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.
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.
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.