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PubMed This is a summary of 22 peer-reviewed journal articles Updated
Dermatology

What Are the Symptoms of an Infected Dermoid Cyst?

At a Glance

A dermoid cyst that becomes red, warm, swollen, painful, or filled with pus should be assessed promptly because infection and sterile inflammation can look alike. Sudden severe abdominal pain, vomiting, faintness, confusion, or new weakness requires emergency care.

In this answer

3 sections

01

Superficial vs. Deep Complications

02

How Cysts Are Managed

03

When to Seek Urgent or Emergency Care

A dermoid cyst can become infected when bacteria enter the cyst cavity, either through the skin or via a connection to deeper structures [1]. You can often tell a superficial dermoid cyst is infected if it becomes increasingly red, warm, swollen, and painful, sometimes with pus, foul-smelling drainage, or a fever [1][2]. However, a cyst that is merely inflamed—often due to a minor sterile rupture under the skin—can mimic an infection without bacteria being present [1]. Because both conditions look alike and require evaluation, you should have any suddenly painful, red, or draining cyst examined by a clinician [1].

Superficial vs. Deep Complications

The symptoms of an infected or complicated dermoid cyst depend heavily on where it is located:

Cyst Type Typical Location Common Symptoms of Complication Usual Evaluation
Superficial Skin Cyst Face, neck, torso Local redness, warmth, swelling, tenderness, pus Physical exam, sometimes ultrasound
Congenital Dermal Sinus Midline head, neck, lower back Recurrent discharge from a skin dimple; rarely fever or neuro signs Specialist exam, MRI
Internal (e.g., Ovarian) Pelvis, abdomen Sudden severe pain, nausea, vomiting Pelvic exam, ultrasound or CT
  • Superficial Skin Cysts: These sit just under the skin. An infection typically causes localized redness, swelling, warmth, and pain [1].
  • Congenital Dermal Sinus Tracts: Sometimes, a dermoid cyst on the midline of the head, neck, or lower back is connected to a narrow, abnormal channel called a dermal sinus tract, which can look like a small skin dimple or pit present from birth [2]. Not every skin dimple is a sinus tract, but if a tract is present and becomes infected, bacteria can travel toward the spine or brain [3]. Symptoms often start with recurrent discharge from the dimple [2], and prompt specialist evaluation is needed to prevent deeper nervous system infections [3].
  • Internal Cysts (Ovaries and Abdomen): Dermoid cysts inside the abdomen do not cause visible skin changes. While they can become infected [4], sudden severe pelvic or abdominal pain with nausea and vomiting is frequently caused by ovarian torsion (the cyst causing the ovary to twist and lose blood supply) or a cyst rupture [5][6]. A ruptured cyst can leak irritating contents into the abdomen, leading to a dangerous condition called peritonitis (severe inflammation of the abdominal lining) [6].

How Cysts Are Managed

If you suspect your cyst is infected, do not squeeze, pop, or try to drain it yourself. Squeezing can force infected or irritating material deeper into tissues, trigger severe inflammation, or worsen the infection [7][8].

Instead, a clinician will tailor management to the cyst’s location:

  • Examination and Imaging: Your doctor will examine the cyst and may use ultrasound (often for superficial or pelvic cysts), CT scans, or MRI (especially to check for deep connections to the spine or brain) to determine the extent of the cyst [9][10].
  • Drainage and Antibiotics: For a superficial abscess (a localized collection of pus), a doctor may perform a minor procedure to open and drain the fluid [1]. Antibiotics are not automatically required but may be prescribed based on the severity of the infection, surrounding skin redness, or fever [11].
  • Planned or Emergency Surgery: Complete surgical removal of the cyst wall is often the definitive treatment to prevent recurrence once an acute superficial infection has healed [12][13]. For internal cysts or sinus tracts, surgery is often carefully planned with specialists [14]. Emergency surgery is generally reserved for urgent complications like ovarian torsion, unstable rupture, or deep central nervous system infections [15][14].

When to Seek Urgent or Emergency Care

Seek timely, same-day clinical assessment for any cyst that becomes suddenly painful, rapidly red, or starts draining pus [1].

However, some symptoms indicate a life-threatening emergency. Go to an emergency room immediately (or call emergency services if you are too sick to travel safely) if you experience any of the following “red flag” symptoms:

  • Abdominal or Pelvic Emergencies: Sudden, severe pelvic or abdominal pain, persistent vomiting, or feeling faint or dizzy [5][4]. Do not wait for a fever or a rigid abdomen, as these could be signs of ovarian torsion, a severe infection, or internal bleeding [5][6].
  • Neurological Warning Signs: Fever combined with a severe headache, stiff neck, confusion, seizures, or extreme sensitivity to light (photophobia) [16][17][18]. These can be signs of meningitis or an abscess in the brain or spine [3][19].
  • Spinal Cord Symptoms: Sudden weakness in your arms or legs, numbness, changes in how you walk, or new difficulty controlling your bladder or bowels [20][21].
  • Signs of Severe Illness (Sepsis): Confusion, difficulty breathing, rapidly spreading redness, or feeling faint and extremely unwell [11][22].

Common questions in this guide

What does an infected dermoid cyst look and feel like?
A superficial dermoid cyst may be infected when it becomes increasingly red, warm, swollen, and painful, especially if pus, foul-smelling drainage, or fever develops. Internal cysts may instead cause sudden severe abdominal or pelvic pain, nausea, or vomiting.
Can a dermoid cyst be inflamed without an infection?
Yes. A cyst can become inflamed after a sterile rupture even when bacteria are not present, and the redness, swelling, and pain can look like an infection. Because the treatments differ and the symptoms overlap, a clinician should examine any suddenly painful, red, or draining cyst.
How quickly should I get care for a painful dermoid cyst?
Seek same-day medical assessment if a cyst becomes suddenly painful, rapidly red, or starts draining pus. Go to an emergency department for severe abdominal or pelvic pain, persistent vomiting, faintness, confusion, trouble breathing, rapidly spreading redness, or new weakness or numbness.
When does an ovarian or abdominal dermoid cyst become an emergency?
Sudden severe pelvic or abdominal pain with nausea, vomiting, dizziness, or faintness requires emergency assessment. These symptoms may indicate the ovary has twisted and lost blood supply, a cyst has ruptured, or a serious internal infection or bleeding is developing.
What should I do if I think my dermoid cyst is infected?
Do not squeeze, pop, or try to drain the cyst yourself. This can push infected or irritating material deeper, worsen inflammation, and spread infection; a clinician can decide whether drainage or another treatment is safe.
What tests and treatments might an infected dermoid cyst need?
Evaluation may include a physical examination and ultrasound, while CT or MRI may be needed for pelvic, abdominal, or deep cysts or for possible connections to the spine or brain. A superficial abscess may need clinician-performed drainage, antibiotics may be used when indicated, and complete cyst-wall removal is often considered after the acute infection heals.
Could drainage from a skin dimple signal a deeper dermoid cyst problem?
Recurrent discharge from a small midline dimple on the head, neck, or lower back can indicate a dermal sinus tract connected to deeper tissues. Prompt specialist evaluation is important because infection can travel toward the spine or brain.

Questions For You

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Related questions

Is Exercise or Sex Safe With an Ovarian Dermoid Cyst? Can an Ovarian Dermoid Cyst Cause Infertility Problems? How Is an Ovarian Dermoid Cyst Treated After Menopause? Ovarian Dermoid Cysts: Do They Cause Irregular Periods? Does a 5 cm Ovarian Dermoid Cyst Always Require Surgery?
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Is an Ovarian Dermoid Cyst Dangerous During Pregnancy? Should a Dermoid Cyst Be Removed Before Pregnancy or IVF? What Do Ovarian Dermoid Cysts Look Like on Imaging? Can a Dermoid Cyst Be Drained or Popped Instead of Removed? What Specialist Treats a Dermoid Cyst by Location? What Causes a Dermoid Cyst, and Are They Hereditary? Can You Prevent a Dermoid Cyst from Forming or Coming Back? What Are Dermoid, Epidermoid, 'Sebaceous' & Pilonidal Cysts? How Is a Dermoid Cyst Diagnosed Without Surgery? Imaging How Often Should an Ovarian Dermoid Cyst Get Ultrasound? Can the Ovary Be Saved After Torsion From a Dermoid Cyst? Can Birth Control Pills Shrink an Ovarian Dermoid Cyst? Can Doppler Ultrasound Miss Torsion From a Dermoid Cyst? How Is Fertility Preserved With Bilateral Dermoid Cysts?

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Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Is this a superficial skin infection, or could the cyst connect to deeper tissues like the spine or brain?
  2. 2.What type of imaging, such as an ultrasound or MRI, is most appropriate to evaluate this specific type of cyst?
  3. 3.Based on my symptoms, do you recommend drainage, antibiotics, or observation as the safest first step?
  4. 4.When the acute symptoms resolve, is surgical removal recommended to prevent this from happening again?
  5. 5.What specific warning signs should prompt me to go to the emergency room instead of waiting for a clinic visit?

References

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    Peritonitis From Ruptured Lipid-Poor Dermoid: Struma Ovarii.

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This page is for informational purposes only and does not constitute medical advice. A clinician should evaluate a painful, red, draining, or internal dermoid cyst, especially when emergency warning signs are present.