Understanding Vulvar Epidermoid Cysts

An epidermoid cyst is a cyst arising from a blockage in the sebaceous glands of the vulva. Vulvar epidermoid cysts may also be called epidermal inclusion cysts, sebaceous gland cysts, or vulvar sebaceous cysts.

An inclusion cyst contains epithelial tissue, whereas an epidermal cyst is the sebaceous gland itself. These cysts can also develop inside the vagina.

Cysts on the vulvar that come from a sebaceous gland are rare, benign, and typically full of fluid. They are most often found around the vulva, near the vaginal entrance, most often in adults, but sometimes children.

Most sebaceous cysts are small and asymptomatic, however, these types of cysts can grow large and cause pain. Vulvar sebaceous cysts can occur to any person, without seeming preference for ethnic background, age, or location.

Symptoms of a vulvar sebaceous cyst

Fluid-filled cyst that looks like a small bump, possibly more than one bump
Various sizes from a few millimetres
May be red and tender
Large cysts may cause discomfort and pain
Fluid may drain from the cyst, may smell bad
Tampons and sex may cause pain
Walking or sitting may be uncomfortable
Cysts may cause itching and pain when urinating

What causes sebaceous cysts of the vulva?

Vulvar sebaceous cysts form when the oil glands become obstructed, with fluid/oil buildup. These cysts may appear by themselves or in clusters. Sebaceous cysts are not sexually transmitted or caught from another person via towels, sheets, or clothes.

Use of creams, douches, soaps, scented or printed toilet paper, or other irritants may have triggered the problem, so these items should be avoided in future.

Treatment of vulvar sebaceous cysts

The most common course of action is to take no action, unless the cyst is causing pain and discomfort. These cysts may occur due to lack of proper washing of the area, and can often be resolved with use of warm water and a washcloth to clean the area daily.

These cysts are not dangerous and do not tend to be infected. Removal of the cyst may be recommended. Sitz baths can help soothe the area, with a bath of warm water several times a day to burst the cyst. Topical creams or gels may also be prescribed.

Diagnosis of a vulvar sebaceous cyst

A physician will do an examination and take a medical history. Usually an examination is enough to determine a sebaceous cyst, but further testing may be required to rule out infections.

A biopsy may be taken to rule out anything nefarious. A sample of fluid from the cyst may be taken for examination.

References

Sand FL, Thomsen SF. Clinician’s Update on the Benign, Premalignant, and Malignant Skin Tumours of the Vulva: The Dermatologist’s View. Int Sch Res Notices. 2017;2017:2414569. Published 2017 Jul 25. doi:10.1155/2017/2414569
Merck Manual, Vulvar Inclusion and Epidermal Cysts By S. Gene McNeeley, MD, Michigan State University, College of Osteopathic Medicine
Gokdemir G, Baksu B, Baksu A, Davas I, Koslu A. Features of patients with vulvar dermatoses in dermatologic and gynecologic practice in Turkey: is there a need for an interdisciplinary approach?. J Obstet Gynaecol Res. 2005 Oct. 31(5):427-31.
Margesson LJ. Contact dermatitis of the vulva. Dermatol Ther. 2004. 17(1):20-7.
Marren P, Wojnarowska F, Powell S. Allergic contact dermatitis and vulvar dermatoses. Br J Dermatol. 1992 Jan. 126(1):52-6.
Nardelli A, Degreef H, Goossens A. Contact allergic reactions of the vulva: a 14-year review. Dermatitis. 2004 Sep. 15(3):131-6.