Starting with your Primary Care Physician
When you discover a new lump or bump, your first stop should often be your primary care physician (PCP). Your PCP can evaluate the cyst, ask about your symptoms, and determine the next steps. They can often manage and treat simple, uncomplicated epidermal cysts themselves. For anything more complex or located deeper within the body, they will refer you to the appropriate specialist. Consulting your PCP first ensures a centralized point of care and that you don't waste time seeing the wrong specialist.
When to See a Dermatologist
If your cyst is on or just under the skin, a dermatologist is the right specialist to see. Dermatologists are medical doctors who specialize in conditions of the skin, hair, and nails. They are experts in diagnosing and treating common skin cysts, including:
- Epidermoid cysts: These are small, benign bumps that develop just under the skin and are filled with keratin. They often occur on the face, neck, and trunk.
- Pilar cysts: Similar to epidermoid cysts, these grow from a hair follicle, most commonly on the scalp.
- Sebaceous cysts: These are older terms often used for epidermoid cysts, referring to a blocked oil gland.
A dermatologist can perform an in-office procedure to drain or surgically remove the cyst, ensuring the sac is fully excised to prevent recurrence.
Dealing with Internal Cysts
For cysts that are not on the surface of the skin, a more specialized doctor is required. The location of the cyst dictates the type of specialist.
Ovarian Cysts and a Gynecologist
For any cyst-like growth in the pelvic area or suspected ovarian cysts, you should see a gynecologist. These fluid-filled sacs develop in or on an ovary. While many ovarian cysts are benign and resolve on their own, a gynecologist will perform an evaluation using imaging tests like an ultrasound to monitor the cyst's size and characteristics. They will determine if watchful waiting, medication, or surgical removal is the best course of action.
Ganglion Cysts and Orthopedists
Ganglion cysts are non-cancerous lumps that most commonly form on the tendons or joints of wrists and hands, but can also appear on feet and ankles. For these, an orthopedist or a hand specialist is the appropriate doctor. They can diagnose the cyst through a physical exam and imaging. Treatment options range from observation to aspiration (draining the fluid) or surgical excision, especially if the cyst is causing pain or interfering with joint movement.
Breast Cysts and Specialists
If you discover a lump in your breast, it is crucial to have it evaluated by a doctor to distinguish it from other breast conditions. This process often begins with your primary care doctor, who may then refer you to a breast specialist or a general surgeon for further testing, such as a mammogram or ultrasound, and possible biopsy. The vast majority of breast cysts are benign and often do not require treatment.
How Doctors Diagnose a Cyst
Regardless of the type or location, a doctor follows a systematic approach to diagnosis:
- Physical Examination: A doctor will examine the lump, feeling its size, shape, and consistency. They will also check for tenderness and signs of infection like redness or warmth.
- Imaging Tests: For internal or hard-to-access cysts, imaging tests are used. An ultrasound is often the first step as it can differentiate a fluid-filled sac (cyst) from a solid mass (tumor). CT scans or MRIs may also be used.
- Biopsy: To definitively rule out malignancy, a doctor may perform a biopsy, which involves taking a small tissue sample for lab analysis. This is typically reserved for suspicious or unusual cysts.
Comparing Cysts and Specialists
| Cyst Type | Typical Location | Recommended Specialist | Common Diagnosis Method |
|---|---|---|---|
| Epidermoid/Pilar | Skin (Face, Scalp, Neck, Back) | Dermatologist | Physical Exam |
| Ovarian | Ovaries (Pelvic Region) | Gynecologist | Pelvic Exam, Ultrasound |
| Ganglion | Joints/Tendons (Wrist, Ankle) | Orthopedist, Hand Specialist | Physical Exam, Ultrasound, MRI |
| Breast | Breast Tissue | General Surgeon, Breast Specialist | Physical Exam, Mammogram, Ultrasound |
What to Expect at Your Appointment
- Initial Consultation: The doctor will ask about when you first noticed the cyst, any changes in size or appearance, and if you have other symptoms.
- Examination: A physical exam will be performed. For internal cysts, this will be followed by a referral for imaging.
- Treatment Plan: Your doctor will discuss the appropriate course of action, which could be anything from observation to drainage or surgical removal. They will also explain the risks and benefits of each option.
- Follow-Up: Depending on the treatment, you may need a follow-up appointment to check on the healing process or to have stitches removed.
Making an Informed Decision about Your Health
While most cysts are benign and pose little health risk, knowing which type of doctor to see is crucial for proper diagnosis and treatment. The key takeaway is to start with your primary care physician, who can provide an initial assessment and point you in the right direction. For skin-deep concerns, a dermatologist is the expert; for pelvic region issues, a gynecologist; and for joint-related cysts, an orthopedist. Never attempt to treat a cyst at home, as this can lead to serious complications. Always consult a healthcare professional for guidance. For more detailed information on types of cysts, consult a trusted resource like the Cleveland Clinic.
