Dermoid ovarian cyst

Overview

A dermoid ovarian cyst is a sac-like growth that can form on or inside an ovary. It is filled with tissue that looks like skin, hair, teeth, or fat. Most dermoid cysts are not cancerous, but they can grow large and cause problems.

Dermoid ovarian cysts are relatively common. They are the most common type of ovarian cyst in women of childbearing age and account for about 20% of all ovarian cysts.

They most often affect women between the ages of 20 and 40, though they can occur at any age, including during teenage years and after menopause.

Symptoms

Common symptoms

• No symptoms at all (many are found by chance during an ultrasound for another reason).
• A dull ache or heavy feeling in the lower belly or pelvis.
• Pain during sexual intercourse.
• Irregular periods or heavy bleeding.
• Feeling full quickly when eating.

Symptoms in children

• Nausea or vomiting.
• Abdominal pain (often on one side).
• A lump felt in the belly.

Symptoms in older adults

• May have no symptoms.
• If the cyst twists (ovarian torsion), sudden severe pain may occur.
• Vague abdominal discomfort or bloating.

Causes

Main causes

• Dermoid cysts form from cells that are present from birth. These cells can develop into different types of tissue, like skin or hair. They are not caused by hormones or lifestyle.

Risk factors

• Being of childbearing age (most common).
• Having a family history of ovarian cysts (rare).
• Having certain genetic conditions (like Turner syndrome or Swyer syndrome).

When to see a doctor

See a doctor urgently if:

• If you have sudden severe pain in your lower belly or pelvis.
• If you have pain with fever, nausea, or vomiting.

Book a routine appointment if:

• If you have ongoing pelvic pain, bloating, or changes in your periods.
• If you feel a lump in your belly or have pain during sex.

Diagnosis

Dermoid ovarian cysts are often found during a pelvic exam or an ultrasound. Your doctor may also use other imaging tests to see the cyst more clearly.

Tests that may be done

• Pelvic exam – your doctor feels for any lumps or tenderness.
• Ultrasound (transvaginal or abdominal) – uses sound waves to create a picture of the ovary and cyst.
• MRI or CT scan – sometimes ordered for a detailed look.

What to expect at your appointment

Your gynaecologist will explain the size and appearance of the cyst. Most dermoid cysts have a typical look on ultrasound (like a mixture of fluid and solid parts). If the cyst looks suspicious, you may need blood tests to help rule out cancer, but this is uncommon.

Treatment

Treatment for a dermoid ovarian cyst depends on its size, symptoms, and whether you plan to have children in the future. Most cysts are removed surgically, but small, symptom-free cysts may just be watched.

Self-care at home

• If you have mild discomfort, rest and apply a warm compress to your lower belly.
• Avoid heavy lifting or intense exercise if the cyst is large.
• Take over-the-counter pain relief (like paracetamol or ibuprofen) if needed, but talk to your pharmacist or doctor first.

Medical treatments

For cysts that cause symptoms or are large, the standard approach is surgery. Surgery can be done with keyhole (laparoscopy) or through a larger cut (laparotomy). The goal is to remove the cyst while keeping as much healthy ovary as possible. Hormonal treatments like birth control pills do not shrink dermoid cysts and are not used for treatment.

When is surgery considered?

Surgery is usually recommended if the cyst is larger than 5–10 cm, causes pain, has suspicious features on ultrasound, or is at risk of twisting (ovarian torsion). In most cases, only the cyst is removed (cystectomy), but sometimes the whole ovary may need to be taken out (oophorectomy).

Living with this condition

If you have a dermoid cyst that is being watched, you can live normally. Attend your follow-up appointments and call your doctor if you get new pain. After surgery, recovery usually takes a few weeks.

Lifestyle tips

• Listen to your body – if you feel pain, take a break.
• Maintain a healthy weight to reduce pressure on your pelvis.
• Stay active with gentle exercises like walking or swimming after you recover.

Diet and exercise

Eat a balanced diet to support overall health. There is no special diet for dermoid cysts. After surgery, start with light activity and increase gradually as advised by your surgeon.

Mental health and emotional wellbeing

Having any ovarian cyst can cause worry, especially about cancer or fertility. Most dermoid cysts are benign. Talk to your healthcare provider about your concerns. If anxiety affects your daily life, consider speaking to a counsellor or calling a mental health helpline.

Prevention

There is no known way to prevent dermoid ovarian cysts because they form from cells present from birth. They are not linked to lifestyle or diet.

Screening programmes

There is no routine screening for dermoid cysts. Some are found during a pelvic exam or ultrasound done for other reasons.

Complications

If left untreated

• Ovarian torsion (twisting of the ovary) – causes sudden severe pain and requires emergency surgery.
• Rupture – the cyst bursts, which can cause sharp pain and internal bleeding.
• Infection – rare but possible if the cyst becomes infected.
• Rarely, a dermoid cyst can become cancerous (this happens in less than 2% of cases).

Long-term outlook

The outlook for people with dermoid ovarian cysts is very good. Most are benign and can be successfully treated with surgery. After treatment, most women go back to normal life and can still have children if their ovaries are preserved. Regular follow-up is important to check for new cysts.

Find support

Local organisations

• Your local hospital or gynaecology clinic · International

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