibility of secondary infection? He doesn’t go to Dr’s easily, so he says it’s fine. Any advise? I have a before , after and after pic of each point I’ve made but unable to attach them. Is there anyway I could send them since they are close up and very clear evidence of each description. And they may come in helpful as you are free to use them moving fwd as you deem necessary. The one with the hole taken afterwards is particularly disconcerting.

    • Leaving a wound open to heal in over time is called healing by secondary intention. This is very commonly done if a wound is at risk of infection, such as after a dog bite, or when draining an infected cyst. Leaving the wound open may leave a less favorable scar, but actually decreases the risk of infection.

  21. Hi, I had 2 cysts removed from one of my breast . One has been also sent to biopsy. Came back negative. But now, 12 weeks later that place feels still hard like a stone, like nothing has been removed. Is this to worry ? Many thanks

    • Thank you for your question. I would recommend contacting the physician who did the biopsy as he or she will be better suited to address your concerns.

  22. Hi there. My son aged 6 yrs just had a cysts on his lower eyelid scraped. The dr said they scraped it and took out all the pus inside. One week later we see it a lump same place again. Does this mean it is back and the dr needs to remove it completely? Why did he not remove it in the first place? thanks

    • Unfortunately I cannot tell what is going on without actually examining your son. I would recommend contacting his physician if you are concerned.

  23. my pcp tried draining and removing my sebaceous cyst in my left armpit. She gave me 5 shots that burned. It numbed the outside good, but not the inside. She pushed and poked and tried to take the cyst out and couldn’t. Now I have to see a surgeon. I can’t go thru this again this was very painful what will the surgeon do to help me not have this pain? Help very scared, nervous and in pain.

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