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Chris Smith, MD
answered this
Epidermoid Cysts - Diagnosing And Managing This Condition

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My mom spotted a hole on my dad's back and she squeezed it and white, stringy stuff come out. I went in, she told me and said I should squeeze it hard (eh..) and I did and tons of it came out. Had a weird small to it too.
What could it be?

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Highbuzz16494
over a year ago
Many who replied to this post, reported the same problem, i.e. small hole in their skin that oozes white stuff when squeezed. For some, the stuff coming out wasn't white, but of different color and consistency. A few participants described it as a brown paste, while one member said it was black. However, in most cases, the stuff coming out was white and sort of stringy.
The hole is usually located on the back, shoulders, and neck, but it can be present in other parts of the body such as arms, wrists, ears, below the eyes, thighs, testicles, and even on feet. In most cases, the stuff that was squeezed out had a foul smell.
Many were worried that squeezing isn't a good way to deal with this problem.
Please let me know if it's not safe to squeeze and if it will make the condition worse?
Just like with pimples, squeezing and trying to pop is definitely not the best solution and can actually make your skin worse. Many who squeezed and popped the little hole, reported that it again "filled" with white stuff after some time. This recurrent nature suggests that it is not a pimple most likely, but a cyst of some sort. Because of the bad smell, several participants suggested that it was probably just some kind of skin inflammation or infection that involved accumulated sebum, the white stuff that collects in pimples. Also, many reported having this problem for years, even decades.
My husband has had this tiny hole in the same spot for 20 years!
The recurring nature and smelly content most likely suggest a sebaceous cyst, which is basically a backed-up sebaceous gland. It's usually nothing to worry about, as long as the area is not irritated or inflamed causing pain and discomfort, which in some rare cases, may require surgery. Surgery may also be required if cyst continues to grow.
Squeezing the sebaceous cyst will usually cause the smelly stuff to pop out of it, emptying the cyst. However, this is only a temporary solution.
Talk to your dermatologist who may suggest a solution, which may include surgery, especially if the cyst is inflamed or causes pain.
Several participants reported that they weren't able to squeeze the content out of the hole because after they squeezed it, it kinda hurt. Some also reported that the affected spot was very inflamed and tender. This may suggest a problem other than a sebaceous cyst.
One participant said that he/she was diagnosed with actinomycosis, a rare infectious bacterial disease that causes sores, or abscesses, in the body’s soft tissues. Another member was diagnosed with hidradenitis suppurativa, a disease that usually begins as pimple-like bumps on the skin. These bumps are often mistaken for pimples, boils, or folliculitis.
Besides squeezing the pimple, the participants also suggested other natural ways to treat it. One claimed that using Apple cider vinegar, turmeric, raw garlic, and coconut oil in larger dosages helped close a pimple.
One participant suggested using talcum powder and rosemary. Rosemary (Rosmarinus officinalis) oil has been proven to be effective against P. acnes, a type of bacteria that causes acne. On the other hand, the talc might accumulate and clog the pores causing pimples or worsening them.
The most likely cause for the problem discussed in this topic is a sebaceous cyst, a slow-growing lump that can move easily under the skin. Medical professionals have suggested that the term sebaceous cyst be avoided since it can be misleading. In practice, however, the term "sebaceous cyst" is still often used to refer to either:
The problem discussed in this topic refers more to epidermoid cyst than pilar cysts, which usually occurs on the scalp (90% of pilar cysts), unlike epidermoid cyst that usually appear head, neck, and torso, as described in the discussion.
Epidermoid cysts are usually caused by a buildup of keratin - a protein that occurs naturally in skin cells - not sebum, hence, it's wrong to call them sebaceous cysts, which occur rarely. Epidermoid cysts are more likely to develop in people with acne or other skin conditions.
Epidermoid cysts are small, hard lumps that develop under the skin. The lump is usually not painful. In some cases, however, cysts can get inflamed and become tender to the touch. The skin on the area of the cyst in case of inflammation may become red and/or warm.
To diagnose epidermoid cysts, a doctor will perform a physical examination of the lump and surrounding skin, as well as take a medical history. In some cases, the doctor may order a biopsy to rule out other skin growths, both benign and malign ones.
Most epidermoid cysts either stop growing or go away on their own without treatment. Squeezing out the content of the epidermoid cyst on your own can lead to infection, so it’s best to leave it alone. Moreover, once a cyst is drained, there is a possibility that it will grow back.
Treatment may be required if the cyst becomes infected, painful, red, swollen, or changes in size. In such cases, treatment options may include:
Although you can't stop epidermoid cysts from forming, you can help prevent scarring and infection by avoid squeezing it and placing a warm, moist cloth over the area to help the cyst drain and heal.
Very rarely, epidermoid cysts can become cancerous.
The suggested treatments and remedies
Small hole in the neck, head or torso (usually on the back) that oozes whitish or yellow smelly content when squeezed, usually indicates an epidermoid cyst, also called (inaccurately) sebaceous cyst. This cyst is usually nothing to worry about and it should be left alone, i.e. should not be squeezed to prevent the infection, unless the cyst becomes painful or inflamed, or grows too big, which may require treatment.

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I think you should stop picking at our and cutting it with knives and **** like that dull hole.

I have a big sore behind my ear on the side of my head about the size of my ear this hole thing at one time was one big sore but appears to have healed and now looks like dried skin, my problem is at the bottom of this big sore is now a gapping hole and a long split where my ear meets my head down in the lobe area it Will not heal it always bleeds and appears as if it's making canyons in my skin and deforming me back there I have had this for several years now can anyone please help me and tell me what this is my dr. could not.

Hello,
        I've noticed that i have small round holes and some elongated holes on my face. There are tiny new ones still forming. I never had acne and i have slightly dry skin so i have no clue why and where im getting these holes from? how can i get hide of them?

Hi. I have the same problem. My skin is infected and there is that channel you mentioned that produces pus. Is it normal for it to do that and will it heal without a scar?

i have mrsa.  and i get the holes and the dots.  the sores won't heal until that dot is out.  if i leave it alone, it gets big.  and sometimes it turns black under the skin.  i peel off and it stinks.

Hi

Thanks for writing in. There can be several causes leading to such deep holes in the skin. It will be difficult to assess exactly what these might be due to but you may find the information given useful.

The small deep hole as in your shoulder skin or back can be a sinus tract that usually develops in response to a deep-seated skin infection or acne. It is an abnormal channel in the body that opens into the environment on one end. A sinus tract typically leads from a focus of infection in deeper tissues to the skin surface. It may even discharge pus/ fluid on the skin surface.

Resembling sinus-tracts are ice pick scars that are atrophic scars remaining after acne. They are deep with a very narrow skin opening and extend into the dermis. The skin looks as if it has a small, deep "hole" in it. They develop after an infected cyst or other deep lesion causes tissue destruction during the healing process and results in a column like scar. Such scars can be treated with punch excision or punch grafting.
You should consult a dermatologist for a diagnosis, who may refer you to a surgeon if required for proper management.

Take care

i really nneed your help.... i may think its inflamed skin or spider bites maybe even skin cancer !!

I need help!!!! i was looking at my legs and noticed small black holes ingraved in my leg it didnt hurt but itched and burned!!! it has come  11/15/08 aroun
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