Local Procedures for Lipomas (Fat Cysts)

In general terms, fluid-filled sacs surrounded by a membrane are called cysts. Epidermoid cysts, or sebaceous cysts as they are also known, are common lesions seen on the skin. These formations, also referred to as lipomas (fat cysts) in the general public, are surrounded by a membrane and contain a thick, oily, and foul-smelling fluid. They do not pose a life-threatening problem. However, they are aesthetically bothersome. They are described as benign skin lumps. Rarely, lipomas can be malignant and grow slowly. Op. Dr. İbrahim Çolhan, serving patients in Adana, explained what local procedures for lipomas are and how lipomas are treated for you.

What Causes a Lipoma (Fat Cyst)?

Sebaceous glands are found in the scalp and throughout the skin. The oil produced by the skin is called sebum. Sebum reaches the skin surface through ducts from the sebaceous glands. Cysts form as a result of blockages in these ducts. Blockages can occur due to acne, surgical wounds, or trauma. A lipoma can form months or even years after a trauma. Since lipomas grow slowly, it may take time to notice them. Lipomas can sometimes be present from birth or can arise from nevi composed of basal cells.

What are the Symptoms of Lipomas (Fat Cysts)?

When touched, they feel soft. However, they are firmer than fat deposits.

• They move slightly when touched.
• They feel round under the skin.
• A single one can form on the body, or multiple ones can form on the entire body or in a specific area.
• They manifest with symptoms such as edema, infection, and redness on the skin surface.

However, you should not assume every swelling you see on your skin is a lipoma. Hard masses on the scalp could be a swelling related to bone or a structural anomaly. Swellings seen in the neck area could be lymph nodes. When suspicious lesions are encountered, necessary examinations should be performed by a specialist doctor.

Do Lipomas (Fat Cysts) Cause Pain?

Epidermoid cysts usually do not cause pain. Large cysts can cause pain due to pressure. When infection is present, lipomas can be painful.

Where Are Lipomas (Fat Cysts) Most Commonly Found?

• Scalp surface
• Back area
• Face
• Neck

If lipomas are in visible areas, they can be bothersome. Especially lipomas on the face attract attention and can disturb the person. Lipomas formed on the scalp can cause discomfort when combing hair.

How Are Lipomas (Fat Cysts) Diagnosed?

Lipomas can be easily diagnosed with a physical examination performed by a specialist doctor. If the cyst is suspected of being cancerous, the doctor may request some tests. As a result of the tests, it may be decided to surgically remove the lipoma from the body.

Ultrasonography is one of the most commonly used diagnostic methods for lipomas. In cases of large cysts, cysts located in different parts of the body, and cases with suspected cancer, computed tomography may be used. If there is suspicion of cancer in the removed cysts, they may be sent for pathological examination.

Some cysts that occur on the scalp may be mistaken for lipomas. If the mass on the scalp is hard, it could be an indicator of a bone pathology. Therefore, a skull X-ray of the patient may be necessary.

Inflammation of a Lipoma (Fat Cyst)

Harmless lipomas, often unnoticed, can cause problems if they become inflamed. Microorganisms entering the cyst from the capsule can cause the cyst to become inflamed. In such cases, pain is felt. If the inflammation turns into an abscess, the pain may increase. The surface of the cyst is usually warm and red. In such cases, antibiotic therapy or cryotherapy may be used. In cases where the infection does not resolve, the inflammation may need to be drained. After the inflammation is drained, the likelihood of the lipoma recurring is almost one hundred percent. This is because the cyst has not been treated. The capsule has not been removed. Only the abscess and inflammation have been cleared. When the infection recurs, there are connective tissue adhesions around the cyst. In such cases, surgical intervention becomes more difficult. The likelihood of scarring increases. Therefore, lipomas should be removed before they grow and become infected.

How Are Lipomas (Fat Cysts) Treated?

Treatment of lipomas is usually performed for cosmetic purposes. This is because lipomas do not cause serious health problems. However, they make the person feel bad aesthetically. Patient expectations are important in treatment. This is because it is as important to remove the cyst as it is to avoid leaving a scar behind.

How Is Surgical Treatment for Lipomas (Fat Cysts) Performed?

The most effective method for treating lipomas is their surgical removal from the body. Since the treatment is for aesthetic purposes, the incision made on the skin is as small as possible. In addition, care should be taken to make an incision parallel to the skin folds. A small scar may occur. 

If the entire cyst is surgically removed, the likelihood of recurrence is very low. Other methods may be preferred to avoid any scarring. However, in such cases, there is a possibility of the cyst recurring. The probability of recurrence is high in non-surgical procedures.

Complications such as infection of the surgical site or dehiscence of sutures can occur in almost any surgical wound.

Aspiration with a Needle:

Aspiration of the cyst with a needle is not a definitive treatment method. It can be preferred in areas where removal is not appropriate or where a scar is not desired. In this method, which aims to drain the contents of the cyst, the fluid cannot be drawn with a syringe as it is a thick, oily substance. The likelihood of recurrence is high.

Mini Excision

This procedure involves draining the contents of the cyst using laser technology through a small incision made over the cyst. The cyst membrane is removed after one month. It is a preferred method as it involves a smaller incision compared to surgical treatment.

Treatment of Lipomas (Fat Cysts) on the Head (Scalp and Face)

The scalp is one of the most common areas where lipomas occur. Generally, the most effective method for definitive treatment is surgical removal of the cyst. The cyst capsule must also be removed, otherwise the cyst may recur.

Is it Necessary to Shave Hair When Removing a Lipoma (Fat Cyst) from the Scalp? 

This can vary depending on the surgeon's experience and approach. However, it is usually not necessary to shave the hair. Blood circulation in the scalp is extremely fast. Therefore, infection is rarely seen in this area. There is no harm in washing the scalp one day after the surgery. The person can continue their daily life as usual.