Cysts and Lipomas: What are they?
Cysts and lipomas are growths, usually skin-colored, that are painless and grow slowly. Often, patients use these two terms interchangeably, thinking they are the same thing, so it's worth clarifying things a bit.
Epidermal Cysts
Epidermal cysts are somewhat firm to the touch, located more superficially in the skin, and have mobility. Often there is a hereditary component, and the individual who develops them may have more than one. Essentially, they are enclosed 'sacs' where some cells produce sebum which, instead of being secreted onto the surface of the skin, becomes trapped within the skin. This condition can persist for many years, and the cyst either enlarges or remains the same.
However, sometimes, especially after pressure, it can rupture. The sebum is released into the skin, and the body reacts with an inflammatory response to a 'foreign body,' meaning a sterile (non-microbial) inflammation. The reason the body does not recognize this material it produces itself is because normally it is secreted onto the surface of the skin. In these cases, treatment is required, often with the use of antibiotics.
After a number of days when the inflammation subsides, it is advisable to remove the residue to prevent relapses. To avoid this situation and for aesthetic reasons, it is good to preemptively remove cysts to achieve the best possible outcome. The removal is done under local anesthesia, and the incision required is significantly smaller than the size of the cyst! It's worth noting that not only the contents but also the 'sac' of the cyst must be removed to prevent relapses.
Lipomas
Lipomas are benign growths of fat located deeper in the skin than cysts and are softer to the touch. Usually, they do not cause problems other than aesthetically, unless they grow very large and begin to cause functional difficulties. Indeed, lipomas weighing over 25 kilograms have been reported in the literature! Often there is a family history of lipomas, and also, some patients may have multiple lipomas, something that should be taken into account during the visit interview and the possibility of a syndrome should be investigated. Finally, lipomas appearing above the spinal column require special attention and imaging examination before any intervention. They are treated either by surgical removal under local anesthesia to prevent any relapse or by liposuction, which has the best aesthetic result as it does not require incision but carries the possibility of relapse.
