Sebaceous Cysts in Dogs: Causes, Diagnosis, and Treatment


Sebaceous Cysts in Dogs: Causes, Diagnosis, and Treatment

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Reviewed by a Licensed Veterinary Doctor (DVM)
Small Animal Dermatology and Surgery
This article is reviewed for clinical accuracy. Skin lumps in dogs should be evaluated by a veterinarian rather than assumed to be benign. Fine needle aspirate (FNA) cytology is the standard first step for any new, growing, or changing skin mass; excision and histopathology provide definitive diagnosis. Never attempt to drain or express a skin cyst at home.

Key Takeaways

  • The term “sebaceous cyst” is used loosely by owners and occasionally by veterinarians, but the precise histopathological term for the most common equivalent in dogs is an epidermoid cyst (also called infundibular cyst or epidermal inclusion cyst), which forms when the infundibular portion of a hair follicle becomes blocked with keratin debris and sebaceous secretions. True sebaceous cysts (dilated pore of Winer, steatocystoma) are less common. The distinction matters because histopathology guides prognosis and recurrence risk; cytology alone on aspirated material (white or yellow-white cheesy/paste-like material that looks like cottage cheese or toothpaste) is suggestive but not definitively diagnostic of the specific cyst type.
  • Epidermoid cysts are benign, slow-growing, well-circumscribed intradermal masses that feel firm to fluctuant, are freely moveable, and are generally non-painful unless ruptured or secondarily infected. A characteristic central pore (comedone-like opening) may be visible through the overlying skin. They are most common in middle-aged to older dogs and show breed predisposition in Schnauzers, Cocker Spaniels, Boxers, Basset Hounds, Doberman Pinschers, and Golden Retrievers.
  • A ruptured sebaceous or epidermoid cyst produces a dramatic acute inflammatory reaction as the keratin contents leak into the surrounding dermis: the area becomes hot, red, swollen, and very painful within hours, and may be mistaken for a bite wound, abscess, or aggressive tumor. Ruptured cysts are not infected per se (sterile inflammation from keratin material acting as a foreign body) but secondary bacterial contamination is common, and differentiation from a true abscess requires cytology. Treatment: warm compresses, prednisolone 0.5-1 mg/kg/day short course for sterile inflammation, antibiotic cover with amoxicillin-clavulanate 12.5-15 mg/kg PO BID for 7-14 days if secondary infection is suspected, and complete surgical excision once acute inflammation resolves (within 4-6 weeks).
  • Surgical excision is the definitive treatment and is curative when the entire cyst wall is removed intact. If the cyst ruptures during surgery or if the wall is incompletely removed, recurrence rates are high (up to 50%). Leaving a cyst untreated is acceptable in a dog that is not bothered by it, as long as the mass is confirmed benign; however, any mass that grows rapidly, becomes ulcerated or fixed to underlying tissues, or develops an atypical appearance should be biopsied to rule out mast cell tumor (the most common skin tumor in dogs, which can closely mimic a benign cyst), melanoma, or other malignancy.
  • The most dangerous diagnostic error with sebaceous or epidermoid cysts is assuming a skin lump is “just a cyst” without obtaining a cytology or histopathology sample. Grade 1-2 mast cell tumors (MCTs), which are far more common in dogs than in humans, frequently appear as small, soft, mobile, skin-colored masses that look and feel identical to benign cysts; manipulating or squeezing a mast cell tumor degranulates mast cells and can trigger a local or systemic histamine reaction. All new skin masses in dogs should be aspirated for cytology before any manipulation or reassurance that they are benign.

A lump just appeared on your dog’s skin, feels soft or doughy, moves freely under the fingers, and when it ruptures it releases a white waxy or cheesy material. This is the classic presentation of what owners call a sebaceous cyst. But the dog’s skin is one of the most common sites for neoplasia, and distinguishing a benign cyst from a mast cell tumor, melanoma, or soft tissue sarcoma cannot be done reliably by palpation alone. Understanding what sebaceous and epidermoid cysts actually are, how they behave, when to intervene, and which signs should prompt urgent evaluation is essential for every dog owner.

What Is a Sebaceous Cyst in Dogs?

The sebaceous glands of the dog’s skin are small, lobular glands that open into the hair follicle above the point where the arrector pili muscle attaches. Their primary product is sebum, a lipid-rich secretion that lubricates and waterproofs the hair and skin surface. “Sebaceous cyst” is a colloquial term that encompasses several distinct histopathological entities in veterinary dermatology:

  • Epidermoid cyst (infundibular cyst, epidermal inclusion cyst): The most common type in dogs. Forms when the infundibular (upper) portion of the hair follicle becomes blocked, causing keratin lamellae, desquamated keratinocytes, and sebaceous secretions to accumulate and distend the follicular lumen. The cyst wall is lined by stratified squamous epithelium; the contents are laminated keratin with a white or yellow-white, dry to paste-like consistency. When aspirated, the material looks like cottage cheese or whitish toothpaste.
  • Isthmus cyst (tricholemmal cyst): Arises from the isthmus region of the hair follicle; less common; wall lined by cells without a granular layer (a distinctive histopathological feature); content is amorphous keratin rather than laminated keratin scales. Sometimes called a “pilar cyst” in older literature.
  • Dilated pore of Winer: A large, dilated follicular infundibulum containing laminated keratin; opens to the surface; usually solitary; common in dogs.
  • Steatocystoma (sebaceous duct cyst): A cyst lined by sebaceous gland epithelium that produces oily/greasy sebum-like fluid rather than dry keratin; true sebaceous secreting cyst; can present as multiple small lesions (steatocystoma multiplex) in some dogs.
  • Dermoid cyst: A congenital lesion found along the dorsal midline; contains mature epidermal and adnexal structures; may communicate with the spinal canal (dermoid sinus) in Rhodesian Ridgebacks and certain other breeds; surgical correction early in life is important to prevent neurological complications if the tract extends to the spinal cord.
  • Follicular cyst related to demodicosis or folliculitis: Secondary cyst formation occurring when Demodex-induced follicular inflammation causes follicular dilation; addressed by treating the underlying mite infestation.

For practical purposes, the evaluation and management of all these types follows a similar decision pathway, with the key distinction being that dermoid cysts along the dorsal midline require urgent evaluation for spinal involvement.

Anatomy: Why Hair Follicles Form Cysts

Each hair follicle has three regions: the infundibulum (upper segment extending from the skin surface to the entry of the sebaceous gland duct), the isthmus (middle segment between the sebaceous duct and arrector pili attachment), and the lower segment (extending from the arrector pili to the hair bulb). The infundibulum is lined by an epithelium that continuously desquamates keratinocytes toward the skin surface; normally, these cells and the sebaceous secretion are carried to the surface and shed with the hair. When the follicular opening becomes obstructed, the keratin debris accumulates and the follicular lumen distends progressively over weeks to months, eventually forming a palpable cyst within the dermis or subcutis. The cyst wall (the retained follicular epithelium) continues to produce keratin, so the cyst slowly enlarges over time. The obstructing event can be physical (scarring from prior trauma or inflammation, hyperkeratosis in seborrheic breeds, comedone formation in demodicosis) or idiopathic.

Which Dogs Get Sebaceous and Epidermoid Cysts?

Epidermoid and sebaceous-type cysts can occur in any breed and sex, but certain breeds have markedly higher incidence due to variations in follicular anatomy and sebaceous gland function:

Breed Predisposition Notes
Miniature Schnauzer Comedo syndrome (Schnauzer comedo syndrome) produces blackheads on the dorsal midline that can progress to follicular cysts and secondary furunculosis; associated with primary keratinization defect
Cocker Spaniel Primary idiopathic seborrhea produces excessive sebaceous secretion; multiple sebaceous cysts common; also predisposed to ceruminous cysts in the ears
Boxer High incidence of all skin tumors including cysts; mast cell tumor must always be ruled out before a skin lump is classified as benign
Basset Hound Facial fold intertrigo and seborrhea predispose to comedones and follicular cysts
Doberman Pinscher Prone to dilated pores of Winer and epidermal inclusion cysts; follicular plugging common
Golden Retriever Epidermoid cysts common in middle age; interdigital cysts (pododermatitis) caused by foreign body reaction to broken hairs driving into the paw web
Rhodesian Ridgeback Dermoid sinus along the dorsal midline from the occiput to the tail; ridge dogs must be examined at birth; early surgical correction before spinal involvement
Poodle (Standard) Idiopathic sebaceous adenitis (SA) destroys sebaceous glands; follicular cysts secondary to SA-associated follicular plugging

Diagnosing a Sebaceous Cyst

Clinical diagnosis is based on signalment, history, and physical examination findings, but cytological confirmation is required before any skin mass is labeled benign. The standard diagnostic algorithm:

Step 1: Physical Examination

Characteristics that suggest an epidermoid or sebaceous cyst on palpation: well-circumscribed, round to oval, firm to fluctuant, intradermal (moves with the skin, not deep to it), freely mobile over underlying tissues, non-painful, slow-growing over months, with a possible central pore visible through the overlying skin (a punctum filled with keratin debris resembling a comedone). Surrounding skin is normal unless the cyst has ruptured previously.

Concerning features that raise suspicion for something other than a benign cyst: rapid growth (days to weeks, not months), ulceration, fixation to underlying tissues, irregular margins, multiple satellite masses, regional lymph node enlargement, constitutional signs (weight loss, lethargy). Any of these features significantly raises the index of suspicion for mast cell tumor, soft tissue sarcoma, melanoma, or other malignancy and requires cytology or immediate biopsy.

Step 2: Fine Needle Aspirate (FNA) Cytology

FNA is performed with a 22-25 gauge needle inserted into the center of the mass and material withdrawn by gentle negative pressure or by non-aspiration technique (capillary action). The aspirated material from an epidermoid cyst is typically large amounts of anucleate squamous cells (ghost cells or squames), keratin debris, and sebaceous lipid material; nucleated cells are absent or very sparse; no mast cell granules, melanin pigment, or mitotic figures. If the aspirate shows mast cells (round cells with purple cytoplasmic granules), the diagnosis is mast cell tumor and surgical planning begins immediately. The sensitivity of FNA cytology for distinguishing benign cysts from malignant neoplasia in dogs is approximately 70-85% in experienced hands; false negatives occur with poorly exfoliating tumors or sampling error. A non-diagnostic aspirate (blood only, or acellular material not consistent with cyst contents) warrants excisional biopsy rather than reassurance.

Step 3: Histopathology (Excisional or Incisional Biopsy)

Histopathology is the gold standard for definitive diagnosis. Excisional biopsy (complete surgical removal of the mass) is both diagnostic and curative for a confirmed benign cyst. The pathologist evaluates the cyst wall architecture, lining epithelium characteristics, and contents to classify the cyst type precisely. If the cyst has ruptured (spontaneously or during excision), the inflammatory reaction around spilled keratin creates a pyogranulomatous foreign body response that can obscure the cyst wall and make histological classification more difficult.

Treatment Options

Observation Without Intervention

Watchful waiting is appropriate for: a cyst confirmed benign by FNA cytology, not causing the dog discomfort, not in a location prone to trauma (head, neck, legs), stable in size over 3-6 months of monitoring. Re-evaluate with repeat FNA if the mass enlarges, changes in character, or becomes inflamed. The owner should be instructed not to express or squeeze the cyst; manual expression is not definitive treatment (the wall remains and refills) and risks rupturing the cyst into the dermis, causing intense inflammatory reaction.

Surgical Excision

Surgical excision under general or local anesthesia is the definitive treatment and is curative when the entire cyst capsule is removed intact. Technique: an elliptical skin incision is made over the cyst; blunt and sharp dissection separates the cyst from surrounding tissue maintaining the integrity of the cyst wall throughout the dissection; the cyst is removed intact without rupture; the subcutaneous dead space is closed with absorbable suture (poliglecaprone 25 Monocryl or polyglactin 910 Vicryl 3-0); skin closure with non-absorbable monofilament or intradermal absorbable. If the cyst ruptures during dissection, thorough lavage of the operative site and removal of all visible keratin material is critical; incomplete removal of keratin debris produces persistent granulomatous inflammation and high recurrence risk. Histopathology of the excised specimen is recommended even when the diagnosis seems obvious, to confirm the cyst type and rule out concurrent neoplasia arising within a cyst wall (rare but documented for squamous cell carcinoma arising within an epidermoid cyst).

Managing a Ruptured or Infected Cyst

A spontaneously ruptured cyst presents as acute, painful, red, hot swelling with possible discharge. Management: distinguish sterile foreign-body (keratin) granuloma from secondary bacterial abscess by cytology of the discharged material (keratin squames with macrophages/giant cells = sterile; degenerate neutrophils with intracellular bacteria = bacterial). For sterile foreign body response: prednisolone 0.5-1 mg/kg/day PO for 7-14 days to reduce inflammation; warm compresses 2-3x daily; amoxicillin-clavulanate 12.5-15 mg/kg PO BID as prophylaxis for secondary infection. For confirmed secondary bacterial infection: culture and sensitivity from aspirate of purulent material; empirical amoxicillin-clavulanate or cephalexin 22-33 mg/kg PO BID pending culture results; 14-21 days course minimum. Surgical excision should be delayed at least 4-6 weeks until the acute inflammation has fully resolved; operating in the acute phase significantly increases complication risk (dehiscence, poor healing, recurrence from incomplete removal in inflamed tissue).

Interdigital Cysts: A Special Case

Interdigital cysts (pododermatitis, interdigital furuncles) appear as painful, red, raised nodules between the toes of the paw web, most often in the interdigital spaces. They are not true sebaceous cysts but are caused by a foreign body reaction to broken, ingrown hairs that penetrate the paw skin; secondary bacterial and fungal infection (Malassezia, Staphylococcus pseudintermedius) compounds the inflammation. Breeds predisposed to interdigital cysts include English Bulldogs, Labrador Retrievers, Great Danes, Basset Hounds, and any breed with short, stiff coat hairs on the feet. Treatment is challenging: underlying allergic skin disease (atopic dermatitis or food allergy, which drives excessive paw licking and self-trauma) must be addressed first; initial medical management with chlorhexidine soaks 2x daily, systemic antibiotic guided by culture (often multidrug-resistant Staphylococcus requiring doxycycline 5-10 mg/kg BID or clindamycin 5.5 mg/kg BID), and anti-inflammatory doses of prednisolone or oclacitinib (Apoquel 0.4-0.6 mg/kg BID); CO2 laser ablation or surgical excision of the interdigital web (metatarsal or metacarpal web resection technique by Swaim) is indicated for refractory cases or when multiple recurrences occur.

Cost Overview

Service Approximate Cost
Veterinary exam + FNA cytology $75-$175
Surgical excision (small cyst, local anesthesia) $200-$400
Surgical excision (GA, routine) $400-$900
Histopathology of excised specimen $100-$200
Culture and sensitivity (infected cyst) $75-$150
Interdigital pododermatitis – full workup + treatment course $300-$800 initial; ongoing management if allergies present

Red Flags: When a Skin Lump Needs Urgent Attention

  • Any skin mass that has grown noticeably within 2-4 weeks: rapid growth is not characteristic of benign cysts and raises concern for mast cell tumor, soft tissue sarcoma, or other malignancy; any rapidly growing mass requires FNA cytology or biopsy as soon as possible, within days, not weeks
  • A skin lump that ulcerates, bleeds from the surface, or develops a raw area: ulceration is uncommon in benign cysts and is a warning sign for high-grade mast cell tumor, cutaneous hemangiosarcoma, or squamous cell carcinoma
  • A lump that is fixed to the underlying muscle or bone and cannot be moved over the deeper tissue layer: fixation to deep structures indicates invasion and is strongly suggestive of malignancy; benign cysts are freely moveable over underlying tissue
  • A lump on or near the digits, nail bed, or paw: subungual (nail bed) and digital masses in dogs have a high rate of malignancy (digital squamous cell carcinoma in large, dark-coated breeds; digital melanoma); a lump at the digit tip or associated with nail bed destruction requires immediate radiographs to check for bone involvement and referral for surgical planning
  • Swelling on the dorsal midline of a Rhodesian Ridgeback puppy or young dog: always evaluate for dermoid sinus with spinal tract communication; palpate for a cord-like structure under the skin from the nape of the neck to the tail; MRI or myelography establishes depth; surgical correction before neurological signs develop is the goal
  • A mass that fluctuates significantly in size day to day (Darier’s sign): waxing and waning size in a skin mass is characteristic of mast cell tumor, which releases histamine in response to stimulation; the mass may also cause local hives (urticaria) when rubbed

Age-Specific Considerations

Puppies (Under 1 Year)

  • Dermoid sinus (dermoid cyst with possible spinal communication) should be assessed in all Rhodesian Ridgeback puppies at the first puppy examination and before any breeding or show registration; the ridge itself is normal but a subcutaneous tract along the midline is not; MRI is the diagnostic test of choice to assess depth; surgeons experienced with this condition should perform the excision; untreated tracts can lead to ascending meningitis and myelopathy as the puppy grows
  • New lumps in puppies are more likely to be histiocytoma (a benign, rapidly growing button-like tumor on the face, ears, or limbs of young dogs under 3 years that often resolves spontaneously in 1-3 months) than epidermoid cysts; FNA cytology distinguishes histiocytoma (sheets of round histiocytes) from cyst contents; no treatment is needed for histiocytoma unless ulcerated or not resolving
  • Multiple small cyst-like lumps in a puppy along the back may represent comedone formation from Demodex folliculitis or, in Miniature Schnauzers, early Schnauzer comedo syndrome; skin scraping and dermatological evaluation is warranted

Adult Dogs (1-8 Years)

  • Epidermoid and sebaceous cysts are uncommon in dogs under 3 years; a soft, mobile skin lump in a young adult dog is statistically more likely to be a lipoma (soft, lobulated, subcutaneous, beneath the skin rather than within it) or mast cell tumor than a cyst; FNA cytology distinguishes: lipoma (fat cells, no other findings), mast cell tumor (mast cells with granules), epidermoid cyst (anucleate squames, keratin)
  • Seborrheic breeds (Cocker Spaniels, West Highland White Terriers, Basset Hounds) may develop multiple cysts as part of a primary keratinization disorder; managing the underlying seborrhea with fatty acid supplementation, medicated shampoos (benzoyl peroxide, salicylic acid), and retinoids (isotretinoin in selected cases) may reduce new cyst formation rate
  • Interdigital cysts in adult dogs of predisposed breeds require a full allergy workup (elimination diet trial for minimum 8-10 weeks for food allergy diagnosis; environmental allergy testing if food allergy ruled out) because recurring interdigital pododermatitis almost always has an allergic driver that must be addressed for long-term resolution

Senior Dogs (8+ Years)

  • Multiple new skin lumps in an older dog should all be evaluated individually by FNA, not dismissed as “just cysts” because the dog is old and cysts are common; the incidence of mast cell tumor, lipoma, liposarcoma, and other skin neoplasia rises steeply with age; the statistical background risk of malignancy in any given skin lump is substantially higher in a 10-year-old dog than a 3-year-old dog
  • Surgical decision-making for cysts in senior dogs requires balancing anesthetic risk (pre-anesthetic bloodwork, cardiac and respiratory assessment) against the risk of leaving an unconfirmed or growing mass; consultation with an internal medicine specialist or veterinary cardiologist may be warranted before elective surgery under GA in dogs with concurrent disease
  • A mass that is stable, benign by FNA, non-inflamed, and not bothersome to an elderly dog with significant comorbidities may reasonably be left untreated; monitoring with repeat measurement and FNA every 3-6 months is a defensible approach; the conversation about surgery versus monitoring should be informed by the individual dog’s overall health status

Myths About Sebaceous Cysts in Dogs

Myth

I can squeeze my dog’s cyst to get rid of it.

Fact

Manually expressing a cyst empties it temporarily but does not remove the cyst wall, which immediately begins refilling. More importantly, applying pressure to a cyst can rupture it into the surrounding dermis, releasing keratin material that triggers an intense foreign body inflammatory reaction (sudden painful swelling, redness, and heat) that looks alarming and requires veterinary treatment. You should also never squeeze any undiagnosed skin lump: squeezing a mast cell tumor degranulates mast cells, releases histamine, and can cause a serious local or systemic histamine reaction. If the mass needs treatment, let your veterinarian handle it appropriately after FNA cytology confirms what it is.

Myth

A soft, mobile skin lump must be a benign cyst or lipoma and does not need a veterinary check.

Fact

Physical examination findings (soft, mobile, round, slow-growing) are not reliable predictors of benignity in dogs. Grade 1 and Grade 2 mast cell tumors are among the most common skin tumors in dogs and most commonly appear as soft, mobile, unremarkable lumps that are clinically indistinguishable from benign cysts. Mast cell tumors can also fluctuate in size from week to week, which sometimes gives the false impression that the lump is resolving on its own. FNA cytology is a quick, inexpensive, and minimally invasive procedure that provides reliable differentiation in the majority of cases and should be performed on any new skin lump before it is declared benign.

Myth

Once a cyst is surgically removed, it cannot come back.

Fact

Recurrence after surgical excision of an epidermoid or sebaceous cyst depends on whether the entire cyst wall was removed intact. If the cyst ruptures during surgery and even a small fragment of the epithelial wall is left behind, a new cyst can form from that remnant at the same site within weeks to months. In seborrheic breeds with an underlying keratinization disorder, new cysts can also form at different sites, which represents formation of new cysts rather than recurrence of the original. Complete surgical excision by an experienced surgeon with careful, blunt-and-sharp dissection technique to keep the cyst wall intact throughout the procedure minimizes the recurrence risk substantially.

Frequently Asked Questions About Sebaceous Cysts in Dogs

How do I know if my dog has a sebaceous cyst?

A sebaceous or epidermoid cyst typically appears as a smooth, round, firm to soft lump within the skin, freely moveable, non-painful, and slow-growing over months. A visible central pore filled with white or yellowish material may be present. When expressed (which you should not do), the contents look like white cottage cheese or toothpaste. However, these characteristics overlap with mast cell tumor and other skin tumors, so a veterinary examination and FNA cytology is required to confirm the diagnosis. Never assume a lump is a cyst without veterinary confirmation.

Do sebaceous cysts in dogs go away on their own?

Most epidermoid and sebaceous cysts do not resolve spontaneously; they slowly enlarge over months to years as the retained epithelium continues producing keratin. Occasionally a cyst will rupture spontaneously and the contents will partially drain, after which it may temporarily appear to diminish; however, the remaining cyst wall will refill. A benign, confirmed cyst that is not causing problems can be monitored without removal, but it will not disappear on its own.

Is a sebaceous cyst painful for dogs?

An intact, non-ruptured sebaceous or epidermoid cyst is generally not painful; most dogs ignore it completely. Pain arises when the cyst ruptures (spontaneously or from trauma), releasing keratin into the dermis and triggering an intense, sudden inflammatory reaction with swelling, heat, and redness that is acutely painful. A cyst in a location that experiences repeated friction or pressure (between toes, on the shoulder where a collar rubs, on the body where the dog lies) may cause intermittent discomfort and is a stronger indication for surgical removal.

Should I have my dog’s sebaceous cyst removed?

Removal is recommended when: the cyst has ruptured or is repeatedly rupturing, is in a location prone to trauma or recurrent friction, is large enough to cause cosmetic concern or interfere with movement, or is growing. Removal is not required for a small, confirmed benign, stable, non-bothering cyst, and observation with monitoring is a reasonable alternative. In older dogs with health conditions, the anesthetic risk of elective surgery for a benign cyst should be weighed against the benefit. The decision is made with your veterinarian based on the individual dog’s situation.

Can I treat my dog’s sebaceous cyst at home?

There is no safe or effective home treatment for sebaceous cysts. Do not squeeze, lance, or express the cyst; this risks rupture into the dermis, secondary infection, and does not remove the cyst wall. Warm compresses may help temporarily soothe an inflamed ruptured cyst but will not heal or resolve it. A ruptured or infected cyst requires veterinary evaluation, appropriate antibiotics if infection is present, and ultimately surgical excision once the inflammation has resolved. Home treatment delays definitive care and can worsen the condition.

Can a sebaceous cyst become cancerous in dogs?

Malignant transformation of a benign epidermoid or sebaceous cyst in dogs is rare but documented; squamous cell carcinoma arising within an epidermoid cyst has been reported. More commonly, what appears to be a “sebaceous cyst” turns out to be a mast cell tumor or other malignancy on cytology. This is why FNA cytology of any new skin mass is important regardless of how benign it appears clinically. Histopathology of removed cysts is recommended to confirm the diagnosis and detect any unexpected malignancy in the cyst wall.

Are interdigital cysts the same as sebaceous cysts?

No. Interdigital cysts (interdigital furuncles, pododermatitis) are not true sebaceous cysts. They are caused by a foreign body reaction to ingrown, broken hairs in the interdigital web, with secondary bacterial and fungal infection. They appear as painful, red, raised nodules between the toes. Treatment requires addressing any underlying allergic skin disease driving the self-trauma, plus topical soaks, systemic antibiotics, and anti-inflammatory therapy. Surgical web resection may be needed for refractory cases. They are managed very differently from simple sebaceous cysts.

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