Sebaceous cysts, otherwise known as wens, are benign growths on the surface beneath the skin and are a very common skin condition, arising in people at any age. Although these cysts can develop in any part of the body, they frequently show up in the skin on the face, neck, scalp and torso. Sebaceous cysts initially present as small lumps under the skin, which are painless, grow slowly and are non-cancerous. However, they can become infected in some instances, which leads to inflammation, pain and pus.

While sebaceous cysts are not a sign of cancer in the majority of cases, in rare circumstances, such as if they recur and grow rapidly after being removed or if they have a diameter greater than 5 cm, they become cancerous. This could lead to certain types of skin cancers like basal cell carcinoma and squamous cell carcinoma.

Also Read: Basal Cell Carcinoma: Causes, Symptoms And Treatment

Causes Of Sebaceous Cyst:

The main reason for the occurrence of sebaceous cysts is the hampered structure or blockage of sebaceous glands or the ducts leading up to these assemblies. Sebaceous glands are small tubules located in the skin of the human body, which synthesize sebum – an oily, fatty substance and release it into the follicular ducts. The sebum then traverses up to the surface to moisturise the skin and hair.

The primary factor that damages or obstructs sebaceous glands is trauma that happens in a particular region of the skin. The trauma could be induced by a minor scratch by a sharp object, inflammatory skin disorders like acne, pimples, or a wound from a surgical procedure.

Furthermore, if the ducts arising from the sebaceous glands are distorted or malformed, or if there are any pre-existing genetic ailments like Gardner’s syndrome, basal cell nevus syndrome, these could also result in sebaceous cysts.

Symptoms:

Small sebaceous cysts are usually yellow or white in colour and do not prompt any pain or discomfort. They feel soft in texture and are composed of pale flaky fragments of keratin, which is the fundamental protein that is present in the skin and nails.

When cysts grow in size, the big lumps can trigger painful sensations, soreness and pressure, especially when they develop on the face and neck. These large cysts also appear white to yellow at first but turn red when they get infected owing to inflammation, becoming warm and tender to the touch.

Diagnosis:

The doctor thoroughly assesses the external indications of the swelling in the skin during a physical examination and verifies the presence of sebaceous cysts. Nevertheless, if the physician analyses the cyst to be of an irregular shape and texture, then some more diagnostic assays are required to make sure that certain forms of skin cancer like squamous cell carcinoma, melanoma, Merkel cell cancer are not the cause.

These laboratory tests comprise:

CT Scan: It help in detecting skin aberrations and determine the best strategy for surgical removal

Ultrasound Scan: This scan aids in investigating the exact contents within the cyst

Punch Biopsy: Type of skin biopsy protocol to extract a small segment of the cyst and study the skin tissue in the lab

Also Read: Skin Biopsy: Procedure, Risks And Results

Treatment:

The treatment for sebaceous cysts depends upon the size and nature of the lump in the skin. Small cysts that do not grow in size or become infected and inflamed do not require any specific medical care and usually disappear on their own after some time.

In some cases, if small cysts get infected, the medical professional injects a steroid to lessen the swelling and pain. When the cysts become larger and fill up with fluid, along with intense pain and tenderness, the doctor performs a basic procedure in the clinic to drain out the lumps in the skin.

If the sebaceous cysts become very huge in size and impede hair growth on the scalp, restrict normal muscle movement in the face, neck, rub against clothing in the torso – either the front or back of the body, then they have to be removed by surgery. The healthcare provider performs various kinds of procedures to eliminate the sebaceous cysts, such as:

Laser-Aided Excision: After creating a tiny hole using a laser at the site of the skin lump, the sebaceous cysts is carefully drained.

Conventional Wide Excision: This process involves methodically removing the cyst using surgical tools, which leaves behind a lasting scar.

Minimal Excision: A small nick is made in the region of the skin directly above the cyst, following which the lump is removed.

Punch Excision: A surgical tool called a scalpel that resembles a cookie-cutter is employed to remove the sebaceous cyst and a minuscule portion of normal skin in the surrounding area.