Sebaceous cysts

Sebaceous cysts are small lumps under the skin. They often arise from swollen hair follicles.
They are usually found on the head, the face, behind the ears, the armpits and the back.
They are round, closed sacs, hard in texture that contain keratin — a “pasty” or “cheesy” looking protein that often has a foul odor. They move freely under the skin and remain the same in size for a long time.
If the cysts become infected or inflamed, they form painful abscesses.

The symptoms include:

  • Skin redness
  • Tender or sore skin
  • Warm skin in the affected area

In such circumstances a drainage procedure may be performed, otherwise the treatment is surgical removal of the entire cyst under local anesthesia. It is an outpatient procedure that can be performed in the doctor’s office.


A lipoma is a benign tumor composed of adipose tissue. It is a fatty lump that is most often situated between the skin and the underlying muscle layer.
It is the most common form of soft tissue tumor and occurs more frequently in women. Most often they are small in size, and do not tend to enlarge. They can be found anywhere on the body.
The exact reason they are formed is unknown. Genetic factors may play a role. They also tend to occur in areas of previous injury.
Lipomas are soft to the touch, usually movable, and are generally painless. They usually do not require any intervention.

They are excised only when:

  • They increase in dimensions
  • They are irregular and hard in texture
  • They aesthetically disturb the patient

Surgical removal is a simple procedure that can be performed in the doctor’s office under local anesthesia.


Nevi, are commonly named birthmarks and moles. They are derived from keratinocytes forming clusters of skin cells. Melanocytic nevi are benign proliferation of melanocytes, the skin cells that make the brown pigment melanin. Hence, most nevi are brown to black. They are very common. They may be congenital or acquired.
Nevi are often excised for aesthetic reasons.
They have also been associated with malignancies of the skin (melanoma).
Any nevus that raises the suspicion of malignancy should be examined by a clinician.

Early signs of melanoma are summarized by the mnemonic “ABCDE”:

  • A (Asymmetry): If you draw a line through the mole, the two halves will not match
  • B (Border): The borders of an early melanoma tend to be uneven. The edges may be scalloped or notched
  • C (Color): Having a variety of colors is another warning signal. A number of different shades of brown, tan or black could appear
  • D (Diameter): The diameter of the nevus is above 6mm
  • E (Evolution): Any change — in size, shape, color, elevation, or another trait, or any new symptom such as bleeding, itching or crusting — points to danger.

If a nevus is suspicious for malignancy, it is necessary to surgically resect it and sent for biopsy.