Subcutaneous Cysts: Symptoms, Diagnosis, and Treatment - Dermatology

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Subcutaneous cysts, often referred to as sebaceous cysts or epidermoid cysts, are common benign growths that can occur in various parts of the body, including the chest area. Based on your description, it seems that you may indeed be dealing with a subcutaneous cyst. These cysts typically present as firm, round lumps beneath the skin and can sometimes become inflamed or infected, leading to pain and discomfort.


Symptoms of Subcutaneous Cysts
The symptoms you described—hardness, oval shape, occasional pain upon pressure, and the ability to express a white or yellowish substance—are characteristic of a sebaceous cyst. These cysts are filled with keratin, a protein found in skin, hair, and nails, and can sometimes become clogged, leading to the accumulation of this material. While they are generally harmless, they can become bothersome if they become inflamed or infected, which may cause redness, swelling, and increased tenderness.


Diagnosis
Diagnosis of a subcutaneous cyst is typically made through a physical examination. A healthcare provider will assess the characteristics of the cyst, including its size, shape, and consistency. In some cases, imaging studies like ultrasound may be used to evaluate the cyst further, especially if there is uncertainty about the diagnosis or if the cyst appears atypical.


Treatment Options
1. Observation: If the cyst is not causing any symptoms or discomfort, it may simply be monitored over time. Many cysts do not require treatment unless they become problematic.

2. Incision and Drainage: If the cyst becomes painful, inflamed, or infected, a healthcare provider may recommend an incision and drainage procedure. This involves making a small cut in the cyst to allow the trapped material to escape. However, this does not remove the cyst wall, so it may recur.

3. Excision: For a more definitive treatment, surgical excision may be performed. This involves removing the entire cyst along with its wall, which significantly reduces the chance of recurrence. This is typically done under local anesthesia in an outpatient setting.

4. Medication: If there is an infection, antibiotics may be prescribed. However, antibiotics alone will not eliminate the cyst.


When to See a Doctor
You should consider consulting a dermatologist or a healthcare provider if:
- The cyst becomes increasingly painful or swollen.

- You notice any signs of infection, such as redness, warmth, or discharge that has an odor.

- You are concerned about the appearance of the cyst or if it changes in size or shape.


Conclusion
In summary, based on your symptoms, it is plausible that you have a subcutaneous cyst, possibly a sebaceous cyst. While these are generally benign, if they become symptomatic, treatment options include drainage or excision. It is advisable to consult with a dermatologist for an accurate diagnosis and to discuss the best treatment options tailored to your specific situation. They can provide guidance on whether a simple incision will suffice or if a more comprehensive surgical approach is warranted. Remember, while these cysts are common and usually harmless, any new or changing skin lesion should be evaluated by a healthcare professional to rule out other conditions.