Lipoma or sebaceous cyst: the difference and when to show a lump under the skin to a surgeon
A lipoma is a benign growth of fatty tissue under the skin, usually soft, movable and painless. An atheroma, often called a sebaceous cyst, is a small sac under the skin filled with thick material, and it can become inflamed. A doctor reliably tells them apart by examination and, if needed, ultrasound. At Maja Hospital in Niš lipomas and cysts are usually removed under local anaesthetic, and the removed tissue is usually sent for histopathology to confirm what kind of growth it is.
What is a lipoma?
A lipoma is a benign growth made of fatty tissue. It lies under the skin, most often on the back, shoulders, neck, arms or abdomen. It usually feels soft, moves under the skin and is not painful. It usually grows slowly, over months or years.
Some people have one lipoma and others have several. A lipoma very rarely turns into a malignant growth, but every new lump should be shown to a doctor once to confirm what it is.
What is an atheroma (sebaceous cyst)?
An atheroma is commonly called a sebaceous cyst. It is a small sac under the skin filled with thick, whitish material. It is usually round, somewhat firmer than a lipoma and attached to the skin, and a small dark dot, an opening, can sometimes be seen on top.
A cyst can become inflamed: it turns red, warm, painful and swollen, and sometimes pus forms. A cyst should not be squeezed, as this can cause inflammation or make it worse.
Lipoma or cyst: how to tell them apart?
Rough differences:
- A lipoma is usually soft, movable and not attached to the skin. A cyst is firmer and attached to the skin above it.
- A small opening can sometimes be seen on top of a cyst. A lipoma has none.
- A cyst can become inflamed and leak material with an unpleasant smell. A lipoma usually does not become inflamed.
These differences help, but they are not reliable. Other growths under the skin can look similar, so the doctor determines the difference by examination and, if needed, ultrasound. The final answer comes from histopathology of the removed tissue.
When to show a lump under the skin to a surgeon?
It is a good idea to book an examination for any new lump under the skin. Do not delay it if you notice any of the following:
- the lump is growing quickly,
- it is hard or does not move,
- it hurts or comes back after removal,
- it is larger than a few centimetres,
- the skin over it is changing,
- a cyst is red, warm and painful.
At the examination the surgeon assesses the growth and suggests whether it should be removed, monitored or examined further.
What does removal of a lipoma or cyst involve?
Smaller lipomas and cysts are usually removed under local anaesthetic: the area around the lump is numbed with an injection and the patient is awake. Through a cut in the skin the surgeon removes the lipoma, or the cyst together with its sac, to reduce the chance of it coming back. The wound is closed with stitches.
In the plastic and aesthetic surgery price list of Maja Hospital lipoma removal under local anaesthetic is listed by the number of growths, and cyst removal by size. For larger or more numerous growths the general surgery price list also includes removal of a cyst or lipoma under general anaesthetic. An inflamed cyst is usually treated first and removed completely once the inflammation settles. The removed tissue is usually sent for histopathology.
Recovery after removal
After a small procedure under local anaesthetic you usually go home the same day, when the doctor considers it safe. The area may be tender for a few days, and a small bruise sometimes appears. Keep the wound clean and dry as the doctor advises. The doctor removes the stitches at the check-up, once the wound has healed. A scar remains at the site, and its size depends on the size of the growth.
Contact the doctor if you notice redness, warmth, more swelling, pus or a fever.
The information in this text is general in nature and does not replace an examination by a doctor.
