Subcutaneous Cysts: Causes and Treatment Options - Dermatology

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Subcutaneous cysts, often referred to as epidermoid cysts or sebaceous cysts, are common benign growths that can occur anywhere on the body, including the feet. These cysts are typically filled with keratin, a protein found in skin cells, and can vary in size. The description you provided—a smooth, round, and elastic lump beneath the skin that appears dark or discolored—suggests that it may indeed be a cyst.


Causes of Subcutaneous Cysts
Subcutaneous cysts can develop for several reasons:
1. Blocked Sebaceous Glands: When the sebaceous glands, which produce oil to lubricate the skin, become blocked, they can form cysts. This blockage can be due to a variety of factors, including skin trauma, acne, or genetic predisposition.

2. Genetic Factors: Some individuals may be more prone to developing cysts due to hereditary factors. Conditions like steatocystoma multiplex can lead to multiple cysts forming in the skin.

3. Skin Trauma: Injuries to the skin can lead to the formation of cysts as the body attempts to heal itself. This can include cuts, abrasions, or even surgical scars.

4. Inflammation: Chronic inflammation of the skin can also contribute to the development of cysts. Conditions like hidradenitis suppurativa can lead to cyst formation in certain areas of the body.


Symptoms
Subcutaneous cysts are usually painless and may not cause any symptoms unless they become infected or inflamed. In such cases, symptoms may include:
- Redness and swelling around the cyst
- Pain or tenderness
- Discharge of pus or a foul-smelling substance if the cyst ruptures

Diagnosis
A healthcare provider can typically diagnose a subcutaneous cyst through a physical examination. In some cases, imaging tests like ultrasound or MRI may be used to assess the cyst's characteristics and rule out other conditions.


Treatment Options
Most subcutaneous cysts do not require treatment unless they become symptomatic or are cosmetically concerning. Treatment options include:
1. Observation: If the cyst is not causing any problems, it may simply be monitored over time.

2. Incision and Drainage: If the cyst becomes infected or painful, a doctor may perform a minor surgical procedure to drain the contents of the cyst.

3. Excision: For cysts that are recurrent or bothersome, complete surgical removal may be recommended. This procedure involves excising the cyst and its wall to prevent recurrence.

4. Injection of Steroids: In some cases, corticosteroid injections may be used to reduce inflammation and swelling.


When to Seek Medical Attention
You should consider consulting a healthcare provider if:
- The cyst becomes painful, red, or swollen.

- There is an increase in size or change in appearance.

- You notice any discharge or foul odor.

- You have concerns about the cyst's nature or if it seems to be growing rapidly.


Conclusion
In summary, the lump you described on your foot is likely a subcutaneous cyst, which is generally benign and common. While they often do not require treatment, it is essential to monitor any changes in size, color, or symptoms. If you have concerns or if the cyst becomes symptomatic, it is advisable to seek medical evaluation for appropriate management.