Can You Just Squeeze Out a Sebaceous Cyst?

Let’s imagine this. It’s an ordinary day, you are taking a bath, and suddenly you feel a bump on your back. It is a swelling on the upper back, not really hurting. You look in the mirror and see a pea-sized swelling with a distinct blue-black dot in the middle. No pain, no other interesting features, and you ignore it.

Fast forward one year — bath time again. That little pea-sized swelling has grown to the size of a Natraj eraser. Still no pain, still that distinctive blue-black dot. So you decide to squeeze it. Out comes a foul-smelling white semi-solid goo, rather like unwashed socks and dirty linen. You think this solves the problem. Elementary, dear Watson — the swelling had stuff in it, you removed the goop, so that should be the end of that.

Wrong.

What is a sebaceous cyst?

You’ve just interfered with a sebaceous cyst. It is a malformation of a normal gland called the sebaceous gland (the oil-producing gland), and it is filled with sebum (the foul, socks-smelling content). Squeezing it out removes the content, sure — but the thing that produced it, the gland and cyst lining, is still in place. Even when the cyst is emptied out, the lining simply produces more. And so it grows again, many times, many seasons, until you decide enough is enough and talk to us at Dr. Amrika’s Aesthetics on Sarjapur Main Road.

Two things can happen to a cyst

Once a sebaceous cyst is there, it tends to go one of two ways. Let’s count them out:

• The cyst grows slowly, over weeks, with no pain — but it never shrinks.
• The cyst grows rapidly, becomes red, and you run a fever. This means it has become infected and needs more intense, and more urgent, care. It may even take two sessions to put right.

Scenario 1: the slow-growing cyst — one clean excision

Here the solution is straightforward: removal of the cyst and all its contents in one go. This is one of the few surgeries with a cure rate of 100% — one and done, as far as that particular cyst is concerned. When a plastic surgeon does this procedure, the resulting scar should be:

• Flat — not saucer-shaped or bulging;
• Blended well with the surrounding tissue, so it does not stand out in any way;
• Not painful after 6 weeks — almost forgettable that the area was ever operated on.

This is the kind of swelling I love, because the fix is easy, affordable and very satisfying for the patient. Pricing is transparent and depends on the size and complexity of the cyst; you can see the current range on our sebaceous cyst removal page, and your exact all-inclusive quote is confirmed at your consultation.

Scenario 2: the infected cyst — why it becomes more work

In scenario 2, a few things can go wrong. If you are diabetic, pre-diabetic or have any kind of reduced immunity (immunosuppression), then an infected cyst can grow from 4 cm to 14 cm practically overnight. It is then treated with pus removal first — this is called an I&D, an incision of the skin and drainage of the pus. It then needs multiple dressings to heal and turn into scar tissue. After about 8 weeks, that scar tissue and the leftover cyst tissue are removed surgically to leave a flat, blended, non-painful scar, as in scenario 1.

So, can we just squeeze out a cyst?

To address the title of this blog — can we just squeeze out a cyst? Short answer: no.

When you force open a cyst, you remove its plug — the thing that was keeping skin bacteria out of the cyst proper. Now that the cyst content and lining are exposed to skin bacteria, infection is inevitable. So you go from scenario 1 to scenario 2 in short order.

What to do instead

So what are your realistic options? When you notice a bump on your skin, consult a plastic surgeon. Get some clarity, peace of mind and a correct diagnosis — and if it turns out to be a different lump altogether, such as a lipoma, you will know that too. You then have the luxury of scheduling treatment at your convenience.

If you’re already in scenario 2, please don’t DIY it. Neighbour, aunty, uncle or Instagram-recommended “home remedies” just make it worse. Walk in for an opinion and immediate relief, and get the right treatment, correct guidance and safe therapy. You can also see real excised cysts in our before and after gallery. According to the NHS, a skin cyst should never be squeezed, since this risks infection — exactly what we see in clinic.

I also have three videos on YouTube about how cysts are produced, how they evolve, how I treat them, and what happens when you ignore or DIY them. (Hint, hint — unicorns may be involved.) Be sure to watch those and understand this fascinating little condition of sebaceous cysts.