Health & Medical Acne

Cysts And Abscesses

A cyst can form virtually anywhere in the body. It is usually a circular or ovoid structure filled with fluid, gelatinous material, or soft cheese-like substance. It has a distinct membrane around it called the cyst wall. Examples of cysts are dental cysts around the roots of teeth, thyroglossal duct cysts in the vicinity of the thyroid, breast cysts, ganglion cysts on the tendons of the extremities, or ovarian cysts which may form if proper ovulation processes do not occur in a timely fashion. Sebaceous cysts are common in the deep soft tissues of the back; Bakers cysts occur in the posterior aspects of the knees. One characteristic which they have is that they are sterile and usually without symptoms unless they impinge upon a nerve or somehow interfere with movement. If a cyst does become infected it is an entirely different process. It may enlarge, be very tender and cause a fever. At this point it is called an abscess. It usually forms communicating channels with other structures or with the skin. It usually becomes imperative that antibiotics be used to clear up the infection. Surgical treatment involves either draining the abscess and allowing it to heal from the inside out, or completely removing it along with all remnants of the cyst wall which, if left in place, can cause the cystic abscess to reform.
Acne cysts form in the deep skin tissues in the more severe forms of acne. They usually form communicating sinus tracts with the skin. Treatment can involve use of antibiotics to eradicate infecting bacteria. Since the cysts are filled with sebum, it was discovered that isotretoin, a Vitamin A derivative, can significantly reduce sebum production. With the involution of the acne cysts, abscesses associated with cystic acne were reduced, as were the needs to incise and drain abscesses.
Sebaceous cysts on the back and torso can become infected and form abscesses. Since they are filled with sebum also, isotretoin is sometimes used to reduce their size. Most of the time they are ignored until, perhaps after a minor trauma, they become infected and form an abscess. In this circumstance, antibiotics are prescribed and warm moist packs are applied. If the abscess does not heal, then surgical intervention is performed to either drain or remove the infected cyst.
Another type of cystic abscess is the tubal ovarian abscess. Bacteria enter the female genital tract and infect the Fallopian tubes. This infection spreads to the ovary where an abscess is formed. Intense intravenous antibiotics are often initiated, but often pelvic surgery is required to remove the abscessed tube and ovary.
There is a type of abscess that can form over and below the coccyx portion of the lower spine, usually between the gluteal cheeks. It is not for certain whether people are born with a cyst and sinuses there, or whether it is a consequence of an ingrown hair. At any rate the cyst can form an intensely painful abscess which is a few inches to several inches long. Treatment is often a wide excision of all the tissue around and including the abscess. It may be closed with a drain inserted or left open to heal. Like other abscesses antibiotics are prescribed for the infection, but the most efficacious aspect of the treatment is the surgical removal of the abscess and its associated cyst wall.
Another type of cyst that can form an abscess is one involving one of the two Bartholin glands (located at the 4 oclock and eight oclock position) of the female vestibular vulva. These glands normally secrete fluids which moisturize the vestibule. If there is an infection and the duct becomes swollen or closed, an abscess can form in the Bartholin gland. This is, as one might imagine, a very painful abscess. Treatment usually involves making a small cut in the swollen area and inserting a Word drainage tube. Once again it is the incision and drainage which is usually the definitive care for an abscess. Antibiotic may be prescribed if there is infection in adjacent tissue.
So, for the myriad cysts which can form in the body, there is a potential of infection under unusual circumstances. The blood stream, for instance, can carry bacteria to these cysts. There can be trauma which even though slight, can lead to infection. The cornerstone of treatment is incision and drainage, antibiotics, or sometimes wide excision of the entire abscess structure. It is important, though, that every lump not be assumed to be a cyst. It could be an enlarged lymph node or some other kind of growth. It is a good idea to bring any such lumps to the attention of your doctor, especially if they are tender and enlarging in size. He can determine if any other testing or treatment is necessary.

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