Why Does My Sebaceous Cyst Keep Coming Back?

I frequently see patients who complain that they had a sebaceous cyst drained, but that it came back.

Why do sebaceous cysts come back?

To answer this question, let’s discuss what a cyst actually is.  Generally speaking, a cyst is a sac lined with cells.  Cysts can occur within organs such as the ovaries, kidneys and liver, or can occur on the skin.  Cysts of the skin are commonly called sebaceous cysts, but there are actually several different types of skin cysts, depending on the cell type of origin:

• A sebaceous cyst arises from the oil glands
• An epidermal inclusion cyst arises from the epidermal skin cells
• A pilar cyst arises from the hair follicles

What do sebaceous cysts look like?

Pilar, epidermal inclusion, and sebaceous cysts all look pretty much the same.  They appear as a large lump just under the skin.  Squeezing this lump may produce a thick, white, cheesy substance (you may have seen videos of this uploaded to You Tube, or posted on Facebook, or even on primetime tv now that Dr. Pimple Popper has her own show!)  This thick white substance is oil and dead skin cells produced by the cells lining the cyst.  The cyst grows larger as the lining cells make more oil and skin cells.

Should you have a cyst removed?

I see a lot of patients for cyst removal simply because they don’t like having a lump, and they want to get rid of it before it gets bigger. But cysts can also become infected.   In this instance, the cyst becomes red, hot to the touch, swollen, and painful as in the photo below.

To treat an inflamed or infected cyst your doctor may drain the infection and place you on antibiotics.  But draining the contents of the cyst does not remove the cyst cavity itself.  So the cyst “comes back” when it fills back up with oil and dead skin cells. Actually removing a cyst involves making an incision in the skin.  The cyst is removed, and the incision is sutured closed.

Why did my sebaceous cyst come back?

Although cysts can come back after they are removed, this isn’t very common. If you’ve had a cyst treated only to return, you most likely had the cyst drained, rather than completely excised.   I would recommend seeing either a general surgeon or plastic surgeon for removal. Most cysts can be removed in the office in less than an hour.

Dr. Greer is a Plastic Surgeon who practices in Cleveland, OH. Her passion is helping moms regain self-confidence by getting rid of sagginess, wrinkles, and stubborn fat. Read more about her at www.greerplastics.org.