Whether they’re on your ovaries, on your breasts, or on your bikini line masquerading as ingrown hairs, cysts can be pretty mundane medical business. But dermoid cysts are different. Thanks to their pretty wild composition, dermoid cysts may take the cake when it comes to Weird Body Stuff.
Dermoid cysts are benign tumors that contain tissues normally found elsewhere on the body.
Dermoid cysts are the non-cancerous form of a type of tumor called a teratoma, according to the National Cancer Institute (NCI). Also referred to as mature teratomas, they can include skin, sweat and oil glands, fat, muscle, bone, hair, and teeth. Dermoid cysts are present since birth and can be found anywhere on the body. However, they’re usually found in the ovaries, testes, head, neck, face, lower back, and central nervous system, according to the NCI.
Dermoid cysts are so unique (i.e., filled with hair and teeth and stuff) because they come from germ cells. As the reproductive cells of the body, these can be either egg cells or sperm cells. During embryonic development, these cells divide and differentiate into the various different kinds of cells required to create a human being, James Adam Greenberg, M.D., chief of the Division of Gynecology at Brigham and Women's Faulkner Hospital and associate professor at Harvard Medical School, tells SELF. “They’re the only [cells] that have the ‘stuff’ of every other cell in their DNA because they’re there to make embryos that grow into fetuses and then babies,” Dr. Greenberg explains. “They have the potential to become anything else.”
Like all tumors, dermoid cysts form when something goes awry during the normal cellular development process.
Dermoid cysts happen when ectodermal germ cells—which go on to form structures on the outer layers of our body, like skin, oil or sweat glands, hair, teeth, etc.—more or less get stuck in the wrong spot while fusing together to become different organs and systems, Rachel Georgopoulos, M.D., an otolaryngologist at Cleveland Clinic, tells SELF. Dermoid cysts are basically encapsulations of wayward cells that ended up in the wrong spot and kept on growing, she explains.
“Normally, a cell grows and divides until [an internal signal] tells the cell it’s done,” Dr. Greenberg explains. When that mechanism goes wrong and your body doesn’t receive that message, the cell growth just keeps going, and a tumor forms.
Dermoid cysts are usually small, grow slowly, and can go undetected for decades.
The manner of presentation depends on where exactly the dermoid cyst is. If someone has a dermoid cyst in a visible area like the face, they might notice it as a small bump during childhood or young adulthood, Patrick Colley, M.D., a head and neck surgeon at the New York Eye and Ear Infirmary of Mount Sinai, tells SELF.
The bump might have a single hair coming out of it, Dr. Georgopoulos says, as well as a tiny divot. But it’s possible for someone to walk around with a dermoid cyst without knowing it for a long time. “Even ones on the face can be pretty inconspicuous,” Dr. Georgopoulos says.
As another example, dermoid cysts on the ovaries can hang around for a while before being caught, often in a person’s 20s or 30s, Dr. Greenberg says. It’s not uncommon for ovarian dermoid cysts to be found incidentally during an MRI or ultrasound for something else, Susan Khalil, M.D., an ob/gyn at Mount Sinai, tells SELF. (Because of the unusual tissue, they’re pretty easily identifiable on imaging tests, Dr. Greenberg says.)
Dermoid cysts are generally harmless. But if they get large enough or are in a certain spot, they can cause symptoms.
What those symptoms are depends on where the cyst is located.
Large dermoid cysts found in the neck, for instance, could put pressure on nearby structures in the throat, like the vocal cords or trachea, causing voice changes or trouble breathing or swallowing, according to Dr. Georgopoulos.
Dermoid cysts in the brain or along the spine can cause neurologic symptoms like weakness or headache, Dr. Colley says.
And a dermoid cyst on an ovary can cause the organ to twist on itself like a kinked garden hose, Dr. Khalil explains. This is called ovarian torsion, and it can lead to symptoms like severe pain, nausea, and vomiting, according to the Mayo Clinic. Ovarian dermoid cysts can also rupture, potentially causing symptoms like intense pain and bleeding.
Whether or not a dermoid cyst is causing any symptoms, they are usually removed to prevent any trouble down the line.
Even if it’s not presenting any issues now, the cyst can continue to expand, Dr. Colley says, as well as produce debris like oil and skin cells. If the cyst is close to the surface, where bacteria could get in, there is also the potential for infection, Dr. Georgopoulos says. And once a cyst grows large or becomes infected, it typically becomes more difficult to remove, Dr. Colley says. So, if your doctor realizes that you have a dermoid cyst, they may recommend you have it surgically removed now to prevent possible complications in the future.
However, this depends on factors like the size of the cyst and where it is, and about weighing the costs and benefits of removing the cyst, Dr. Khalil explains. For instance, if someone has a smaller dermoid cyst on one of their ovaries, their doctor will need to determine if they can remove the cyst without removing the entire ovary or potentially affecting fertility, if that’s something that matters to the patient, in which case the doctor may opt for watchful waiting. So, if you have a dermoid cyst (or any cyst at all, really), a thorough discussion with your doctor can help you decide what to do.