Cysts

A cyst is a closed sac under the skin filled with material. That material may be liquid, soft or hard (calcified and scarred). They can be found anywhere on the body. They are usually slow-growing, painless, freely movable lumps beneath the skin. Occasionally, however, a cyst will become inflamed and tender.

When treatment is desired, cysts are usually easily treated as an in-office procedure with local anesthesia. Treatment options include (1) injection of a steroid medication into the cyst in order to reduce inflammation (2) drainage and (3) complete surgical removal.

There are literally hundreds of different kinds of lumps, bumps and cysts associated with the skin. Fortunately, the vast majority of these are harmless and painless. The chart below provides a guide for some of the most common forms of skin lumps, bumps and cysts.

Dermatofibromas

Dermatofibromas are firm bumps, or nodules, that form in the deep layers of the skin. Dermatofibromas are harmless and common. They tend to occur in response to an injury, even minor events like an insect bite. This makes them more likely to appear on the arms and legs. Dermatofibromas may persist for years or indefinitely.

They can appear pink or dull red, or can resemble a mole (nevus). They are usually small (about a quarter- to a half-inch wide) but can grow to be over an inch in diameter. When pinched, dermatofibromas tend to create a dimple on the skin where the nodule attaches to the upper layers of the skin.

There is no prevention if the skin responds to injury by producing a dermatofibroma growth. They are benign lesions so can be left alone without treatment. If they are painful or their presence is bothersome (for example - easily traumatized by shaving) they can be removed with minor surgery.

Epidermoid Cysts (Sebaceous Cysts)

Cysts are growths in the deeper layers of the skin. They are small closed sacs containing fluid or solid material composed of dead skin cells. There are many types of cysts of different sizes that appear on various parts of the body. Ruptured cysts can become inflamed (red and painful) and discharge pus. Occasionally cysts become infected and resemble a boil. Cysts may require minor surgery to be removed.

Treatment

  • Antibiotics might be prescribed if there is an underlying infection
  • Dermatologist removes the discharge and the sac (capsule) that make up the walls of the cyst to prevent recurrence

Folliculitis

Folliculitis is an inflammation of one or more hair follicles. It appears as a rash or white-headed pimples or pustules near a hair follicle. It can occur anywhere on the body, but typically affects hairy areas, such as the neck or groin. Follicles can be damaged from repeated friction (such as rubbing of too tight clothes) or blockage of the hair follicle (for instance, from shaving). In most cases, follicles become infected with Staphylococcus bacteria.

There are two types of folliculitis:

Superficial Folliculitis affects the upper area of the hair follicle and may cause red, inflamed skin, small clusters of red bumps, blisters that break open and crust over and/or itchiness and tenderness. When the infection occurs in men’s’ beards, it is called Barber’s Itch.. When it is caused by a fungal infection, it is known as Tinea Barbae (ringworm).

Deep Folliculitis affects the entire follicle from its deepest parts under the skin to the surface of the skin. This less-common form of folliculitis is seen in people who are undergoing chronic acne antibiotic treatment, people with HIV or people with boils and carbuncles.

Treatment

  • Antifungal medications
  • Oral antibiotics
  • Topical medications
  • Eliminating the cause

Keratosis Pilaris

Keratosis pilaris is a very common condition in which there are numerous rough follicular spots, which may be skin-coloured, red or brown. Most often they arise on the outer aspect of the upper arms. They may also occur on the thighs and cheeks, and less often on the forearms and upper back. Keratosis pilaris is most obvious during the teenage years and may also be present in babies and persist into adult life. However, it is uncommon in elderly people. It is particularly prevalent in those who are overweight, or have atopic dermatitis or ichthyosis. Keratosis pilaris tends to be more severe during the winter months or other times of low humidity when skin dries out. Although unsightly at times, it is completely harmless.

Treatment

  • Usually does not require treatment
  • In most cases disappears on its own by age 30
  • Intensive moisturizing is the first line of treatment
  • For more difficult cases, use of medicated creams with urea or alpha-hydroxy acids

Lipomas

Lipoma is a fatty lump or tumor that is typically located between the skin and the underlying layer of muscle. These growths are slow-growing and easy to identify since they are palpable to touch. Fatty tumors of lipoma can occur at any age, but are most commonly detected during middle age. It is important to note that lipomas are not cancerous and do not usually indicate future harm. However, if the growth is bothersome, continues to grow, or becomes painful, lipomas can be removed with in-office surgery.

Neurofibromas

Neurofibromatosis is a genetically inherited disorder of the nervous system (brain and spinal cord) which mainly affects the development of nerve cell tissues, causing tumors (neurofibromas) to develop on nerves, and may cause other abnormalities.

Characteristics

  • Soft fleshy growths under the skin
  • Slow growing and generally benign and painless
  • Pain may indicate a need for medical attention
  • May experience an electrical shock at the touch

Treatment

  • Usually does not require treatment, particularly if it does not cause any symptoms
  • If it affects a nerve, it may be removed surgically

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