Cysts can be unsightly particularly if they are in cosmetically sensitive areas such as the face – the overlying skin is usually normal in colour, but it may have a bluish tinge, particularly if the cyst is tense and close to the surface of the skin.

Cysts can also be uncomfortable as they can cause pressure effects on surrounding structures. However, probably the main problem that cysts can cause is infection.

If a cyst becomes infected, then it grows in size and becomes very painful.

Antibiotics can help in this situation, especially if there is redness and tenderness around the cyst, however, antibiotics are not the main treatment. The main treatment of an infected cyst is to drain the infected contents. Often the cyst will burst spontaneously and, although this can be messy, it offers tremendous relief. If the cyst doesn’t burst spontaneously, then the treatment is to ‘lance’ or drain the cyst.

This involves making a cut in the cyst to allow the pus and infected material out of the cyst. This can be done under local anaesthetic in the clinic, although local anaesthetic is often less effective in the presence of infection and so the procedure can be uncomfortable, although the instant relief that it affords can be dramatic. If you present to your doctor when your cyst is infected, it will only be possible to have a course of antibiotics and to have the cyst lanced if appropriate.

It will not be possible to have your cyst removed when it is infected because it the wall of the cyst is very fragile when infected and it is very difficult to remove completely.

Furthermore, local anaesthetic is not very effective in infected tissues. It is important to let the infection fully settle before coming back to have your cyst removed fully.

You do not need to have your sebaceous cyst removed. They are not cancers and will not spread (although some people may have multiple cysts).

Having said that, if there are any unusual features, then you should have your cyst checked out by your doctor to make sure that it is a benign sebaceous cyst (benign means not a cancer) and not anything more sinister. Unusual features include:

• a rapid increase in size – although they may increase in size rapidly when infected pain associated with the cyst – benign cysts are painless, although they may be uncomfortable – again, there will be pain if the cyst is infected
• hardness – a benign cyst is smooth and has a firm consistency, if your cyst is hard, has irregular edges or feels craggy, then you should get it checked out.

If you are worried, then you should get your cyst checked by your doctor. Once it is confirmed that your sebaceous cyst is nothing more sinister, then you can leave it, as long as it does not cause any problems. However, sebaceous cysts can frequently case problems.