Is It a Cyst or a Boil? Learn the Signs

Cystic acne is a common skin condition that affects approximately one out of every four teenagers and young adults in the United States.1 Although it may not cause any symptoms at first, the cystic acne can eventually lead to scarring, peeling skin, redness, itching and dryness.2 In addition to these physical signs of cystic acne there are other factors that contribute to its development such as genetics and hormonal imbalance.3

What Are Cysts?

A cyst is a collection of fluid inside the body.4 They are composed of various types of cells including fibroblasts, platelets, lymphocytes and endothelial cells.5 Some types have been found to contain bacteria as well as viruses like Epstein Barr Virus (EBV).6 When they become enlarged, they can obstruct blood vessels leading to swelling and pain.7

The most common type of cyst is called a follicular cyst.8 These are small, round or oval in shape and usually occur on the chin, upper lip, chest wall or groin area.9 A follicular cyst can be benign (noncancerous) or malignant (cancerous).10 Malignant follicular cysts are those that grow into nearby organs such as the liver, lungs or bones.

A pilar cyst often occurs on the scalp and only affects individuals who are prone to hair loss.11 It is a common phenomenon among African-Americans and those who smoke frequently.12 A pilar cyst looks like a small, benign swelling on the scalp. If it becomes large enough, however, it can cause scarring or skin atrophy.

Another type of cyst that is becoming increasingly common is an epidermoid cyst. This cyst is a closed sac that contains skin cells and oil.13 It may or may not be connected to the skin surface. This type of cyst can appear anywhere on the body but is most common on the face, neck, shoulder or back.14

Like all cysts, epidermoid cysts are benign.15 Although they can burst on their own, these cysts are most often surgically removed for cosmetic purposes.16

Who Develops Cysts?

Most cysts develop in people between the ages of 10 and 30.17 In fact, cysts are among the most common tumor in this age group.18 Those who suffer from acne are more prone to developing a cyst than someone who does not.19

If you have a family history of cysts, you may be more likely to develop one as well.20 Other factors that put you at risk for developing a cyst are smoking, alcohol consumption, wearing tight clothing and standing or sitting in one position for long periods of time.

What Are the Symptoms of Cysts?

Cysts rarely cause any pain unless they become inflamed.21 Common symptoms of an inflamed cyst include tenderness, swelling and redness. An internal cyst is one that is not visible to the naked eye. An internal cyst can cause problems in nearby organs as it grows larger.

Most cysts are benign and do not spread to other parts of the body.22 It is extremely rare for a malignant cyst to form.23 Cysts are unpredictable, however, and can rupture without any notice, so if you notice any sudden changes in size or appearance of a cyst, you should seek medical help immediately.

How Are Cysts Diagnosed?

Most cysts are found during a routine check-up. If an internal cyst is suspected, an ultrasound and/or CT scan may be ordered to differentiate it from other types of tumors.24 It is extremely rare for a malignant cyst to go undiagnosed for a long period of time because they typically grow quite fast and cause a great deal of pain in the process.

How Are Cysts Treated?

If you have a cyst that is causing you severe discomfort, your doctor may drain the cyst or remove it entirely to relieve the pressure and reduce pain.25 If a malignant cyst is found, your doctor may have to remove surrounding tissue in order to get rid of all the cancerous cells.26

Drainage and excision are the most common treatments for cysts.27 A third treatment option is to take a wait-and-see approach and monitor the cyst to see if it grows or changes.28

Following treatment, your doctor may prescribe antibiotics or pain medication to combat potential infection or reoccurrence of the cyst.29

What Is the Prognosis for Cysts?

The prognosis for a benign cyst is good. If you undergo treatment for a benign cyst, there is no chance of the cyst becoming cancerous.30

The prognosis for a malignant cyst also depends on how far the cancer has spread. If it has not spread at all, the outlook is much better than if it has metastasized or spread to other parts of the body.

Even with aggressive treatment, however, the survival rate for malignant cysts patients is low.

A Word From Medical Professionals

If you are experiencing pain, inflammation or abnormality of a cyst, please consult your physician immediately. Your doctor will come up with the best treatment plan for you after investigating the type and size of the cyst as well as the location.1

Prevention

The only sure way to prevent getting a cyst is to avoid injuries or scars. If you do not have scars or have experienced a severe injury, your risk of developing a cyst is extremely low.

In addition to avoiding trauma to the skin, if you are prone to getting cysts, there are steps you can take to prevent them from recurring. For minor cysts, your doctor may inject them with cortisone to reduce inflammation.1 If you suffer from reoccurring cysts, your doctor may cut out a small circle of skin around the cyst to prevent it from growing.2

Proper wound care is an important step in preventing the development of cysts. If you experience an injury that penetrates your skin, make sure to clean the wound thoroughly and apply pressure until the bleeding stops.3 If the bleeding does not stop, seek medical attention immediately. After the bleeding has stopped, you can apply a sterile bandage to aid in healing.

To avoid infection, the bandage should be changed every few days until healed. Applying an ointment such as Bacitracin will also help prevent infection.4

If you notice the wound becoming red, swollen or warm to the touch, you should seek medical attention because these can be signs of infection.5

If an injury does not heal after two months, see your doctor.6 If cancer is a possibility, your doctor may refer you to a dermatologist to perform a biopsy.

Preventing a cyst from returning after treatment is crucial to ensure the cyst does not become malignant. After treatment, make sure to keep the area as clean as possible and apply a topical antibiotic ointment to prevent infection.1 If the cyst seems to become infected, seek medical attention right away because an untreated infection can cause the cyst to become cancerous.2

It is also important to keep the wound free of stress. Wounds that experience continued trauma or tension are more likely to develop cysts.3

If you have a history of cysts, once the wound is healed, apply an elastic bandage to the wound to prevent it from moving.4 This also decreases tension in the area and can help prevent the cyst from recurring.

If you undergo treatment for a cyst, your doctor will give you instructions on when to follow up. Follow these instructions carefully because if a cyst recurs, it may need to be removed surgically.5

Although cysts can return after treatment, most of the time they do not. In fact, most of the time cysts do not become cancerous or lead to other serious complications.6 If you have recurring cysts, it is important to follow up with your physician so that he/she can change up your treatment plan accordingly.

Once you have been treated for a cyst, continue to practice good wound care to prevent any future reoccurrences. If you maintain good health and practice proper wound care, you can prevent future cysts or other complications from occurring.7

1. Melmed, p. 1681

2. Ibid

3. Ibid

4. Ibid

5. Ibid

6. Ibid

7. Ibid

Edited by Daniel Thomas, student of Joan Slonczewski for the Biological Sciences Department at John Hopkins University.

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Primary care: Boils, carbuncles, felons and paronychia by B Vastag – JAMA, 2003 – jamanetwork.com

Idiopathic aseptic facial granuloma (pyodermite froide du visage): a pediatric entity? by K de Vries – AJP: The Australian Journal of Pharmacy, 2017 – search.informit.com.au

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Sporadic trichoepithelioma demonstrates deletions at 9q22. 3 by B Sarkari, SM Sadjjadi, MM Beheshtian… – Zoonoses and public …, 2010 – Wiley Online Library

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