Cyst

Overview

A cyst is a small closed pocket or sac that forms under the skin or inside the body. It usually looks like a lump and can be filled with fluid, air, or soft material. Most cysts are harmless and grow slowly. Some sit just under the skin where you can feel them, and others are found inside the body during a scan for something else. A cyst is not the same as a cancer, but any new or changing lump should be checked by a doctor so you know for sure what it is.

Yes. Skin cysts are very common and many people have one at some point. Cysts inside the body are also found often, usually by chance on scans.

Anyone can get a cyst, at any age. Some types are more common in adults, some appear in children, and some run in families. Things like blocked glands, skin damage, and certain long-term conditions can make cysts more likely.

Symptoms

Common symptoms

• A round or oval lump that feels smooth and moves a little when you press it
• A lump that grows slowly over months or stays the same size
• A small dark dot in the middle of the lump (common in some skin cysts)
• Mild soreness or tenderness when pressed
• Thick, pale, cheesy-smelling material that leaks out if the cyst bursts
• Redness, warmth, or pain if the cyst becomes inflamed or infected
• No symptoms at all — many cysts are found by accident

Symptoms in children

• Small lumps on the scalp, face, neck, or around the eyes are the most common types in children
• Some cysts are present from birth and grow slowly with the child
• Most are painless, but a child may complain if one becomes sore or catches on clothing
• Any lump that is getting bigger, changing shape, or is in the middle of the back or near the spine should be checked by a doctor

Symptoms in older adults

• Skin cysts are more common as skin gets older and drier
• Internal cysts are often found on scans done for other reasons and are usually harmless
• A lump that has been there for years but starts to grow, change colour, bleed, or become painful should be checked promptly
• Older skin is more easily damaged, which can lead to cyst formation

Causes

Main causes

• Blocked skin glands or hair follicles that fill with fluid or soft material
• Skin cells that get pushed deeper into the skin and form a sac (this is what happens in the most common type of skin cyst)
• Infection or inflammation of a gland or follicle
• Wear and tear around a joint or tendon, which can cause a fluid-filled swelling
• Some cysts form before birth as part of how the body develops
• A small number of cysts are linked to inherited conditions that affect the skin or internal organs

Risk factors

• A family history of cysts
• Damaged or sun-damaged skin, or skin that has been injured or scarred
• Acne or other skin conditions that block follicles
• Smoking (linked to some types of skin cysts)
• Getting older
• Certain inherited conditions, such as ones that cause many lumps on the skin or cysts inside organs

When to see a doctor

See a doctor urgently if:

• The lump is hot, very painful, or leaking pus
• Redness or swelling around the lump is spreading
• You have a fever with the lump
• The lump is bleeding or has burst and will not heal
• The lump is making it hard to breathe, swallow, move a limb, or pass urine

Book a routine appointment if:

• You have a new lump you are unsure about
• A lump is getting bigger or changing shape, colour, or feel
• The lump is in a place that catches on clothes or bothers you
• You want to know what the lump is and whether it needs treatment
• A lump keeps coming back after it has been drained

Diagnosis

In most cases a doctor can tell what a lump is by asking you questions and feeling it. They will look at the size, shape, and movement of the lump, and check the skin over it. If anything is unclear, or if the lump is deep inside the body, they may arrange a scan or a small sample. If a cyst is removed, it is often sent to a laboratory to confirm exactly what type it was.

Tests that may be done

• A physical examination — the doctor feels the lump and checks the skin around it
• An ultrasound scan, which uses sound waves to show whether the lump is fluid-filled or solid
• A fine needle sample, where a thin needle takes a little fluid or cells to look at under a microscope
• Blood tests if infection or another condition is suspected
• A CT or MRI scan for cysts deeper inside the body
• Laboratory testing of a cyst after it has been removed

What to expect at your appointment

The appointment is usually quick and painless. You may be asked when you first noticed the lump, whether it has changed, and whether it is sore. If a scan or sample is needed, it is usually done within a short time and you can go home the same day. You should get clear information about what was found and what, if anything, happens next.

Treatment

Most cysts need no treatment at all. If a cyst is small, painless, and not changing, the usual advice is to leave it alone and keep an eye on it. Treatment is considered when a cyst is sore, infected, growing, in an awkward spot, or bothering you for cosmetic reasons. Options range from simple self-care to a minor procedure to remove it.

Self-care at home

• Keep the area clean and dry, and wash gently with mild soap and water
• Do not squeeze, pick, or try to pop the cyst — this can cause infection and scarring
• Do not try to cut it out yourself
• A warm, clean compress for 10 to 15 minutes a few times a day can help ease tenderness
• Cover a burst cyst with a clean dressing and keep it clean while it heals
• Take a photo every few weeks so you can see whether it is changing
• See a doctor if it becomes hot, very painful, or starts leaking pus

Medical treatments

If a cyst is inflamed or infected, your doctor may suggest ways to calm it down, which can include a small procedure to drain it, an injected medicine to reduce swelling, or treatment for infection if one is present. Your doctor or pharmacist will explain the options and any risks, and will help you decide what fits your situation. Draining a cyst often gives quick relief, but the cyst can come back because the sac that makes it is still there.

When is surgery considered?

Surgical removal is the most reliable way to stop a cyst from coming back, because the whole sac is taken out. This is usually a short, minor procedure done with local anaesthetic (numbing medicine) so you stay awake and the area does not hurt. It may be recommended if the cyst keeps coming back, gets infected often, is large, is in a place that is easily irritated, or if the doctor is not sure what it is. There is usually a small scar, and your doctor will explain the risks and aftercare.

Living with this condition

For most people a cyst is a minor nuisance rather than something that changes daily life. You can work, exercise, and wash as normal. The main things to do are to leave it alone, keep the skin clean, and check it now and then for changes in size, colour, or tenderness.

Lifestyle tips

• Avoid tight clothing or straps that rub against the lump
• Keep your skin clean and moisturised, and avoid harsh scrubbing
• Do not use sharp tools, tweezers, or needles on a lump
• Notice and note any change, and take a photo if that helps you track it
• Keep up with any follow-up appointments your doctor suggests

Diet and exercise

There is no special diet that gets rid of a cyst, and no food has been shown to cause or cure common cysts. Eating a varied, balanced diet and staying active support your general health and help your skin and immune system work well. If a cyst is sore, you may want to avoid pressure or friction on that area while you exercise, but you do not usually need to stop being active.

Mental health and emotional wellbeing

It is very common to feel worried about a new lump, especially while you are waiting for a check-up. A cyst in a visible place can also make you feel self-conscious. These feelings are understandable and usually settle once you know what the lump is. If worry is affecting your sleep, mood, or daily life, talk to your doctor — support is available and you do not have to cope alone. If you ever feel unable to cope, contact your local emergency number or a crisis line in your country straight away.

Prevention

You cannot fully prevent most cysts, especially the ones that come from how skin cells grow. But you can lower the chance of problems by looking after your skin: keeping it clean, avoiding harsh products, not squeezing lumps, and protecting skin from injury and sun damage. If you have a condition that causes repeated cysts, your doctor can advise on skin care and treatment.

Screening programmes

There is no routine screening programme for cysts. The practical approach is to check your own skin now and then, and to have any new, changing, or unusual lump looked at by a doctor.

Complications

If left untreated

• Infection, which can turn a cyst into a painful abscess (a pocket of pus)
• Rupture, where the cyst bursts under the skin and causes redness, swelling, and soreness
• Scarring, especially if the cyst is squeezed, picked, or bursts
• Gradual growth, which can become uncomfortable or unsightly
• Rarely, a lump that looks like a cyst turns out to be something else that needs treatment

Long-term outlook

The outlook is very good. Most cysts are harmless, cause no trouble, and never need treatment. If one does need removing, it is usually a short, straightforward procedure, and most people recover quickly with a small scar. Having a lump checked early is the simplest way to keep things on track — and in the great majority of cases, the news is reassuring.

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