A cyst is a sac-like pocket of tissue, often filled with fluid, air, or semi-solid material, that can form anywhere in the body. These closed pockets have a distinct wall, setting them apart from surrounding tissues. Many cysts are benign and may resolve on their own. However, recurrence after treatment can be frustrating, raising questions about why this happens.
What Cysts Are
A cyst is a closed sac within body tissues, characterized by a distinct membrane or lining. This structure differentiates a true cyst from a “pseudocyst,” which lacks an epithelial lining. The material inside a cyst varies, from natural body secretions to abnormal products, contained within its capsule.
Unlike tumors, characterized by uncontrolled cellular division, cysts are typically fluid-filled or contain semi-solid contents within their sac. The presence of this wall or lining is central to a cyst’s nature and explains why specific treatments are needed to prevent recurrence.
Primary Reasons for Recurrence
A common reason cysts return after treatment is incomplete removal of their sac or wall. If even a small number of cells from the cyst lining remain, they can continue to produce fluid or material, leading to reformation. This is like a balloon that, even if deflated, can be reinflated if its material remains intact.
Some cysts are prone to recurrence due to delicate walls or location. Epidermoid cysts, for instance, form from blocked hair follicles or skin glands. Their thin, fragile wall can rupture during removal, and remaining fragments can regenerate a new cyst. Recurrence rates can range from 10-25% if not completely excised.
Pilonidal cysts, found near the tailbone, have recurrence rates from 5-40% depending on surgical technique, often due to their complex structure in an area prone to irritation. Drainage alone, which removes contents but leaves the sac, has a very high recurrence rate.
Underlying Factors in Recurrence
Beyond incomplete removal, several underlying factors predispose individuals to cyst formation and recurrence. Chronic inflammation, for example, can create an environment where cysts repeatedly develop. This ongoing irritation can stimulate the body to form protective sacs that fill with fluid or other substances.
Genetic predispositions also play a role in cyst recurrence. Some individuals may inherit a higher likelihood of developing specific types, such as epidermoid cysts, or conditions like polycystic ovary syndrome (PCOS), characterized by numerous small ovarian cysts. A genetic link is suggested for conditions like dermoid ovarian cysts, where family history increases risk.
Hormonal imbalances are another factor, particularly for ovarian and breast cysts. Fluctuations in hormones like estrogen and progesterone can lead to fluid-filled sacs. Conditions such as endometriosis, where uterine-like tissue grows outside the uterus, can also cause recurring cysts (endometriomas).
Blockages in ducts or glands can also lead to fluid accumulation and cyst formation. For example, Bartholin’s cysts occur when ducts near the vaginal opening become obstructed. Galactoceles can form in lactating women due to blocked milk ducts. Ganglion cysts, often found near joints, may recur due to persistent irritation. These conditions create an ongoing susceptibility.
Addressing Recurring Cysts
When a cyst recurs, a thorough diagnosis and medical evaluation are important to determine the cause and appropriate course of action. Consulting a healthcare professional is necessary for assessment, especially if the cyst becomes painful, infected, or grows rapidly. Self-treatment, such as attempting to squeeze or pop a cyst, can lead to infection and may not prevent recurrence.
For recurring cysts, treatment often focuses on complete removal of the cyst wall. Surgical excision, where the entire cyst and its lining are removed, is often the most effective method to prevent recurrence. This approach lowers the chance of the cyst returning compared to simple drainage.
In some cases, particularly for larger cysts or those in specific locations, drainage combined with sclerosis may be used. This involves injecting a substance to damage the cyst wall and prevent refilling.
Beyond direct removal, managing underlying conditions is crucial for addressing recurring cysts. This can involve hormonal therapies for conditions like PCOS or endometriosis, anti-inflammatory measures, or other treatments tailored to the predisposing factor. Regular monitoring through self-examination and follow-up appointments is important to detect any new formations early.