A lipoma is a benign overgrowth of fat under the skin. Lipomas are usually quite soft and can occasionally cause pressure problems, but rarely get infected. Occasionally lipomas can become painful and may need to be removed.

Skin cysts (known as epidermoid cysts) are essentially an invagination of skin, that keep shedding the outer layers of skin within a closed capsule. This eventually gets bigger and bigger and can become infected and painful. Sebaceous cysts are rarer than skin cysts and more common in acne sufferers. The grease glands become blocked and the grease gradually fills up as a collection, which makes sebaceous cysts much harder to treat.

How can I tell the difference between a lipoma and a cyst?

At the early stages of a cyst and lipoma, they can feel quite similar. As cysts grow, they generally feel like an egg or rubber under the skin, they often have little drainage hole where white cheesy material can be seen discharging. Lipomas are usually a bit deeper in the skin and are usually soft and squeezy, and feel like they can be moved slightly under the skin.

Can both lipomas and cysts become cancerous?

Both are entirely benign and have a negligible risk of developing cancer, however occasionally these lumps are misdiagnosed and some rare cancers can present as a lump under the skin that may resemble a lipoma or cyst, so it is always best to get an expert medical opinion and see a specialist.

Can a lipoma and a cyst heal alone or do they need to be removed?

Lipomas rarely go away on their own but also rarely cause problems. I have plenty of patients who have not wanted to have their lipomas removed. Cysts can become infected and discharge completely. They can heal over with a scar but have a high chance of recurrence.

Small cysts are often easy to remove and will leave small scars. If you let your cyst grow and it becomes infected then it will be much harder to treat at a later stage and will have a higher chance of recurring. Therefore cysts are best removed early before they get infected. Both skin lesions are easily removed with surgery under local anaesthetic using simple procedures that leave small straight line scars.

More Information:

Lipomas and cysts are both common, benign lumps under the skin, but they have key differences. Here’s how to tell them apart:

Lipoma

• Texture: Soft, doughy, and moves easily under the skin when pressed.
• Growth: Slow-growing, usually 2–5 cm in size but can get larger.
• Pain: Usually painless, but may cause discomfort if pressing on nerves.
• Location: Found on the neck, shoulders, back, arms, or thighs.
• Cause: Overgrowth of fat cells, possibly genetic.
• Appearance: Skin over it looks normal, no visible opening or head.

Cyst

• Texture: Firm or soft, but more fluctuant (fluid-filled).
• Growth: Can grow quickly and may fluctuate in size.
• Pain: Can be painful, especially if infected (red, swollen, warm, pus-filled).
• Location: Common on the scalp, face, neck, back, or genitals.
• Cause: Blocked hair follicle or oil gland, leading to fluid buildup.
• Appearance: Often has a central punctum (small dark dot), may discharge thick fluid if ruptured.

Key Differences

• Lipomas are fatty tumors, while cysts contain fluid or semi-solid material.
• Cysts may become infected, while lipomas typically don’t.
• Lipomas feel more rubbery and mobile, while cysts can be firmer and fixed.
• Cysts may have a visible opening, but lipomas do not.

When to See a Doctor

• The lump is growing rapidly.
• It’s painful, red, or draining pus (signs of infection).
• It’s hard or fixed in place (could indicate something more serious).
• You’re unsure if it’s a lipoma or a cyst.

Yes! Here’s a breakdown of treatment options for both lipomas and cysts:

Lipoma Treatment

Most lipomas are harmless and don’t need treatment unless they’re causing pain, growing, or for cosmetic reasons. Options include:

• Observation: If it’s small and not bothersome, you can leave it alone.
• Surgical Removal: A minor procedure under local anesthesia to excise the lipoma completely.
• Liposuction: A less invasive option to suction out fat, but the lipoma may return.
• Steroid Injections: Can shrink the lipoma but won’t remove it completely.

Cyst Treatment

Cysts may require treatment if they become painful, infected, or bothersome:

• Warm Compresses: Helps small cysts drain naturally.
• Drainage (Incision & Drainage): A doctor can make a small cut to drain fluid, but the cyst may come back.
• Surgical Removal: Best for recurring cysts—removing the entire cyst sac prevents regrowth.
• Antibiotics: If infected, oral antibiotics may be needed along with drainage.
• Cortisone Injection: Can reduce inflammation in non-infected cysts.