My experience with a cyst

I had a cyst on my left back shoulder for the longest time and it had not given me any problems.

How does a sebaceous cyst look like? It could be a round or dome-shaped lump, with a dark dot in the centre. It could range from very small (0.5cm) to big (5cm). There could be skin discolouration such as redness, tender or warm to touch and sometimes, it could move easily.

What causes a sebaceous cyst? According to Cleveland clinic, it is formed when there is a pocket created just underneath the skin, which allows dead skin cells and a protein called keratin that are present to help form our skin’s outer layer (epidermis), to be trapped in there. The pocket could be caused by a skin trauma or an injury like a scratch or a condition like acne, which could disrupt and pushes the skin cells below the epidermis into the second layer called dermis.

Different layers of our skin. Image from VectorStock.

In my case, I discovered I got two such cysts side-by-side. One of it was about the size of a 20-cent coin and white with a dark dot in the centre. The other one, which I recently found out through this episode, was already swelling badly and it was painful. Normally, such type of cysts is asymptomatic. It usually does not cause discomfort to the person unless it becomes swollen and gets infected like in my case. It can also become itchy, which could be a sign that the cyst has ruptured and pus could be observed.

The infected cyst on the left was swollen red with the ruptured site exposed. The uninfected one right beside it.

At this point, it would be better to seek treatment at a GP soon. The reason being a ruptured cyst exposes you to bacteria. In my case, a swab test on my ruptured cyst found there was Staphylococcus epidermidis, a common type of bacteria normally found on the skin. The doctor will prescribe antibiotics and would refer you to a general surgeon for the next steps. You can either choose to wait and see if the swelling goes away (not applicable if it has ruptured), or you can ask a surgeon to get it removed completely. This is because the cyst resides in a capsule, which has to be removed surgically to prevent a recurrence.

By Photo Credit: Janice CarrContent Providers(s): CDC/ Segrid McAllister - This media comes from the Centers for Disease Control and Prevention's Public Health Image Library (PHIL)

Where else can a sebaceous cyst form? It can form on the face, chest, back, scalp, neck, legs, arms and genitalia.

As my condition was pretty bad - an infected ruptured cyst and a not yet ruptured one beside it and vulnerable to getting infected as well. Therefore, the doctor recommended me to have it removed completely.

Surgical excision of a sebaceous cyst can be done under local anaesthesia. The surgeon would inject anaesthetic around the area where the cyst is. Thereafter, the surgeon would carefully make a small cut over the cyst to drain out the collection of fluid and remove the capsule, which is critical to prevent a cyst from growing back. If you are interested, there are many clips on YouTube that show you how it is be done. Here is one of them below for you to watch. I think it is helpful, as it allowed me to understand how it is usually done.

For my case, I chose to undergo general anaesthesia for this procedure. The surgeon told me it is a simple procedure that will take about 30 minutes to complete. I don’t think I could stay still lying on the operating bed on one side for such a long time. Moreover, I was not prepared to hear the whole procedure happening behind my back that may make me more nervous than I already am.

The procedure went smoothly and I felt alright with some tightness and pain around my left back shoulder. There will be a small scar after the skin heals, which could take about month, but I think it is not an issue for me. In my situation described earlier, I would opt to remove it completely for a peace of mind.

In summary, a sebaceous cyst could form on almost any parts of our body and that is usually due to a skin trauma, injury or condition. It is not contagious and can opt to remove it surgically in a simple procedure. If it becomes infected, the doctor will prescribe antibiotics and monitor your condition. You must never self-treat an infected cyst as you could expose yourself to bacteria infection. Removing the capsule that forms in the pocket surgically is essential to prevent it from growing again.

There will be a follow up blog to cover how much this procedure cost. So be sure to come back to The Frankly to find out.

More info on sebaceous cyst: Click here

More info about keratin: Click here

More info on types of bacteria found on our skin: Click here