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Sebaceous Cyst

A sebaceous cyst, more accurately termed an epidermal inclusion cyst or epidermoid cyst, is a sac beneath the skin filled with keratin and dead skin cells. It forms when those cells become trapped below the surface and build up inside a capsule, producing a firm, round, slow-growing lump with a thick, cheese-like content. Despite the common name, these growths contain keratin and not sebum. They are benign and usually painless unless they become inflamed or infected. Two things decide how well removal goes. The first is completeness: the capsule wall has to come out along with the contents, because any wall left behind can regenerate the cyst. The second is timing. Excising a cyst while it is actively inflamed raises the recurrence risk, so the practice's guidance is to treat the inflammation first and wait a minimum of eight weeks after it settles before removing the cyst. Dr. Julia Tzu performs the excision at the Financial District office and closes the site with attention to the resulting scar, which on the face and neck is often the reason a patient came in.

5 min read·Last updated: 2026-02-08·Reviewed by Dr. Julia Tzu, MD, FAAD, FACMS

At a Glance

  • Epidermal inclusion cysts form when keratin and dead skin cells become trapped beneath the skin[1]
  • Complete removal of the cyst wall (capsule) prevents recurrence[2]
  • Cysts that are only drained often recur because the sac can refill[2]
  • Never attempt to pop or drain a cyst at home, as this can cause infection[1]

What are the symptoms of Sebaceous Cyst?

  • Small, round, movable bump under the skin
  • Slow-growing lump
  • Skin-colored, whitish, or yellowish appearance
  • Small central opening (punctum) sometimes visible
  • Thick, cheese-like or cottage cheese-like material inside
  • Usually painless unless infected
  • May have unpleasant odor if punctured or infected
  • Redness, tenderness, and swelling if infected

When should you seek care for Sebaceous Cyst?

  • Redness, pain, swelling or warmth around the cyst, which are signs of inflammation or infection and are treated before any excision
  • A cyst that ruptured, or one currently draining
  • Growth or a change in size or texture
  • A cyst positioned where it catches, rubs, or interferes with daily activity
  • Cosmetic concern, particularly on the face, neck, or scalp
  • Uncertainty about what the lump is, as several other growths present the same way
  • A cyst returning after a previous removal, which suggests capsule was left behind
  • An inflamed cyst now settled down, because removal is planned at least eight weeks afterwards

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What causes Sebaceous Cyst?

  • Keratin and dead skin cells trapped under skin
  • Blocked or damaged hair follicle
  • Skin trauma or injury
  • Acne or other skin conditions
  • Ruptured sebaceous gland
  • Developmental defect in skin
  • Genetic predisposition

How is Sebaceous Cyst treated?

We offer a service to help manage this condition: Cosmetic Cyst Removal Surgery.

Prognosis

  • Benign with excellent prognosis
  • Complete removal including capsule prevents recurrence
  • Drainage alone often leads to recurrence
  • Some cysts remain stable for years without treatment
  • Infection can occur but is treatable
  • No risk of transformation to cancer
Julia Tzu, MD, FAAD, FACMS, Triple board-certified cosmetic and surgical dermatologist

Julia Tzu, MD, FAAD, FACMS

Triple board-certified cosmetic and surgical dermatologistManhattan's Financial District

Trained at Stanford, Johns Hopkins, Penn & NYU

Complete sac removal to limit recurrence

When Dr. Julia Tzu surgically removes a sebaceous cyst, she carefully dissects out the entire sac, not just its contents, since leaving the sac wall behind is what allows a cyst to recur. She then closes the site with cosmetically optimized technique to minimize the appearance of the scar.

More About Dr. Tzu

Frequently Asked Questions

What is a sebaceous cyst?
A sebaceous cyst, technically called an epidermal inclusion cyst, is a small pocket under the skin filled with keratin and dead skin cells. They appear as round, skin-colored bumps that grow slowly and are usually painless. Despite the name, they contain keratin rather than oil (sebum).
Are sebaceous cysts dangerous?
Sebaceous cysts are benign and not dangerous. They don't transform into cancer. However, they can rupture or become infected, which causes pain, redness, and swelling. Infected cysts need medical attention. Any new lump should be evaluated by a healthcare provider to confirm the diagnosis.
When should I see a doctor about a cyst?
See a doctor if a cyst becomes painful, red, or swollen (signs of infection), if it ruptures or drains, if it grows rapidly, or if you're uncertain what the lump is. Also consult a provider if the cyst bothers you cosmetically or interferes with daily activities.
How is a cyst removed?
The most effective removal involves surgically excising the entire cyst, including its wall (capsule). This prevents recurrence. Simple drainage provides temporary relief but the cyst often returns because the sac remains. The procedure is usually performed under local anesthesia as an outpatient.
Can I pop a cyst at home?
Never try to pop, squeeze, or drain a cyst at home. This can cause infection, scarring, and the cyst will likely return. Only a medical professional should remove or drain a cyst using sterile technique. Home attempts often make the situation worse.
Do cysts come back after removal?
If only drained, cysts commonly return because the sac can refill with keratin. Complete surgical removal including the entire capsule usually prevents recurrence. Your provider will remove the whole cyst wall to give you the best chance of permanent resolution.
Why do some cysts come back after removal?
Almost always because part of the capsule wall stayed behind. The sac is a living structure and will produce keratin again from whatever fragment remains, refilling the cyst over months. Complete removal of the wall along with the contents is what prevents that, and it is the whole reason draining a cyst without excising it is a temporary measure.
Should an inflamed cyst be removed right away?
No. Excising a cyst during active inflammation raises the risk that it comes back. The inflammation is treated first, and excision is scheduled a minimum of eight weeks after it resolves, when the tissue has returned to normal.
How much does cyst removal cost?
Cyst removal surgery typically runs between $2,000 and $3,500, depending on the size of the cyst, its location, the complexity of the repair, and the surgeon's experience. Coverage turns on why the cyst is being removed: an inflamed or infected cyst is a medical problem, while removing a quiet one for appearance is cosmetic and paid out of pocket.
Can a cyst be squeezed or drained at home?
Squeezing can introduce infection, and it leaves the capsule entirely in place, so the cyst refills. It also frequently leaves a scar worse than the one a planned excision would have produced, and turns a straightforward procedure into a delayed one.

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Sources & References

This article draws from 3 peer-reviewed sources.

Medical Institutions

Medically reviewed by Dr. Julia Tzu, MD, FAAD, FACMS · Last reviewed: 2026-08-19