You are not alone if you find watching pimples pop to be exciting and gratifying. But what about when it's not a zit? The latest pop-ular internet trend is focused on popping and removing cysts, with photos and videos displaying intricate, surgical removals and extractions of nodules that range from the size of a pea to, well, much bigger.
Some cyst videos are racking up hundreds of thousands of views, making dermatologist Sandra Lee, a.k.a. Dr. Pimple Popper, a celebrity of sorts. The Southern California-based dermatologist refers to pimple, blackhead, and cyst extractions as "magic" and refers to her followers as "popaholics" who are entranced by her volcanic squeeze videos.
As freaky as they may be, experts say cysts are actually pretty common. "Cysts can occur anywhere in the body as well as the skin," said New York City dermatologist Jeannette Graf, MD. "There are many different types of cysts, associated with tissues and glands from different organs. At the same time, the skin also is a very large organ that frequently sees different kinds of cysts."
That said, there's a big difference between cystic acne and other gnarlier types of cysts.
Inflammatory cysts, Graf explains, also known as acne cysts, can be filled with fluid and will disappear or resolve on their own if untreated.
Large cystic pimples are usually caused by — yep, you guessed it — hormones. The tendency to get them is genetic, too, said dermatologist S. Manjula Jegasothy, MD and founder and CEO of Miami Skin Institute. "Generally, these small or large cystic pimples start as normal clogged pores but then become inflamed and go 'underground,' or under the skin, and become cysts."
The risks of cystic pimples range from soft tissue infections to scarring if they are popped or scratched incorrectly, according to Jegasothy, so never try to pop them yourself. Your best course of action is to leave them alone even if they're driving you nuts, because anything you do will not relieve the actual cyst and will only make it worse.
Try taking an OTC medicaiton like Advil to alleviate pain and apply a warm compress to improve blood circulation and healing. If it just won't go away or stop hurting, see a doc, who might be able to inject a concentrated dose of cortisone to shrink the area and relieve the pain. (If you have acne-prone skin, try this organic zit zapper from the Women's Health Boutique.)
Then there are sebaceous cysts: those kinds filled with the thick, cheesy material you've seen in the more dramatic popping videos out there. Sebaceous cysts are associated with an internal trauma to the hair follicle, which creates a sack and continues to grow as this cheesy material while the sack grows with it. The cysts have to be extracted with an incision that must include removal of the sack to keep it from growing back. Most, if not all, of the time, they'll require sutures after removal, too. In other words, don't try this at home.
Graf said that sebaceous cysts can grow so large that they are cosmetically and functionally "disturbing," also noting that some can lead to bacterial abscesses that must be relieved immediately.
What makes sebaceous systs different from pimples and cystic acne is how they look, Graf said. But for the most part, they all vary in size, location, and history of inflammation. Dr. Pimple Popper also sometimes refers to "pilar" cysts, which are sebaceous cysts located on the scalp.
How to treat them
Regardless of cyst type or location, you should never try to pop them yourself.
"It is important to stress the need to resist the urge to pop a cyst on your own and squeeze it out since the risk of infection is very real," said Graf. "It is always a good idea to have any growth seen by a dermatologist. If told that it is benign, the cardinal rule is don't play with it, don't manipulate it, and don't try to drain it."
And yes, even if you're dealing with something far less severe than this 30-year-old cyst, it's still important to get the smaller ones checked out — just in case.