Dermatology  (Expert Forum)

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Facial Cysts? Treatment?

Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
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Facial Cysts? Treatment?
by VickyJones, Dec 19, 2004 12:00AM
35 YO mother of two - have always had very clear skin with little problem with pimples or blemishes. Been on BC pills since a teenager (save for pregnancies, of course.) Good diet, non smoker, light alcohol intake, regular exercise, good weight, etc. etc. etc. No medical problems.

Except.....

For the last year or so I've been getting what seem to be cysts forming on my face: large bumps forming under the skin - almost always in same place each month, usually starting a week before my period. They seem like large pimples but they don't "pop" and anything I do to them just irritates the skin and makes them more painful. They eventually go away but are back in the same spot in a week or two. And I'm getting more - stared out with one, now I've got 5+ on my face each month.

They are movable lumps under the skin, and about the size of a pencil eraser. Very hard and contained. Somewhat painful as they become quite noticable in how much they protrude.  No acne medicine has made any difference and no "head" or pus ever forms - just a dense lump on my face.

These are very unsightly (I've got 5 along my chin this month plus two on my forehead.) I haven't been to a dermatologist before but certainly am considering making an appointment for this. I was thinking perhaps it was stress related or bad diet but changes in both of these haven't resulted in a slow down for the monthly bumps on my face.

1) Do you think these are cysts? Does this have a particular same or syndrome? Is this common?

2)Would new birth control pills make any difference?  I know that some brands of pills are marketed to help keep skin clear but that seems to be more along the lines of acne and this doesn't seem to be acne.  I'm currently on the low-dose "mini-pill" and have been taking this particular brand for almost five years.

3)Why now, at my age, are they suddenly appearing?

4)If they suddenly started appearing will they suddenly STOP appearing?

5)If they are cysts, is there any treatment? Or is just leaving them alone to go away on their own the only option?

Thanks very much, I look forward to your reply.
by Alan Rockoff, MD, Dec 20, 2004 12:00AM
I think they're more likely to be acne cysts (blocked pores) than real cysts.  Perhaps you're squeezing them.  Birth control pills would probably not make much difference.  I don't know why they started now, but it's not as uncommon as you might think.  You need to see a dermatologist for proper diagnosis and treatment, so you can make them stop appearing.  Meantime, I'd advise leaving them alone.

Take care.

Dr. Rockoff
Member Comments (4)
by Jenell, Jan 17, 2005 12:00AM
Mother of 2, I also have the same problem the past 6-8 months. I'm a mother of 1, 38yrs old and never had acne either. I went to a dermatologist and they agreed that they were cysts caused by stress and hormones. They want to put me on a medication like accutane but better. I'm going to do this but I'd love to have them cut out today! It's driving me crazy. I loved your letter. I couldn't believe someone else had them. I feel for you. It's makes me cry when I can't stop picking them. I can't help it, it's driving me crazy. I'll do whatever it takes to make them go away. I'll let you know how the medicine works, but you should do the same. Jenell
by kunasaj, Jan 23, 2005 12:00AM
I am 21 years old and feel your "pain". I have had acne since the age of 17 and since then everything has gone downhill from there. I have seen dermatologists before for my condition; however, I never noticed any improvement in my complection from any perscriptions (everyone is obviously different). I have "combination" skin which is oily consisting of large pores. I have honestly tried almost every product including Proactiv, Murad, over the counter etc. However there is one thing I have not tried and that is to quit smoking and to drink more H2O. Who knows...maybee some green tea too.
If anyone has any advice in regards to small (tiny) bumbs all over, under the skin's surface, please let me know. They are not painful and I don't consider them to be "acne".

My experience...
Facial cysts, including areas on the neck started to form about two years ago. One Cyst, which turned into two, located on the side of my face by the earlobe, I had recently removed by a plastic surgeon. It turned into two after my consisitent picking so I suggest not to pick or squeeze them. The cyst that I had removed was thought to have an ingrown hair and that is the reason why I decided to have surgery. However, I do not reconmend getting your cysts "cut out" because for one, as the doctor will tell you, there is no guarantee that it will not come back. Second, as in my situation, they may not remove "all" of it and therefore, it is not that it came back but that it was never all removed. Finally, the scarring is not that pleasant and believe me, it is noticeable.
My personal advice is to not touch them because they will get a lot larger within a very short period of time (inflamed), and to use or take a anti-inflamatory to keep the inflamation (inflammation) down. My experience with cysts is that they come and go but when they go they are realy still there and come back in the same spot, unless new ones start to form.

Sometimes I thought I had cysts when mounds under the skin started to develope, which are red, and sometimes sore (painful). I think these are just a bacterial infection deep under the skins surface and if not treated and touched, can spread elsewhere.

If you are very concerned, seek medical attention before your condition worsens but do not go "under the knife" unless truley needed.
by Kristi B, Aug 12, 2007 04:35PM
To: Dr. Rockoff
Hello I am a 36 yr old women who has developed a nickel size hard knot on my forehead.  I'm not quite sure if the skin moves of the knot or if the knot is moving under the skin.  I t has gradually gotten larger.  It is not sore or red like a acne blemish.  It's very noticeable.  Any ideas as to what this might be.  No recent injury to the area.  I've probably had it for over a year.  My primary care dr. recommended seeing a plastic surgeon. What are your thoughts?
Kris
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by Kitten2448, Apr 21, 2010 09:17PM
To: Kitten24
I'm a 33 year old and mother of one that is 10. After I had him my hormones have changed and my skin has small pencil sized eraser cysts on my face in the oily t zone area they have got worse over the last couple of months and will not go away. The only thing that has changed is the stress has got worse for me as well as depression. I always get a large pimple one week before my period, and have severe mood swings!!! I thought I was alone on this topic but as I see I'm not.
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