If these small bags appear on your skin, they may not be acne, so don’t squeeze them!

I believe that many people have seen this kind of small "pimples" that appear inexplicably on the skin. Do you feel the urge to squeeze them? Especially when you see the white and yellow secretions slowly flowing out, you will feel so happy...

Image source: References

If you often do this, stop and take a look! The small bag that you keep squeezing as a pimple is likely to be an epidermoid cyst.

1. How do epidermoid cysts appear?

Epidermoid cyst is a common skin cyst, also known as keratinous cyst, infundibulum cyst, epidermal inclusion cyst, etc.

Epidermoid cysts usually have no symptoms. They can appear in many parts of the body, but are more common in the head and neck, trunk, and parotid area. In addition, epidermoid cysts may also appear on the palms, soles, surgical wounds, etc. Epidermoid cysts in the skull and spinal canal are relatively rare. They are usually formed when the neural tube separates from the ectoderm and closes in the early embryonic development, and the skin appendages are buried in the skull or spinal canal.

Epidermoid cysts are usually caused by the following factors:

① During the embryonic period, abnormal development of the ectoderm may lead to cysts in the skin tissue. Such cysts usually appear as single or multiple cysts on the skin surface, with local skin pigmentation or hypopigmentation.

② When the skin is damaged due to trauma, the skin's defense function decreases, and bacteria, dust and other substances can easily invade the skin, forming foreign body wrapping and gradually developing into cystic lesions. In addition, skin trauma may also cause skin tissue or foreign bodies to enter the deep skin, thereby forming cysts.

③ Chronic inflammatory stimulation caused by folliculitis, sebaceous gland hyperplasia, etc. may also lead to the formation of epidermoid cysts. Inflammation may promote excessive growth of epithelial cells, thereby forming cystic structures. When the skin has excessive oil secretion but is difficult to discharge, the secretion will accumulate in the sebaceous gland ducts, which may cause cysts on the surface of the skin.

④ When foreign objects such as thread ends and hairpins enter the skin, they will be wrapped by tissue to form foreign body granulomas, which will further develop into cystic structures, namely epidermoid cysts.

In addition, epidermal cysts have a certain genetic pattern, and people with a family history may be more likely to develop epidermoid cysts. Endocrine dysfunction causes changes in other body functions and may also cause epidermal cysts.

2. Do I need to worry if I find an epidermoid cyst?

Epidermoid cysts are cystic structures consisting of a cyst wall and cyst contents. The cyst wall is usually the epidermis of the skin, which consists of two layers: the outer layer is the basement membrane and the inner layer is the skin appendages such as sebaceous glands or hair follicles.

The cyst contents are usually located in the center of the cyst and are a cheese-like substance composed of keratinocytes, cell fragments, and oils. Sometimes calcification can be seen, which is caused by the deposition of calcium salts in the cyst. People who have squeezed a cyst should know that the cyst contents have an unpleasant odor.

If a cyst grows on the face, neck or other parts of the body that affect appearance, and if it is large or has changes in color or pigmentation, it will affect your mood to some extent. After all, no one wants to see it when looking in the mirror.

However, epidermoid cysts are usually benign, grow slowly and rarely become malignant, so the condition is generally not serious. However, if the cyst is repeatedly infected or ruptured, it may cause local chronic inflammation, adhesion to surrounding tissues, and may even induce cancer.

3. What should you do if you find an epidermoid cyst?

If the epidermoid cyst is small and asymptomatic, it can be observed and does not require immediate treatment.

Usually, you should keep your skin clean and dry, wear loose and breathable cotton clothes, and choose mild and non-irritating toiletries to reduce the risk of irritation and infection to the cyst. At the same time, maintaining a healthy lifestyle, such as eating a light diet, avoiding spicy and irritating foods, and strengthening physical exercise, will help enhance the body's immunity and promote the recovery of the cyst.

In addition, we should pay close attention to the changes of the cyst. If there are symptoms such as enlargement and pain, we should seek medical attention in time. The doctor will develop a personalized treatment plan based on the size, location, symptoms and specific conditions of the cyst. For example, if there is a secondary infection, the doctor will conduct targeted anti-infection treatment based on the results of bacterial culture. Some physical therapies including laser, freezing, electrocautery and other methods as well as surgical methods are generally used to inhibit the progression of the cyst or completely remove the lesions and prevent recurrence of the disease. Therefore, if an epidermoid cyst is found, it is recommended to seek medical attention in time and choose the appropriate treatment method under the guidance of a doctor.

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Image source: References

Finally, one more point needs to be emphasized: if you find an epidermoid cyst, do not squeeze it yourself.

It is difficult to completely remove the cyst wall by squeezing it yourself. If the cyst wall remains, it will cause the cyst to recur. The squeezing process may also cause infection, spread inflammation, lead to local redness and swelling, increase pain, and even form abscesses, aggravating the condition. For epidermal cysts in dangerous triangular areas such as the face, if squeezing causes the infection to spread retrogradely into the skull, it may also cause serious intracranial infection and threaten life and health.

References:

[1] UpToDate. Overview of benign skin lesions.

[2]Trinh CT, Nguyen CH, Chansomphou V, et al. Overview of epidermoid cyst[J]. European journal of radiology open, 2019, 6: 291-301.

Author: Red Fish

Reviewer: Feng Jun, deputy chief physician of the Dermatology Department of Sinopharm Tongmei General Hospital