Sebaceous Cysts: Causes, Symptoms, and Removal (Plus Pictures)
Key takeaways:
Sebaceous cysts are common growths under the skin. They’re usually harmless and don’t need treatment.
Unless they get infected or inflamed, sebaceous cysts usually aren’t painful or tender. If your cyst causes symptoms, a healthcare professional may suggest antibiotics or surgery as treatment.
Although home remedies may work, surgery is the most effective treatment for sebaceous cysts. This involves removing the entire cyst lining to prevent it from coming back.
Table of contents
Lumps and bumps can pop up on the skin for different reasons. And it can be hard to know when they’re a cause for concern. One common type of bump that causes people to see their healthcare professional is a sebaceous cyst.
Although generally harmless, sebaceous cysts sometimes grow large or cause pain. Some people may also be bothered by their appearance. And even when treated, sometimes they keep coming back. Let’s review what causes sebaceous cysts, what you can do about them, and how to treat them for good.
What are sebaceous cysts?
A sebaceous cyst is a sac under the skin. The medical term for a sebaceous cyst is “epidermoid cyst” or “epidermal cyst.” This is because it’s lined with the same cells that make up the outer layer of your skin (called the epidermis). Sebaceous cysts contain keratin (the protein that makes up skin cells) and cellular debris.
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Sebaceous cysts are benign (not cancerous) and have specific characteristics. They can range from the size of a pea to the size of a quarter or more. Features of sebaceous cysts include masses that are:
Slow-growing
Not tender
Easily movable when pressed
Covered by normal-looking skin
Sometimes marked by a small hole in the center that connects the cyst to the skin’s surface (called a punctum)
Sebaceous cyst images
Common locations where sebaceous cysts appear include:
Face
Back
Neck
Armpit
Behind ear
Here are some photos of sebaceous cysts in different locations and on different skin tones.
What causes sebaceous cysts?
Sebaceous cysts come from hair follicles, and they can happen when hair follicles become plugged or clogged. One way this can happen is when inflammation disrupts the hair follicles, like with inflammatory acne.
Other causes of sebaceous cysts include:
Skin trauma
Genetic conditions (like Gardner syndrome)
Chronic sun damage
Some medications (like Zelboraf)
Do sebaceous cysts cause any symptoms?
Sebaceous cysts are often painless growths and cause no symptoms at all. But sometimes they begin to cause symptoms and may need treatment. Reasons a healthcare professional may suggest treatment include:
Pain or physical discomfort
Emotional distress
Highly visible location that bothers you (like the face)
Signs of infection or inflammation (redness, swelling, or draining)
How are sebaceous cysts diagnosed?
In most situations, a healthcare professional can diagnose a sebaceous cyst just by examining your skin and asking you questions about your symptoms. Sometimes, the results of a small skin biopsy called a punch biopsy can help confirm the diagnosis.
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How do you treat a sebaceous cyst?
Sebaceous cysts usually don’t need any treatment. The cyst might go away on its own or it may continue to grow slowly with no symptoms. But even if it goes away, sebaceous cysts often come back. Over time, they may start to cause symptoms.
If you start having symptoms, a healthcare professional might suggest treating it. Here are a few different treatment options:
Corticosteroid injection: For an inflamed cyst, a small needle is used to inject corticosteroid, which can reduce swelling and pain. This doesn’t remove the cyst, and it could come back.
Incision and drainage: For inflamed or infected cysts, the area is cleaned and then numbed with a small needle. A small opening is made over the cyst with a scalpel, and the fluid inside the cyst is pushed out. This lowers inflammation and swelling, but it doesn’t remove the cyst.
Surgical excision: Surgery involves removing the cyst and the sac surrounding it. This is the only way to remove a sebaceous cyst for good. If the sac or any portion of the cyst remains, the cyst may reform in the same area.
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What happens during a sebaceous cyst excision?
A primary care provider, surgeon, or dermatologist (skin specialist) can remove sebaceous cysts in their office through an excision. Sebaceous cyst removal is a common medical procedure with a very low rate of complications. There are a few different types of excision, but they all aim to remove the entire sebaceous cyst.
Here’s what you can expect with a sebaceous cyst removal (conventional excision):
A healthcare professional cleans the area of skin with an antiseptic to keep it from getting infected.
They inject a local anesthetic (numbing medicine) around the cyst with a small needle.
They use a surgical knife to open the skin and forceps to remove the cyst and its entire capsule.
They close the skin. Depending on the size of the cyst, you may not need stitches.
They apply a sterile gauze bandage to the incision.
The removed tissue will probably be sent to a lab to confirm the diagnosis.
In some situations, you may get a prescription for antibiotics.
If you have stitches, you’ll return to the office to have them removed within 1 to 2 weeks.
Keep in mind, there’s always the risk of a small scar after a cyst is surgically removed. There may also be a chance that the cyst comes back if it isn’t removed completely.
Should you pop a sebaceous cyst?
You probably shouldn’t try to pop a cyst. As long as it’s not causing any symptoms, a healthcare professional will likely suggest keeping the cyst clean and not trying to drain it on your own. If you try squeezing or puncturing the cyst, it might rupture into the surrounding skin. A ruptured sebaceous cyst is more likely to get inflamed or infected and need medical treatment.
Self-care for sebaceous cysts
You can try at-home treatment for the cyst if it isn’t causing any symptoms. Here are some guidelines to follow for at-home treatment of a sebaceous cyst:
Don’t attempt to pierce or pop a cyst.
Use a clean cloth to apply moist heat several times a day.
If it’s draining, cleanse the skin with soap and warm water several times a day.
Cover draining cysts with a clean bandage.
When should you get medical care for a sebaceous cyst?
Even though most sebaceous cysts never need treatment, you should get medical care if the cyst becomes bothersome. Some of the reasons to get medical attention are:
Swelling around the cyst
Pain in the cyst
A quickly growing cyst
Signs of infection (like redness and pus)
Frequently asked questions
A cyst removal isn’t painful, but you may feel some pressure. Before the procedure, your skin is numbed with a small needle. You may feel a little prick and a sting during the numbing process, but after that you shouldn’t feel any pain.
If a sebaceous cyst pops on its own, keep the area clean with mild soap and water. It’s OK if more cyst contents continue to drain, but don’t squeeze the area too hard. The area should heal on its own. Let a healthcare professional know if you see signs of infection, like:
Red or violet skin discoloration that’s spreading
Pus drainage
Pain that continues or worsens
If a sebaceous cyst pops under the skin, it usually heals on its own within a week. You may notice some tenderness in the area while this happens. Don’t pick at or press the area. A warm compress to the area can help lower the inflammation and tenderness.
Most people recover from cyst removal surgery in 1 to 2 weeks. If you have stitches, they’re usually removed within this timeframe as well. After you heal, you will likely have a small scar in the area.
The bottom line
Sebaceous cysts are one type of benign cyst that can develop under the skin. Home remedies may be helpful, but the definitive treatment for sebaceous cysts is surgical removal. Resist the urge to try and pop or squeeze it. This can cause an infection or inflammation. It’s best to let a healthcare professional know if you have a cyst on your skin. They can help guide you on next steps for treatment and proper care.
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Images used with permission from VisualDx (www.visualdx.com)
References
American Osteopathic College of Dermatology. (n.d.). Biopsy.
Boussemart, L., et al. (2013). Prospective study of cutaneous side-effects associated with the BRAF inhibitor vemurafenib: A study of 42 patients. Annals of Oncology.
Genetic and Rare Diseases Information Center. (2024). Gardner syndrome.
Zito, P. M., et al. (2023). Epidermoid cyst. StatPearls.
Zuber, T. J. (2002). Minimal excision technique for epidermoid (sebaceous) cysts. American Family Physician.
