and Managing Sebaceous Cysts: Common Concerns and Solutions

Sebaceous cyst issues?

Hello Doctor, I have been experiencing acne for a long time.
However, about a year ago, I discovered that many of these may not be acne but rather sebaceous cysts.

1.
I would like to ask if it is normal for my cysts to sometimes swell up (just a little more noticeable) and not be visible most of the time.

2.
I originally thought I only had one or two cysts on my face, but I recently discovered that there are at least six.
Do I need surgery or any treatment for this? (I am concerned about scarring from surgery on my face, so I'm unsure how to proceed.)
3.
I would like to know if what I feel is like a small water balloon inside is indeed a cyst.

4.
Can I apply acne medication to the cysts, or should I avoid applying anything to prevent them from rupturing?
5.
Given my tendency to develop cysts, will I likely have new ones appear in other areas after surgery? Would it be advisable to avoid surgery in this case? Do you have similar patients, and what methods have they used to address this issue?
6.
Is the size of the cyst determined by its swollen state, or is the true size what it is after it has subsided and shrunk?
I apologize for the many questions, and I appreciate your patience and advice!

Niming, 20~29 year old female. Ask Date: 2023/11/26

Dr. Wu Yuxin reply Dermatology

There are many questions, but online consultations may not address your actual concerns.
It is advisable to seek medical attention and discuss with a clinical physician.

Reply Date: 2023/11/26

More Info

Sebaceous cysts, also known as epidermoid cysts or pilar cysts, are common benign growths that can occur on various parts of the body, including the face. They are typically filled with a substance called keratin, which is a protein found in skin cells. Understanding and managing these cysts can alleviate concerns and help you make informed decisions about treatment.

1. Cyst Fluctuation: It is normal for sebaceous cysts to fluctuate in size. They may appear more prominent or swollen at times, especially if they become inflamed or infected. This can happen due to irritation or pressure on the cyst. If the cyst becomes painful, red, or shows signs of infection (such as pus), it is advisable to seek medical attention.

2. Number of Cysts: The presence of multiple cysts is not uncommon. If you have noticed an increase in the number of cysts, it may be worth consulting a dermatologist. Surgical removal is often recommended for cysts that are bothersome, recurrent, or show signs of infection. While scarring is a concern, a skilled dermatologist can minimize this risk through careful surgical techniques. In some cases, cysts can be drained rather than excised, which may reduce scarring.

3. Cyst Characteristics: The sensation of a "small water balloon" when you touch the cyst is typical. This feeling is due to the fluid or keratin inside the cyst. If the cyst feels firm or hard, it may be more mature or encapsulated.
4. Topical Treatments: It is generally not recommended to apply acne medications directly to sebaceous cysts. These medications are designed to treat acne by targeting inflammation and bacteria, but they do not affect the cyst itself. Attempting to pop or squeeze a cyst can lead to infection or scarring, so it’s best to avoid this.

5. Recurrence After Surgery: Individuals who are prone to developing sebaceous cysts may experience new cysts after surgical removal of existing ones. This tendency can be due to genetic factors or skin type. However, surgical removal can provide relief from the current cysts and may prevent complications associated with inflamed or infected cysts.

6. Cyst Size: The size of a sebaceous cyst can vary depending on whether it is inflamed or not. When the cyst is swollen, it may appear larger than its true size. Once the inflammation subsides, the cyst may shrink back to its original size. It is important to monitor any changes in size and report them to your healthcare provider.

In summary, sebaceous cysts are generally benign and can be managed effectively. If you are experiencing discomfort, increased size, or multiple cysts, it is advisable to consult a dermatologist for a thorough evaluation and discussion of treatment options. They can provide personalized recommendations based on your specific situation, including whether surgical intervention is necessary and what the potential outcomes may be. Regular monitoring and proper skin care can also help manage the condition and prevent complications.

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