Epidermal Cyst: Symptoms, Causes, Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Koppisetti Satya Naga Ravi Teja , Dermatologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Epidermal Cyst, also known as an epidermoid cyst, is a common, benign, slow-growing skin cyst that develops when epidermal (skin) cells become trapped beneath the skin surface. The cyst is filled with keratin, a soft, cheese-like material, and most commonly appears on the face, neck, scalp, trunk, or back. Although usually painless, it can become inflamed, infected, or rupture, causing redness, swelling, pain, and drainage. Early diagnosis and appropriate treatment are important to relieve symptoms, prevent infection, and reduce the risk of recurrence.

What are the Symptoms of Epidermal Cyst?

While many epidermal cysts remain asymptomatic, they can sometimes cause discomfort or other noticeable symptoms:

Visible Lump: The most obvious symptom is a small, round bump under the skin.
Tenderness: If the cyst becomes inflamed or infected, it may become tender or painful to the touch.
Redness and Swelling: Infected cysts may also exhibit redness and swelling.
Foul Odor: If the cyst ruptures, it may release a foul-smelling, cheesy-like substance.

What are the Common Causes and Risk Factors of an Epidermal Cyst?

Epidermal cysts develop when epidermal cells become trapped beneath the skin instead of being shed normally. These cells continue producing keratin, which gradually accumulates inside the cyst.

Although most epidermal cysts cannot be prevented, avoiding repeated skin trauma and treating acne promptly may reduce the risk of developing new cysts.

Causes

Blocked hair follicles
Trapped epidermal cells beneath the skin
Skin injury or trauma
Acne-related skin damage
Rare inherited genetic disorders

Risk Factors

Acne-prone skin
Previous skin injuries
Male sex
Middle adulthood
Certain genetic conditions such as Gardner syndrome

When to See a Doctor for an Epidermal Cyst?

Individuals with a rapidly growing skin lump, painful swelling, recurrent cysts, or signs of infection should consult a Dermatologist or General Surgeon for evaluation and treatment.

You should see a doctor if you experience:

A cyst that continues to enlarge
Pain, redness, or swelling around the cyst
Recurrent or multiple epidermal cysts

Seek immediate medical attention if you:

Develop severe pain with spreading redness or fever
Notice significant pus drainage or foul-smelling discharge
Experience rapid swelling suggesting an abscess or severe infection

These symptoms may indicate an infected cyst requiring urgent medical treatment.

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How Are Epidermal Cyst Diagnosed?

Diagnosing an epidermal cyst typically involves a physical examination by a healthcare provider. The provider may inspect the cyst's appearance, size, and location. In some cases, additional tests, such as ultrasound or biopsy, may be required to rule out other conditions or confirm the diagnosis.

Doctors may also review the patient's medical history and check for signs such as a central punctum (a small opening on the cyst), which is characteristic of epidermal cysts. Imaging studies like ultrasound can help differentiate cysts from other soft tissue lumps. If there is suspicion of infection, redness, or rapid growth, further evaluation may be needed. In rare cases, a biopsy or removal of the cyst followed by laboratory analysis is performed to exclude malignancy or other skin conditions.

What are the Treatments for Epidermal Cyst?

Treatment for epidermal cysts includes observation, medications for infection, and minor surgical removal to eliminate the cyst and prevent recurrence.

Non-Surgical Treatments

In many cases, epidermal cysts do not require treatment and may resolve on their own. However, if the cyst is symptomatic or causes cosmetic concerns, several non-surgical options are available:

Warm Compresses: Applying warm compresses to the cyst can help reduce inflammation and promote drainage.
Topical Antibiotics: If the cyst is infected, topical antibiotics may be prescribed to control the infection.
Steroid Injections: Corticosteroid injections can reduce inflammation and shrink the cyst.

Surgical Treatments

For persistent, symptomatic, or large cysts, surgical removal may be necessary. Surgical options include:

Incision and Drainage: This procedure involves making a small incision in the cyst and draining its contents. While practical, it may not remove the cyst entirely, leading to recurrence.
Excisional Surgery: Complete removal of the cyst and its capsule is the most definitive treatment. This can be done under local anaesthesia and typically involves minimal scarring.

Infected Epidermal Cyst Treatment

Infected epidermal cysts require prompt medical attention. Treatment options include:

Antibiotics: Oral or topical antibiotics may be prescribed to treat the infection.
Incision and Drainage: Similar to non-infected cysts, an incision and drainage procedure can help alleviate symptoms.
Surgical Removal: In some cases, complete surgical removal of the cyst may be necessary to prevent recurrence.

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What is the Recovery Process for an Epidermal Cyst?

Recovery is usually excellent after complete removal of an epidermal cyst. Most individuals resume normal activities within a few days, while complete wound healing may take several weeks. Removing the entire cyst wall significantly reduces the chance of recurrence.

Keeping the surgical area clean, following wound care instructions, avoiding squeezing or picking at the cyst, attending follow-up appointments, taking prescribed medications if needed, and reporting signs of infection promptly help support complete recovery.