How to Recognise Sebaceous Cysts and Ways to Remove them

Sebaceous, Epidermoid and Pilar cysts have all in the past known as ‘sebaceous cysts’ and been grouped together. All of these cysts are benign and not contagious but the sebaceous cyst is different in nature.  It is a much less common type of cyst that is filled with a clear oily liquid made by the sebaceous (oil/grease) glands which lubricate the surface of the skin and the hair. They have been classified together as they resemble each other as round dome shaped bumps lying just under the skin surface of various sizes. Sebaceous cysts are unattractive and sebaceous cysts removal is a sought after procedure. Interestingly Youtube is full of self help and home treatment examples although this is definitely not recommended due to the danger of infection and incorrect sebaceous cyst treatment and even incorrect identification. "True" sebaceous cysts (i.e. cysts which originate from sebaceous glands and which contain sebum) are relatively rare and are known as steatocystomas or, if multiple, as steatocystoma multiplex.

A cyst is a closed sac that has two main features: A lining and contents that are liquid or semi solid. With sebaceous cysts the contents are liquid and whilst they are benign and not contagious they are not so common as the epidermoid and pilar cysts.

The differences between the lining of epidermoid and pilar cysts can be seen under a microscope.   An epidermoid cysts consists of epidermal cells (the outside layer of the skin) and the lining of a pilar cyst is made up of cells similar as those found in the roots of hairs. Neither originate from the sebaceous gland and both contain keratin (a protein found in the body that hardens and makes up nails and hair) not sebum.

Epidermoid cysts affect young to middle aged adults and can appear after a hair follicle has been inflamed so they are common with acne sufferers and also with in-growing hair sufferers and they are not usually hereditary.   Pilar cysts usually affect women more than men and appear most usually in middle age. They can be heredity. Both types grow slowly whereas a sebaceous cyst can enlarge quite quickly. With epidermoid and pilar cysts the contents can discharge a cheesy foul smelling pus and can become infected and sore occasionally in which case antibiotics can be prescribed.  They can appear yellow or whitish and range in size from a small pea to those which are several centimetres across.

Pilar cysts are most common on the scalp and Epidermoid cysts are most common on the face, neck and upper trunk Sebaceous cyst removal can be through minor surgery where treatment is performed under local anaesthetic and the sebaceous cyst aftercare will be a scar. For treatment of sebaceous cysts Electrolysis has proven to be one of the most trustworthy and successful methods for removal.

Sebaceous cyst removal using electrolysis is not strictly ‘removal’ but rather ‘treatment’. A fine probe is inserted into the cyst and the Radio Frequency energy release thus softening or desiccating the contents.  There is no clinical research into whether the ‘sac’ is treated but procedures using this method have reported no re-growth to date.

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Radina Simeonova is associate author with Sterex Ltd, expert in electrolysis - the permanent hair removal and also offering epilation equipment, age spot removal, sebaceous cyst removal, thread vein and skin tag removal.