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Dermatology (Expert Forum)
Facial Cysts with Ingrown Hair
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
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Facial Cysts with Ingrown Hair
by sloaneylou, Oct 26, 2003 12:00AM
Dr. Rockoff,
Have you ever heard of the type of situation I am facing? I've been to 8 dermatologists, an endocrinologist, and an internist, but no one seems to be able to figure this one out!
I'm a 33 year old woman who always had "perfect" skin until I hit my thirties. Over the past three or four years, I've experienced a steady stream of boils/cysts on my face - all on my jawline, as well as an occasional one on my forehead. The breakouts intensify about one week before my period.
I've been put on various antibiotics...I've received cortisone shots...and have also taken prednisone, but to no avail. My face will clear up, only to break out again - in the exact same places where the cysts previously appeared.
In the last year or so, the situation has become worse. These welts are huge - and unbelievably painful. Even though I know I am not supposed to pick at them, the pain is so bad, I have done so anyway. And to my horror, I realized that not only is there pus inside these cysts, but hairs as well. Some of these hairs are vellus. Once I pulled out a vellus hair that was SIX inches long.
In other cysts, the hairs are incredibly coarse, much thicker than hair anywhere else on a human body. Most recently, I pulled out a 2-and-a-half inch coarse hair from a cyst on my forehead. I didn't even know that hair could grow out of one's forehead! The pain caused by these hairs is unreal - I truly believe they are getting wrapped up around nerves. For instance, with this forehead welt, before I took out the hair, I touched the cyst - and the pain extended down to my eyebrow and all the way up to my scalp.
Once I extract the hair, much of the pain subsides... and the cyst is able to heal up and go away. However, in a few months, the welts come back - in the exact same places.
When I went to the endocrinologist, he did not feel this was PCOS, because I do not have a broad pattern of male hair growth, just in selected places. Also of note: I have been prescribed spironlactone but have not been on it for very long (3 months approx), and so do not know if this will be of much help.
So, my questions are:
* Should I have these cysts surgically removed?
* Should I go on accutane?
* Have you ever heard of long hairs within facial cysts? If so, do you believe that the acne is stimulating the hair growth, or vice versa?
I am so discouraged - I feel I have tried everything possible to rid myself of this horrible acne - and, so, any advice you might have would be helpful. Thanks!!
Have you ever heard of the type of situation I am facing? I've been to 8 dermatologists, an endocrinologist, and an internist, but no one seems to be able to figure this one out!
I'm a 33 year old woman who always had "perfect" skin until I hit my thirties. Over the past three or four years, I've experienced a steady stream of boils/cysts on my face - all on my jawline, as well as an occasional one on my forehead. The breakouts intensify about one week before my period.
I've been put on various antibiotics...I've received cortisone shots...and have also taken prednisone, but to no avail. My face will clear up, only to break out again - in the exact same places where the cysts previously appeared.
In the last year or so, the situation has become worse. These welts are huge - and unbelievably painful. Even though I know I am not supposed to pick at them, the pain is so bad, I have done so anyway. And to my horror, I realized that not only is there pus inside these cysts, but hairs as well. Some of these hairs are vellus. Once I pulled out a vellus hair that was SIX inches long.
In other cysts, the hairs are incredibly coarse, much thicker than hair anywhere else on a human body. Most recently, I pulled out a 2-and-a-half inch coarse hair from a cyst on my forehead. I didn't even know that hair could grow out of one's forehead! The pain caused by these hairs is unreal - I truly believe they are getting wrapped up around nerves. For instance, with this forehead welt, before I took out the hair, I touched the cyst - and the pain extended down to my eyebrow and all the way up to my scalp.
Once I extract the hair, much of the pain subsides... and the cyst is able to heal up and go away. However, in a few months, the welts come back - in the exact same places.
When I went to the endocrinologist, he did not feel this was PCOS, because I do not have a broad pattern of male hair growth, just in selected places. Also of note: I have been prescribed spironlactone but have not been on it for very long (3 months approx), and so do not know if this will be of much help.
So, my questions are:
* Should I have these cysts surgically removed?
* Should I go on accutane?
* Have you ever heard of long hairs within facial cysts? If so, do you believe that the acne is stimulating the hair growth, or vice versa?
I am so discouraged - I feel I have tried everything possible to rid myself of this horrible acne - and, so, any advice you might have would be helpful. Thanks!!
Doctor's Answer
by Alan Rockoff, MD, Oct 27, 2003 12:00AM
, Oct 27, 2003 12:00AM
You should not have these cysts removed--all you'll get for your trouble is scarring.
You should indeed consider taking Accutane. You should also consider removing the hair: Vaniqa cream (Rx), depilatories, waxing, electrolysis, or laser.
Whatever you do, however, you must on no account pick or squeeze these lesions. Further, you must stop extracting the hair. I know this is a hard prescription to follow, but unless you stop, I can say with rueful confidecne that you just won't get better.
Best.
Dr. Rockoff
You should indeed consider taking Accutane. You should also consider removing the hair: Vaniqa cream (Rx), depilatories, waxing, electrolysis, or laser.
Whatever you do, however, you must on no account pick or squeeze these lesions. Further, you must stop extracting the hair. I know this is a hard prescription to follow, but unless you stop, I can say with rueful confidecne that you just won't get better.
Best.
Dr. Rockoff
Thank you so very much for your response.
If I may ask you for just a bit more information... Do you have any insight as to WHY there is such extreme hair growth inside these cysts? Have you ever heard of
this type of situation?
In other words, why don't I just have "regular" acne, with only pus inside the welts? Would the accutane alone help with both the cysts AND the hair growth?
Thanks again for your advice.
Dr. Rockoff
At first