Lumps, Bumps, and Cysts

RECENTLY IN THE NEWS:

NBC News (3/5/2015) reports on its website that "family practioners, gynecologists and even dentists are getting into the cosmetic procedure business, and dermatologists say they're seeing the side effects."  Several dermatologists "from around the country told NBC News that they've had to the fix the mistakes of physicians who are dabbling in their specialty."  In a statement, the American Academy of Dermatology said, "A dermatologist is a licensed medical doctor and the only residency-trained physician fully educated in the science of cutaneous medicine, which includes medical and surgical conditions of the skin, hair, nails, and mucous membranes."

DRY SKIN CARE:

Keep your bathing to a minimum!  Wash with lukewarm water and keep your bathing to less than 10 minutes.  Wash with a soapless cleanser such as Dove and avoid harsh soaps such as Ivory or Irish Spring.  After bathing, moisturize within a few minutes of patting dry with a towel.  Moisturize with a sensitive-skin moisturizer without fragrance.  If you have a skin condition such as eczema, you will need to moisturize a few times per day.

WOUND CARE:

The day after your procedure, allow the cleanser and water to wash over the site.  That is adequate cleaning of the wound.  Thereafter, apply a generous layer of petroleum jelly (Vaseline) or another greasy substance such as Aquaphor healing ointment.  If the area is in contact with clothing, we advise you to cover it with a dressing.  Repeat the same procedure the next day and every day until the wound has healed.

HOW TO APPLY YOUR TOPICAL RETINOID (ACNE PATIENTS):

Topical retinoids include adapalene (Differin), tretinoin (Retin-A, Atralin, Ziana, Veltin, Tretin-X).  Apply a pea-sized amount to your entire face a few minutes after washing your face at bedtime (since most retinoids are inactivated by sunlight).  If your face is dry with the retinoid, apply a moisturizer prior to the application of the retinoid.  

CARE FOR SKIN IN THE SUN:

Use a daily moisturizer with a sunscreen of SPF 15 or higher on the areas that will be exposed.  If you're going to be directly out in the sun, wear an SPF of 30 or higher and make sure the sunscreen says that it is "broad spectrum."  Remember to reapply after two hours and after swimming or any exercising.  Physical sunscreens which contain titanium dioxide and/or zinc oxide are gentle and will not react with the skin.   Seek shade between the hours of 10 am-4 pm.

Check your skin for any new, changing, non-healing or itching lesions four times a year or every major holiday.  If you notice anything that is new or changing or not healing, please call and get it checked.

Our team of professionals and staff believe that informed patients are better equipped to make decisions regarding their health and well-being. For your personal use, we have created an extensive patient library covering an array of educational topics, which can be found on the side of each page. Browse through these diagnoses and treatments to learn more about topics of interest to you.

As always, you can contact our office to answer any questions or concerns.

There are literally hundreds of different kinds of lumps, bumps and cysts associated with the skin. Fortunately, the vast majority of these are harmless and painless. The chart below provides a guide for some of the most common forms of skin lumps, bumps and cysts.

Dermatofibromas

Characteristics

  • Red, brown or purple growth; generally benign
  • Usually found on arms and legs
  • Feels like a hard lump
  • Can be itchy, tender to the touch and sometimes painful

Treatment

  • Usually does not require treatment
  • Most common removal by surgical excision or cryotherapy (freezing it off with liquid nitrogen)

Epidermoid Cysts (Sebaceous Cysts)

Characteristics

  • Round small bumps, usually white or yellow
  • Forms from blocked oil glands in the skin
  • Most commonly appear on the face, back, neck, trunk and genitals
  • Usually benign; occasionally leads to basal or squamous cell skin cancers
  • If infected, will become red and tender
  • Can produce a thick yellow, cheese-like discharge when squeezed

Treatment

  • Antibiotics might be prescribed if there is an underlying infection
  • Dermatologist removes the discharge and the sac (capsule) that make up the walls of the cyst to prevent recurrence
  • Laser surgery may be used for sensitive areas of the skin, like the face

Folliculitis

Characteristics

  • Red pimples around areas having hair
  • Inflammation of the hair follicles
  • Caused by infection or chemical or physical irritation (e.g., shaving, fabrics)
  • Higher incidence among people with diabetes, the obese or those with compromised immune systems

Treatment

  • Topical antibiotics
  • Oral antibiotics
  • Antifungal medications
  • Eliminating the cause

Keratoacanthoma

Characteristics

  • Red, dome-shaped, thick bumps with craters in the center
  • Abnormal growth of hair cells
  • Triggered by minor skin injury such as a cut or bug bite
  • Ultraviolet radiation from sun exposure is the most common risk factor

Treatment

  • Cryotherapy (freezing off the bump with liquid nitrogen
  • Curettage (surgically cutting out or scraping off)

Keratosis Pilaris

Characteristics

  • Small, rough white or red bumps that neither itch nor hurt
  • Usually worse during winter months or when there is low humidity and the skin gets dry

Treatment

  • Usually does not require treatment
  • In most cases disappears on its own by age 30
  • Intensive moisturizing is the first line of treatment
  • For more difficult cases, use of medicated creams with urea or alpha-hydroxy acids

Lipomas

Characteristics

  • Soft fatty tissue tumors or nodules below the skin's surface
  • Usually slow growing and benign
  • Appear most commonly on the trunk, shoulders and neck
  • May be single or multiple
  • Usually painless unless putting pressure on a nerve

Treatment

  • Usually does not require treatment unless it is compressing on the surrounding tissue
  • Easy to remove via excision

Neurofibromas

Characteristics

  • Soft fleshy growths under the skin
  • Slow growing and generally benign and painless
  • Pain may indicate a need for medical attention
  • May experience an electrical shock at the touch

Treatment

  • Usually does not require treatment, particularly if it does not cause any symptoms
  • If it affects a nerve, it may be removed surgically

Skin Cysts

Characteristics

  • Closed pockets of tissue that can be filled with fluid or pus
  • Can appear anywhere on the skin
  • Smooth to the touch; feels like a pea underneath the surface
  • Slow growing and generally is painless and benign
  • Only needs attention if it becomes infected or inflamed

Treatment

  • Usually does not require treatment; often disappears on its own
  • May need to be drained by a physician
  • Inflamed cysts respond to an injection of cortisone, which causes it to shrivel