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Doctors' Answers to "Frequently Asked Questions" - Cysts

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Accutane and Cysts [posted 1/14/99]
Question: I have been plagued with cysts on my inner thighs and under my arms for seven years now. The acne on my face isn't bad. However, the cysts on my thighs come out a few days before my period or when I'm under stress. Several times these cysts have had to be removed. The grow to be quite large and are lanced on occasion. We've tried all sorts of treatments: Dispertab, Tetracycline, Doxcycline, Benezxyol Peroxide, different washes. Earlier this summer, a cyst which was on my face turned a black/green color. It was removed. The doctor recommended Accutane. I'll admit I'm not thrilled with the idea of taking this medication. I am a college student at a highly competitive university and want to avoid unnecessary hassles during the school year. What is your opinion on Accutane? How much longer do I have to look forward to these bumps? Does Accutane cure the acne? If not, how long do people stay on the drug?

Answer: Accutane is the best for acne vulgaris, the risk is fairly low as long as one watches liver function and cycles the drug. Risk for women who get pregnant is extreme, but I suspect you have no intention at this phase of your life. Have you tried birth control pills? Very effective in most women.

Baker's Cysts [posted 10/16/98]
Question: Are there any new treatments for Baker's cysts

Answer: Surgical removal and occasional steroid injections are about the only way to treat it.

Adenomyosis Cystic Hyperplasia
Question: What is adenomyosis cystic hyperplasia?

Answer: Adenomas are benign growths-- usually in "glands". Cysts are fluid filled structures. Often the adenomas will enlarge and fill with fluid leading to this condition. It usually is benign, but it can cause pain from local distention and bleeding into the cysts.

Question: I have underarm cysts. I have had an ultrasound. It is not cancer, and I had a mammogram two month ago. However, near the time of my period the cysts under my arm swell up and my breasts become very painful-- especially my nipples. What is causing this. My doctor did discuss this with me. It is a very uncomfortable time for me and lasts about two weeks at a time.

Answer: Most likely the cysts represent accessory nipples or extra breast tissue. Many women will have breast tissue into their axillae(underarms). Occasionally, there will be extra nipples as well in a line running from your arm pit to your nipple and towards your umbilicus(belly button). There may be extra breast tissue or extra nipples anywhere along this line. With the swelling at the time of your period this is most likely.

Question: I am wondering if a cyst is contagious. Can it be given to another person through sexual relations?

Answer: It depends on where the cyst is and the cause of the cyst. New cysts on the penis or vagina will tend to be sexually transmitted. However, an examination will be necessary to determine the cause of the cyst.

Ovarian Cysts
Question: What causes an ovarian cyst and what can I expect now that an ultrasound has identified a cyst on my ovary?

Answer: Cysts form each month in the ovary as a result of an egg coming to "ripeness" prior to a women's cycle. This is usually in one ovary, but can be in both ovaries. Occasionally, there are multiple cysts in one ovary. The cyst which is formed on a monthly basis will rupture, expelling the follicle towards the fallopian tubes and consequently to the uterus. If the cyst does not rupture these cysts may persist. There may be pain around the middle of a woman's cycle over the ovary which represents the rupture of these cysts, which is a normal and necessary part of a normal cycle. Occasionally, these will bleed and become quite painful, with lower pelvic pain and pain on intercourse. Usually once a cyst is identified it is merely followed to ensure that it does not continue to enlarge.

Ovarian Cysts
Question: I have a 5 year old daughter who has kidney disease, hypercalciuria and hyperoxaluria. When she went in for her normal ultrasound they discovered that she has several benign cysts within her left ovary. How do they know that it is benign? How normal is it for a 5 year old to get cysts in the ovary?

Answer: Cysts form in the ovary every month after puberty. These rupture and expel an "egg" into the fallopian tube in post puberty females. In pre-puberty females cysts can also form. They are rarely studied since young girls rarely need ultra-sounds. Benign cysts have a different appearance on ultra-sound than cancerous growths. However, the only absolute way is to insert a needle into the cyst. If the cyst appears benign I wouldn't he too concerned. A follow up ultra-sound will demonstrate either no change or regression of the cysts. Ovarian cancer is almost unheard of before 18.

Question: I've had a cyst in my lower left arm for most of my life. I have never had any problems with it until recently. It has become very irritated to the touch. Also, the skin around it has started to darken. What type of cyst could it be and what would cause it to become irritated after all these years?

Answer: It is hard to tell without seeing it. However, if it is changing or feels tender, it probably needs to be excised.

Question: About 3 months ago I grew a terrible bump on my head behind my left ear. It slowly got bigger for about a week until it was red at the edges and had a greenish/white pus head on it. My cousin is a doctor and he popped it and gave me some oral Duracef samples, which I did not finish. He also gave me Bactroban ointment to rub on it. He said that it might just be an ingrown hair that got infected (I have long hair that I usually keep in a pony tail). The bump went away and then about 1.5 months later I got another one in the exact same location. I used the Bactroban many times daily and killed the thing before it could pus up. Now last week I got another one on the opposite side of my head but again behind my ear. I have been rubbing the Bactroban on it, but to no avail. It is extremely painful. I want to know if these bumps sound familiar or like anything else and where they may come from.

Answer: This is either a sebaceous cyst or recurrent skin boils. A sebaceous cyst is common where ever you have hair, especially in the groin, back, or head. They exude a cheesy material and will occur at the same spot until surgically removed. Sebaceous boils tend to occur in individuals and can be minimized by use of a "deodorant" soap. Prompt use of antibiotics is important for these. To tell the difference, you'll need to see a physician with the next one.

Facial Cyst
Question: My 8 year old has a cyst or pilomatrixoma on her face. The dermatologist wants to remove it. He says that it will probably involve a stitch. I am concerned about the possibility of scarring, and wonder if I need a plastic surgeon to handle it. I don't want to leave her with a scar that is worse than the cyst. What happens if we leave it? I don't know this doctor... but for something this small is it worth getting a second opinion? Thanks

Answer: In general, I refer patients to plastic or facial surgeons for any surgical procedure. There are some dermatologists who are as skilled-so knowing the physician is critical. However, these surgeons usually perform slightly better cosmetically-at a higher price.

Sebaceous Cyst
Question: Several months ago, I spoke to a urologist regarding an irritation on my foreskin. A biopsy was done and it turned out to be a sebaceous cyst. The urologist said that it's not harmful, and that it I could make the choice of having a circumcision or not. I don't think I want to go ahead with this procedure. If I leave things as they are, will the sebaceous cyst turn into something worse? Can it become cancerous? Will I have anything to worry about in the future? Is there any other way to remove it besides surgically?

Answer: The sebaceous cyst will not turn into cancer. It will also not go away without some type of surgery. This may be a local incision and not require a circumcision. I would also get a second opinion about the cyst since I’ve never seen a sebaceous cyst on the penis itself.

Sebaceous Cysts [posted 8/7/98]
Question: I have been taking 1 mg estrace daily since June 1997. I am experiencing small, sometimes tender bumps on the upper labia. These lumps/bumps periodically appear in my arm pits also. My doctor recommended I change deodorants and stop shaving for one month. I did so, but lumps still come and go. My biggest concern are those on vaginal labia. Should dosage or medicine be changed? I also had a complete hysterectomy in June 1997. A mammogram in October 1997 was normal.

Answer: The first question is whether these are sebaceous cysts or from the Bartholin Glands. If from the Bartholin Glands, surgical drainage may be necessary. However, since you are having these in your axillae as well as in the peri-vaginal area, I suspect they are sebaceous glands whose output is increased by estrogen in some women. These may become tender and drain, but are not cancerous or any permanent risk.

Stopping the Spread
Question: What can I do to get rid of sebaceous cysts or stop them from spreading. They get inflamed/infected and create an abscess.

Answer: In order to eliminate sebaceous cysts, they must be surgically removed. They do not spread ;but, may become infected.

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