Lipomas: Treatment Options and Infection Risks

Lipoma

I have a lump on my back that resembles an epidermoid cyst, but recently it has become itchy due to a bacterial infection.
A dermatologist has suggested that I have it excised.
How should I proceed, and what could happen if the epidermoid cyst is left untreated? Would it be serious if it develops a bacterial infection?

Hsin-Yi, 20~29 year old female. Ask Date: 2004/06/04

Dr. Hong Shouhong reply Family Medicine

The correct term you are referring to is sebaceous cyst.
It occurs due to excessive secretion from sebaceous glands, leading to clogged pores and more severe acne, which causes the follicle to rupture.
This allows bacteria to invade, resulting in skin inflammation known as an abscess.
Once the inflammatory condition improves, the sebaceous glands continue to secrete oil, forming a sebaceous cyst.
Sometimes, it may continue to enlarge, creating a soft mass under the skin.
Patients typically do not experience pain, but if a bacterial infection occurs, it can become red and swollen, and in severe cases, lead to cellulitis.
Therefore, surgical excision is considered a better management approach.

Reply Date: 2004/06/04

More Info

Lipomas are benign tumors composed of adipose (fat) tissue, and they are generally harmless. However, when a lipoma becomes infected or shows signs of inflammation, it can lead to discomfort, itching, and other complications. In your case, since you have developed an infection in the area of the lipoma, it is essential to address this issue promptly.

Treatment Options for Lipomas
1. Observation: If the lipoma is small, asymptomatic, and not causing any issues, your doctor may recommend simply monitoring it over time. Many lipomas do not require treatment unless they become bothersome.

2. Surgical Removal: The most common treatment for a lipoma, especially if it is causing discomfort or has become infected, is surgical excision. This procedure involves removing the lipoma entirely, which usually resolves any associated symptoms. It is typically performed under local anesthesia and is considered a minor outpatient procedure.

3. Liposuction: In some cases, liposuction can be used to remove a lipoma, especially if it is large. This method is less invasive than traditional excision but may not remove the lipoma completely, leading to a higher chance of recurrence.

Risks of Leaving a Lipoma Untreated
If a lipoma is left untreated, it generally does not pose a significant health risk. However, there are a few considerations:
- Infection: As you've experienced, a lipoma can become infected, leading to pain, swelling, and the potential for more severe complications if not treated. An infected lipoma may require antibiotics and possibly surgical intervention to drain any abscess that forms.

- Growth: Lipomas can grow over time. While they are benign, larger lipomas may become more uncomfortable or noticeable, leading to cosmetic concerns or discomfort.

- Misdiagnosis: Sometimes, what appears to be a lipoma may be another type of tumor or cyst. If a lipoma changes in appearance, grows rapidly, or becomes painful, it is crucial to have it evaluated by a healthcare professional to rule out other conditions.

Infection Risks and Management
If your lipoma has become infected, it is essential to manage the infection effectively. Here are some steps you should consider:
1. Consult Your Doctor: Since your doctor has already recommended excision, it is advisable to follow through with this recommendation, especially if you are experiencing symptoms of infection.

2. Antibiotics: If there is an active infection, your doctor may prescribe antibiotics to help clear the infection before or after the surgical procedure.

3. Hygiene: Keep the area clean and dry. Avoid scratching or irritating the lipoma, as this can exacerbate the infection.

4. Follow-Up Care: After treatment, follow your doctor's instructions for care and monitoring of the site to ensure proper healing and to prevent recurrence.

In summary, while lipomas are generally benign and not a cause for concern, an infected lipoma requires prompt attention. Surgical removal is often the best course of action, especially if there are signs of infection. Always consult with your healthcare provider for personalized advice and treatment options based on your specific situation.

Similar Q&A

Effective Treatment Options for Lipomas Beyond Surgical Removal

Hello, Dr. Wu. Besides surgical excision, what other treatment options are available for lipomas, and which one is considered better?

Dr. Wu Yuxin reply Dermatology
To manage a lipoma, the only option is surgical excision; otherwise, close observation is recommended.

Managing Persistent Inflammation in Lipomas: Surgical Options Explained

Hello Doctor, around August 2015, I noticed a lipoma on the left side of my lower back. By January or February 2016, the lipoma had grown significantly, about the size of my palm, and appeared bruised. When I returned to the dermatologist, the doctor mentioned that the tissue sur...

Dr. Xu Kaixi reply Surgery
I apologize for the late response. If the medication has been administered for a period of time without significant improvement, it is advisable to consider surgical intervention. You may seek assistance from a general surgery or plastic surgery outpatient clinic.

Understanding Lipoma Formation: Causes, Prevention, and Treatment Options

When I was a child, I had a lipoma on my arm (which I only learned about when I grew up). After turning 28, I began to develop many lipomas of varying sizes on my body, including my hips, thighs, abdomen, and small arms. A few years ago, I had a 2 cm lipoma removed from my abdome...

Dr. Li Junde reply Surgery
According to your description, Mr. Zhou, your condition appears to be multiple subcutaneous lipomas, which are mostly benign tumors. Unless there are symptoms, cosmetic concerns, or rapid changes in size, they can be monitored over time. If there is no significant change, surgery...

Understanding Facial Lipoma Surgery: Risks and Treatment Options

Hello, I would like to inquire about the issue of lipomas on the face. I have a lipoma on my cheek that was surgically removed last December, but there is still a 2 cm lipoma remaining. The previous surgery was performed through an intraoral approach, and I am unsure if this is w...

Dr. Zheng Jueyi reply Otolaryngology
Hello, whether it is easy to injure the facial nerve depends on the location. It is recommended to discuss with a clinical physician or review imaging studies for proper assessment. Wishing you safety and health. Sincerely, Dr. Jue-Yi Cheng, Director of the Department of Otolaryn...