The Toronto Dermatology Centre is one of the best places in Toronto to manage your skin lesions such as epidermoid cysts or sebaceous cysts. Our staff of outstanding Toronto dermatologists offer both a comprehensive assessment and diagnosis of your skin lesions, and also discuss all the best treatment options.
Epidermoid cysts form as a result of the growth of epidermal cells within a focal area of the dermis. The easiest way to understand these cysts is to think of them as a very deep whitehead that cannot be removed without help from a physician.
Most epidermoid cysts grow slowly and do not cause any problems. However, because of trauma or other factors (e.g. they can rupture on their own if they get too big), cysts can become inflamed and less commonly infected which results in redness, tenderness and pain. Epidermoid cysts can occur at any age, but are more common in young adulthood, and appear to be more common in men. Epidermoid cysts are also commonly referred to as “sebaceous cysts.”
Patients with sebaceous or epidermoid cysts present to clinic for a variety of reasons, including the cosmetic appearance of a lump on their body, the odiferous cheese/curd-like material that can be extruded, or because of discomfort associated with inflammation or infection. Most often the “infected cyst,” is really just inflamed due to rupture of the cyst contents into the dermis (mid-level of skin).
Clinically, the lesions appear as firm, round, flesh-colored nodules of various size, often with a central punctum. The
most commonly affected areas are the head and neck and trunk. Cysts have also been reported on oral, genital (e.g. after female circumcision), and ocular mucosae, and pretty much anywhere on the body.
The cause is not quite clear, but some factors which may play a role include occlusion of the pilosebaceous unit, HPV infection, or traumatic implantation of epidermal elements. The diagnosis of epidermoid cysts is usually made clinically. Sometimes epidermoid or sebaceous cysts run in the family (inherited).
Epidermoid cysts require treatment only if symptomatic or if the patient wants it removed for cosmetic purposes. A tender, inflamed, uninfected cyst often benefits from intralesional triamcinolone acetonide (Kenalog®) injection of 10-40mg/mll sometimes a few treatments are required. For cysts presumed or proven to be infected, incision and drainage is recommended following by oral anti-staphylococcal antibiotics.
Epidermoid or sebaceous cysts are safely excised by your physician under local anesthetic (typically 15-20min and no down time) and it is important that the “sac” is removed, not just the white gunky contents. Squeezing or puncturing a cyst or incising/draining can reduce temporarily the size of the cyst, but it will always regrow unless the sac is removed surgically. These cysts are excised using a classic large incision, mini incision, or trephination with a punch biopsy device. Mini-incisions or punch biopsy trephination is more popular now as recurrence rates are relatively low (less than 10%) and the scar size is minimized.
We regularly remove and treat epidermoid cysts at Toronto Dermatology Centre; it is a common, effective, and safe treatment.
*Result may vary from person to person.
Here is a selection of medical scientific articles by our expert dermatologists Dr. Benjamin Barankin and Dr. Anatoli Freiman as they pertain to cysts:
Toronto Dermatology Centre is located in Toronto, Ontario, and serves men and women in North York, Vaughan, Richmond Hill, York, Aurora, Thornhill, Mississauga, Scarborough, Brampton, Etobicoke, Pickering, Peterborough, Guelph, Kitchener, Oakville, Barrie and all of Greater Toronto (GTA).