What Are Epidermoid And Pilar Cysts (Sebaceous Cysts)
They are benign (non-cancerous) and usually cause no harm or problems. If required, they can usually be removed easily by a small operation done under local anaesthetic. The main reason why some people want them removed is for cosmetic reasons, as they can look unsightly.
More About Epidermoid And Pilar Cysts
Sebaceous Cysts are sacs that are filled with a white toothpaste like material. They develop in various places in the body and arise from different tissues in the body. Two of the most common types of cyst that occur under the skin surface are epidermoid and pilar cysts. The term sebaceous cyst is not strictly speaking correct, but still widely used.
- An epidermoid cyst is a lump where the sac forms from cells that normally occur on the top layer of the skin (the epidermis).
- A pilar cyst is a lump where the sac forms from cells similar to those that are in the bottom of hair follicles (where hairs grow from).
In both cases, the pasty content of the cyst looks a bit like toothpaste. This substance is keratin. Keratin is made by skin cells and is the substance that hairs are made from and the substance that covers the top layer of the skin. You can see the same kind of substance around the root of a hair when you pull it out.
What do these cysts look like and what are their symptoms?
Both epidermoid and pilar cysts are smooth round lumps which you can see and feel just beneath the skin surface. They are very common. Often they are small (pea size) but sometimes they slowly get bigger over many months to become a few centimeters in diameter. They look very similar to each other but can be distinguished from each other if the cells that form the cyst sac are looked at under the microscope.
Where Can They Grow?
- Epidermoid cysts can affect anyone but are most common in young and middle-aged adults. They can appear anywhere on the skin but develop most commonly on the face, neck, chest, and upper back.
- Pilar cysts can affect anyone but are most common in middle-aged women. They can appear anywhere on the skin but develop most commonly on the scalp. It is common for several to develop at the same time on the scalp.
What Symptoms Can They Cause?
- They become infected, when they may become red, inflamed and painful. A course of antibiotics will usually clear an infection if it occurs.
- The cyst may leak the toothpaste-like material on to the skin if the cyst is punctured or damaged. This can have a certain unpleasant smell.
- A crust may grow on the skin over the cyst.
- A cyst can very occasionally form in an uncomfortable place such as in the genital skin or beside your nail.
What causes epidermoid and pilar cysts?
It seems that some cells that are normally near to the surface of the skin (cells of the epidermis or cells in hair follicles) get into deeper parts of the skin but continue to multiply. This may occur for various reasons – for example, following an injury to the skin. The cells that multiply form into a sac and produce the keratin that they would normally make on the top layer of the skin. The keratin becomes soggy and forms into a toothpaste-like substance.
A tendency to form pilar cysts runs in some families. So, there is a genetic factor in some cases. Epidermoid cysts in themselves are not hereditary and most form for no apparent reason in healthy people. However, some people with rare syndromes have many epidermoid cysts as one of their features.
Are epidermoid and pilar cysts harmful?
No, they are almost always benign. That is, they are not cancerous, do not spread to other parts of the body or cause any serious problems. Very rarely (we have never seen a case, yet), a skin cancer may develop from an epidermoid or pilar cyst. If they do not bother you then it is best just to leave them alone.
Skin Surgery For Cyst Removal:
*Cost of removal of a cyst: £240
The cost of surgery for cyst removal is typically £240 for a small cyst. Click here for more detailed pricing. Please be aware lab and consultation are charged separately
When would you consider cyst removal?
- They are sometimes easy to catch and traumatise. This typically occurs on the scalp when combing hair.
- If the cyst has become infected or irritating (often best to treat with Antibiotics and to wait until the infection is settled and it is smaller again due to better cosmetic results).
- It is growing.
- For cosmetic reasons
- They can smell quite pungent
How Skin Surgery For Sebaceous Cysts Is Performed
If the cyst is infected and has formed an abscess around it, which cannot be controlled with antibiotics it has to be lanced and the abscess laid open and drained. Once the abscess has receded and the infection settled the cyst should then usually be removed in full, as outlined below. Lancing the cyst will usually only provide a temporary solution as the capsule is not removed.
The complete cyst can usually be easily removed by a simple operation. The surrounding skin is numbed by injecting some local anaesthetic. A small incision (cut) is made over the cyst. The cyst is carefully dissected. The wound is then closed. A small scar will result. Sometimes, after the removal of a cyst, it gradually regrows in the same site under the scar. This is unusual (we have not had a case yet) but, if it occurs, it can be removed again.
If you wish to make an appointment you can contact us or book your cyst removal appointment online. Alternatively you can ask for a telephone consultation. If you do so, please read the section “How TVVS works”, thoroughly. If you are worried about pain, please click here to see how we provide painfree surgery.
For more information look at patient.info.
For a glossary on minor surgery terms, click here
Locations Appropriate for Referral or Treatment:
We provide Minor Surgery / Skin Surgery for Lipomas, Cysts, Warts, Moles, Skin Tags, Xanthelasmas and Split Earlobes in Maidenhead, Berkshire, which is near Windsor and Ascot and Heathrow Airport and close to London, South Buckinghamshire, South Oxfordshire, Hampshire and Surrey. We are adjacent to Henley-On-Thames, Marlow, and Twyford. We are close to Slough, Bracknell, Basingstoke, Egham, Gerrards Cross, Chalfont St Peter, Northolt, Harrow, Wembley, Rickmansworth, Richmond, Twickenham, Staines, Virginia Water, Sunningdale and Sunninghill, Ruislip, Reading, Wokingham, West Drayton, Uxbridge, Farnborough, Woking, Guildford. Oxford, Banbury, Milton Keynes, Coventry, Essex, Sussex, Kent, Swindon, Portsmouth, Bristol, Bath, Brighton, Eastborne and Southhampton are all no more than an 45 minutes to 2 hours away. We are also accessible to certain locations in South Wales