Cyst

 A cyst is a closed sac with a distinct membrane that develops abnormally in a cavity or structure of a child’s body. It is a benign, closed pocket of tissue that can be filled with liquid or solid material. A cyst can become infected or inflamed and may need to be surgically removed.

Patients can be seen by Texas Children's experts in Plastic Surgery.

Causes & Risk Factors

A cyst may be congenital (meaning it was present at birth) or acquired. 

  • Congenital cysts are formed during embryonic development and likely come from parts of the skin that become buried beneath the skin. 
  • Acquired cysts can be caused by:

      - Clogged pores or sweat glands

      - Infection in the skin

      - Reaction around a foreign body, such as earrings

      - Wear and tear  

Symptoms & Types

Cysts usually don’t have any other symptoms and can be tolerated by children. They tend to be non-tender, discrete and slow-growing lesions. 

The type, size and location of some cysts can cause pain, limitation in movement, drainage, infection or disfigurement in some children, however. Infected cysts can cause drainage and lead to skin infection caused by bacteria (cellulitis). Common types of infected cysts include:
 

  • epidermoid cyst – filled with parts of the skin
  • cellulitis – can contain hair follicles, certain fatty glands and other skin-related structures

Diagnosis & Tests

The doctor will perform a thorough skin exam. Depending on the type and location of the cyst, the child may need additional tests, which can include an imaging study such as an ultrasound, MRI or CT scan.

Treatment & Care

Most cysts do not require treatment.  

Doctors will recommend surgical removal for cysts:

  • causing pain or discomfort
  • in cosmetically sensitive areas
  • prone to frequent irritation or infection 

For removal, the entire cyst lining must be taken out to prevent the lesion from returning.  Risks of surgical removal include incomplete removal of cyst, recurrence, infection and poor scarring. 

Cysts in the nose (known as nasal dermoid cysts) must be differentiated from nasal glioma (which are very uncommon) and encephalocele (a rare defect where a groove can occur between the forehead and the nose). 

Ruptured cysts can be left open to drain and do not require removal. 

Some types of cysts may respond to acorticosteroid injection and shrink enough that they do not require surgery.

Living & Managing

When indicated, a thorough evaluation by your child’s doctor should be conducted to assess for cysts in internal organs. 

As noted above, most cysts do not require intervention by a doctor. But in cases where a cyst is surgically removed, the doctor may recommend follow-up appointments.

References & Sources

1. cyst. 2013. In Merriam-Webster.com. Retrieved April 3, 2013, from http:// www.meriam-webster.com/dictionary/cyst.

2. Li WY, Reinisch JF. Cysts, pits, and tumors. Plast Reconstr Surg 2009;124(1S):106e-116e.

3. Stone, Mary Seabury. "Cysts." Dermatology. 2nd. Ed. Jean Bolognia. New York: Mosby, 2008: 1681-83.