Cysts are common benign bumps beneath the skin. They may develop from a block pore or oil gland. Skin cells and debris develop underneath the skin surface. This causes inflammation to develop and it becomes encapsulated or walled off by the body. Cysts may increase in size over time and result in intermittent drainage that has a characteristic odor. They may become infected, however inflammation more commonly occurs when the cyst is active and producing more debris within the capsule. During periods of inflammation, the cyst may become locally tender, increase in size, and develop overlying redness. This redness generally does not extend beyond the cyst boundaries. During periods of inflammation, patients may benefit from incision and drainage (which decompresses the cyst and reduces the inflammation) or steroid injection. Risks and benefits of both approaches will be discussed in consultation.
For cysts that are asymptomatic, elective excision is an option for cosmesis. During this procedure, the blocked pore (referred to as the punctum) is removed through a small ellipse overlying the cyst. Carefully resecting the punctum as well as cyst capsule may lower the risk of recurrence.