Chronic Cysts

I am looking for suggestions:

Chronic Infected Cysts (red, hard, hot, tender) for past five years. Have no idea what the trigger could be but each series lasts months at 2-3 per week.  I have tracked food, activity, medicines, seasons, etc., but there is no pattern. The only thing that works is to visit my dermatologist each week to get each injected with 2-4mm of mixture (46mg xylocaine 2% without epinephrine + 4cc Kenalog 40mg)

I am currently on Ziana, Altabax on cysts, Clindamycin pads, wash face with cetaphil.

I have tried seb wash, differin, clindamycin 1%/benzoyl peroxide 5% gel, erythromycin, xolegel, epiduo, triaz. Cysts in the past have been biopsied (negative).

My antibiotic use has been Keflex mostly with varied results. Also Amoxicillian but it is difficult to know if antibiotics work because I always get injections at same time; perhaps they work by reducing new ones but I can’t live on antibiotics.  In 2008, I had taken 10 days of antibiotics three times in 3 months. Not good.

I also can’t be continually fighting infections as I have a connective tissue disorder.  I am allergic to doxcycline hyclate and minocyclin.  I have not tried Bactrim but, like I said, living on antibiotics is not ideal.

I have been referred to an infectious disease doctor only to be told by two of them that infected cysts is a dermatological issue and not in their realm even if it is chronic.  Since two different doctors said this, I stopped trying.

Any thoughts?

Thank you for your time.

[Bhupinder Kaur, MD]

Hello,
A sebaceous cyst is a closed sac occurring just under the skin which contains a "pasty" or "cheesy" looking substance called keratin. Blocked sebaceous glands, swollen hair follicles and excessive testosterone production will cause such cysts.

Generally no treatment is required but they become painful then it means they are infected,Then surgical excision by traditional wide excision, minimal excision, and punch biopsy excision may be required. This is followed by a course of oral antibiotics.

I hope it helps. Take care and regards.

[BruceMartin]

Thank you for your response. I do know what a sebaceous cyst is and am aware that testosterone can cause them. The curious part of my situation is:

1) I take the same testosterone dosage each day and can go months without cysts and then have a period of months with 2-3 a week.

2) Every cyst is infected. Not one has just been a cyst or lump without red, hot and tender.

3) Nothing seems to help other than injection so I have to go to the doctor every week for multiple injections.  My research has shown this is also abnormal.

Therefore, I am looking for possible explanations.

Thanks again.  You are the only responder and it is appreciated.