Sebaceous cysts on the scrotum (also called epidermal cysts of scrotum) are very common and usually harmless. They are not sexually transmitted or contagious, and do not cause cancer.
Treatment of scrotal sebaceous cysts focuses on cosmetic relief, and is not medically recommended or necessary. We understand that scrotal sebaceous cysts may cause embarrassment and significant psychological distress and anxiety. Therefore treatment can be an incredibly useful option in helping patients regain confidence and move on with their lives.
Symptoms
What are the symptoms of scrotal sebaceous cysts?
Scrotal sebaceous cysts are lumps in the skin of scrotum. They are painless and typically have been there for months or years. They may remain unchanged in size and number but sometimes existing lumps can become bigger, or new lumps may appear with the passage of time.
Most patients have multiple cysts, and often there are cysts of different sizes. Often the attention is drawn by larger, more obvious cysts but examination will reveal other smaller lumps which can be felt in the thickness of scrotal skin, and these have not appeared above the skin surface.
These cysts are benign (harmless) and are rarely a cause for concern. If the cysts become infected they can become painful and may burst or discharge pus. Occasionally cysts become painful and infected after the patients have unsuccessfully tried to get rid of them at home by cutting through the lesion.
What do scrotal sebaceous cysts look like?
Appearance: Scrotal sebaceous cysts appear as whiteish, yellowish or skin coloured lumps and are filled with a clear oily liquid or a putty like substance.
Size: They can vary greatly in size, from 1-2 mm to larger ones measuring 1-2 cm each. In fact a typical patient can have lesions of different sizes at the same time.
Number: Similarly they can vary in number from solitary lesion to scrotal skin studded with multiple cystic lesions. The cysts may occasionally cover the entire scrotum.
Distribution: Scrotum is the commonest site for genital sebaceous cysts but can occasionally appear on the shaft of the penis or on the prepuce (foreskin). Multiple scrotal cysts often show a typical distribution pattern of being scattered around both sides of midline.
Whom does scrotal sebaceous cysts affect?
Scrotal sebaceous cysts can develop at any age but are usually first noticed in teenage years and early adulthood..
What complications can scrotal sebaceous cysts lead to, if untreated?
Scrotal sebaceous cysts can become infected, causing swelling, redness and tenderness around the cyst and they may burst, producing pus with a foul odour. If you are experiencing symptoms associated with an infection you should seek medical advice as this requires treatment with antibiotics.
Can scrotal sebaceous cysts go away?
Occasionally, small scrotal sebaceous cysts may go away on their own. The use of a warm compress a couple of times a day can help reduce the size of the cyst or swelling by encouraging the cyst to drain or reabsorb into the body.
However, larger cysts are unlikely to go away without surgical treatment.
Can you get a sebaceous cyst in a different area of your body?
Sebaceous cysts are caused by the sebaceous glands being blocked. The majority of the sebaceous glands are on the face and scalp, but are also present on all parts of the skin (except the palms of the hands and the soles of the feet). Essentially, a sebaceous cyst can appear anywhere where hair grows.
Causes
What causes scrotal sebaceous cysts?
Sebum is a thick and greasy oil that is produced by microscopic sebaceous glands in the skin. The body produces sebum naturally to keep our skin moisturised and our hair healthy. Sebaceous cysts are caused by an accumulation of sebum which causes the sebaceous glands to block and cysts to develop.
Are scrotal sebaceous cysts an STI, and/or is it an infectious disease?
No, a sebaceous cyst is not an STI, and it can not be transmitted to someone else through sexual contact. Sebaceous cysts are also not cancerous.
What factors can increase the likelihood of getting scrotal sebaceous cysts?
It is not always possible to prevent cysts from developing. Keeping your skin clean and maintaining good skincare is enough. Try to avoid shaving and waxing the hair on the scrotum as this can lead to ingrown hairs which can damage the hair follicles.
In some cases, there may be a genetic predisposition to develop sebaceous cysts.
What factors can lead to more severe scrotal sebaceous cysts?
Attempting to remove scrotal sebaceous cysts yourself can make them bigger and there is a high risk that the area will become infected and may scar.
Diagnosis
How are scrotal sebaceous cysts routinely diagnosed?
A physical examination is usually enough to diagnose scrotal sebaceous cysts. An examination is only ever performed with your explicit consent, and your clinician will treat you with the utmost respect and dignity. You will be offered the presence of a chaperone during your examination.
What factors can help a correct diagnosis?
In cases of diagnostic uncertainty or suspicious growth, a biopsy +/- HPV testing can be offered. This is usually not needed as it is common that a physical examination is enough to establish the correct diagnosis. Your clinician will be able to explain this in the appointment and answer any questions you may have.
What can I do to help the diagnosis?
Avoid shaving the area around the cysts before your appointment. This might cause irritation or an infection.
Can another infection be mistaken as scrotal sebaceous cysts?
Unlike epidermoid cysts, which originate from the skin, and unlike pilar cysts, which come from hair follicles, true sebaceous cysts originate from your sebaceous glands. Your clinician will be able to tell the difference between these lesions in your appointment.
Other possible causes of scrotal lumps such as genital warts or molluscum contagiosum may be mistaken for scrotal sebaceous cysts. However, the size, texture and appearance of scrotal sebaceous cysts will usually mean your clinician will be able to confidently tell you what your diagnosis is.
Is there any other way to diagnose scrotal sebaceous cysts?
Unless there is diagnostic uncertainty, confirmation beyond an examination by your clinician is not normally required.
Can I request a second opinion about my diagnosis?
Of course. We understand that you may wish for a second pair of eyes to assess your condition. You are more than welcome to book an appointment with another clinician as well - either at our clinic or elsewhere.
Treatment
As you have gathered by now, small scrotal sebaceous cysts are a perfectly normal feature of the body and treatment is not medically required.
However, there are patients who have multiple or large sebaceous cysts, and this knocks their confidence. We have seen many patients for whom life has come to a standstill due to these lesions and it is difficult for them to build and maintain relationships.
Sometimes patients prefer sexual intimacy with their partner in darkness, due to the presence of these lesions. In such an event, a simple procedure can help to regain your confidence and rebuild your life.
Prognosis
What is the long term prognosis for someone who has scrotal sebaceous cysts?
The prognosis with sebaceous cysts is excellent in most cases.
Once treated, am I immune from getting scrotal sebaceous cysts again?
Most people who are treated with scrotal sebaceous cysts do not show recurrence of their lesions, and therefore do not need to return for further treatment. However, as with any treatment, this is not something we can guarantee.
Is there anything I can do to prevent scrotal sebaceous cysts from returning?
You do not need to do anything specific other than maintain a good hygiene and skincare routine.
Do I have to tell my partner I have (or had) scrotal sebaceous cysts?
As scrotal sebaceous cysts are not infectious or sexually transmitted there is no implication or concerns for your sexual partner(s). There is no requirement for you to share your diagnosis or its treatment with your partner(s).
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Page reviewed by Dr. Manoj Malu (Clinical Director)
Last reviewed date: 19 January 2023
Next review due: 19 January 2026
Whilst this content is written and reviewed by sexual health specialists, it is for general guidance only. It is not intended to replace the advice of your clinician.
References & Further Reading
- JAMA Dermatology: SEBACEOUS CYST: ITS IMPORTANCE AS A PRECANCEROUS LESION
- International Journal of Dermatology: Sonographic appearance of sebaceous cysts. Our experience and a review of the literature
- StatPearls: Epidermoid Cyst
- Actas Urologicas Espanolas: Nd-YAG laser photocoagulation of scrotal sebaceous cysts
- Indian Journal of Medical Research: Multiple epidermal cysts of scrotum
- The Internet Journal of Surgery: A Case Of Multiple Sebaceous Cysts Over Scrotum In A 35 Years Old Male