Cysts are balloon-like structures in the skin filled with solid or fluid material. They most often contain sebaceous material, the oily substance that would normally be present on the surface of the skin for normal lubrication. The cyst occurs when the hair follicle becomes blocked. Sometimes the patient has a hereditary propensity to develop cysts. Sometimes this goes along with oily skin and acne. Sometimes cysts may occur randomly. Cysts can occur anywhere on the body, although the face, neck, back and area behind the ears are the most common sites. They may become ruptured or infected.
Cysts can range in size from tiny to huge. Small cysts can easily be expressed within seconds with a comedone or cyst expresser. Larger cysts may need a longer period of time to be spent on surgical removal or simply be lanced to remove most of the cyst contents. Cysts may stay in the skin for years, but they may also increase in size or rupture, which causes them to become tender, red and infected. Such cysts need drainage and may also require an oral antibiotic. Cyst removal is typically done through surgical excision. A small incision is made in the area of the cyst and then the cyst and surrounding tissue will be removed to ensure complete excision. A local anesthetic is used for this procedure. Most cysts do not return when thoroughly removed. Some patients are left with a small scar after a cyst is removed, which can be further treated with a reconstructive treatment, although most scars will fade over time.
A mucoid or myxoid cyst is a fluid-filled cyst that commonly develops over the joints of the fingers or toes. This type of cyst is considered to be similar to a ganglion cyst, which develops on the joints of the hand or foot, but only appears on the digits. It feels like a firm, rubbery lump and is not usually painful unless it grows large enough to put pressure on a nerve. It is caused from a leakage of the synovial or joint fluid going out of the joint space and pushing out more to the surface. Treatment for a mucoid cyst often involves draining the clear gelatinous fluid with a sterile needle. Sometimes we add an injection of intra-lesional dilute corticosteroid. Draining the fluid can also help relieve any symptoms caused by larger cysts. Some of these cysts may recur after initial treatment.