Epidermoid Cyst

What is Epidermoid Cyst?

Epidermoid cyst

An epidermoid cyst is small, hard benign (noncancerous) lumps or encapsulated lesion that develops beneath the skin from the epidermal cells. They can also emerge from the hair follicles (follicular infundibulum). These cysts are common and the epidermal cells comprise of fat and protein keratin. They can emerge on the face, head, scalp, behind the ear, neck, upper back, chest, arms, labia, scrotum or genitals.

Terminology

The epidermoid cyst has synonyms which include epidermal cyst, follicular infundibular cyst, epithelial cyst and keratin cyst. Although it is often confused with sebaceous cyst, epidermoid cysts, and pilar cysts, they are not a synonym.

Epidermoid cyst on the face
Epidermoid cyst on the eyelid

Types of Epidermoid Cyst

Intracranial Epidermoid Cyst

The intracranial epidermoid cyst is a cyst in the brain that commonly occurs among people aged between 20-40 years. The symptoms depend on which part the epidermoid is pressing.

  • Headaches
  • Vision problems
  • Difficulty in moving hand or legs
  • Speech difficulties
  • Dizziness or difficulties with balancing and walking
  • Cannot over think of day-to-day situation
  • Difficulty in hearing and a sound keeps on buzzing near the ear
  • Sleepiness and laziness are common amongst children

Epidermoid Cyst on the Forehead

There are some skin conditions that lead to the lump and bump on the surface or just below the forehead. It develops as a result of infection, clogging of the sebaceous gland or even around the foreign bodies like the earrings.

Milia

Small white epidermoid cysts on the face measuring anywhere between 1 to 2 mm are most common in children and newborns.

Epidermal inclusion cyst

It is a kind of epidermoid cyst that develops from the epidermis i.e. surface skin layer. It occurs when the epidermis is pushed deep into the dermis after a trauma or surgery.

Favre-Racouchot syndrome

Aged people suffering from elastosis and accumulated sun exposure tend to develop this type of epidermoid cyst and solar comedones.

Gardner’s syndrome

Its a case of multiple epidermoid cysts, lipomas, osteomas, fibromas, and polyps of the colon.

Causes of Epidermoid Cyst

Epidermis constitutes a thin protective layer of cells that are shed by the body on a continuous basis. The moment these cells move deeper into the skin and start multiplying than sloughing, it forms epidermoid cysts.

Keratin that occurs naturally in the skin cells can get trapped below the skin due to disruption of the hair follicle or the skin itself. Epidermoid cysts are mostly a response to an HPV infection, high exposure to the sun or acne. People suffering from acne or other skin conditions are prone to develop the cyst. Epidermoid cysts can also be a cause of a genetic disease called basal cell nevus syndrome.

Risk Factors

  • Acne
  • Surgery
  • Trauma
  • Exposure to UV light or sun
  • Human papillomavirus (HPV) infection
  • Genetic predisposition (such as familial adenomatous polyposis)

Signs & Symptoms

Usually varying between ¼ inches to 2 inches (about 5 cms on an average) in size, the following symptoms may indicate the formation of epidermoid cysts:

  • Round (dome-shaped) small bumps on the skin
  • Small blackhead that plugs the central opening of the cyst
  • Drainage of smelly, thick and yellowish matter
  • Redness, swollen and tenderness

Treatment

Usually, it doesn’t need any specific treatment, and it heals on its own over time. However, it may need to be treated if it ruptures or becomes inflamed and infected.

  • Injection: If the cyst is swollen, then corticosteroid injection can be injected to reduce the inflammation. It can be drained out with a small incision in the cyst.
  • Incision & drainage: The contents of the cysts are gently squeezed out by making a small cut on the cyst. Although it an easy method, there are chances of reoccurrence of the cyst after the treatment.
  • Total Excision: By this method, the cyst is surgically removed and is highly effective if there is no inflammation. Total excision is done there will be sutures. Cysts on the face usually disappear in a week, but on other body parts, it can take a week or two.
  • Minimal Excision: Another surgical approach, minimal excision is highly preferred because the scarring is very less and the entire cyst goes away. The minor wound can heal naturally with no sutures.
  • Laser Removal: Laser treatment is selected to minimize any scarring. Normally usage of carbon dioxide laser evaporates the cyst.

Home Remedies

Easing the symptoms of epidermoid cyst is possible by the following home remedies and practices by application of:

  • Apple cider vinegar
  • Aloe Vera
  • Warm castor oil
  • Hot/cold compress

References

  1. https://www.healthline.com/health/epidermoid-cysts
  2. https://www.mayoclinic.org/diseases-conditions/sebaceous-cysts/symptoms-causes/syc-20352701
  3. https://www.drugs.com/health-guide/epidermoid-cyst.html

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