What Is the Difference between a Cyst and a Pimple?

You may have heard of polycystic ovarian syndrome, kidney cysts, renal cysts, but there are three other types of cysts that happen outside of the body and may be mistaken for acne.

But first, what is a cyst, and what is the difference between a cyst and a pimple?

Normally, when we talk about cysts, we’re referring to cystic acne. This is nodular acne that balloons under the skin. Cystic acne has a sac-like cavity that is usually filled with fluid and dead keratin. The difference between a cyst and a normal pimple is that cysts may have to be lanced and squeezed out. And unfortunately, cysts frequently return, especially if you don’t get rid of the sack’s outer lining that once held the fluid. So, in regards to treatment, it’s very important to distinguish between a cyst and a pimple.

#1 Preauricular cysts are commonly mistaken for acne.

(Picture: Smooth O/Wikimedia)

Preauricular cysts often happen because of infection and discharge within the preauricular pit. However, not everyone has a preauricular pit. 

A preauricular pit is a small hole above your ear canal (ear opening). This hole indicates a sinus tract under the skin. Again, everyone does not have these holes. They often form as a result of unique development during fetal hood. These holes can be prone to recurrent infection. When infected, the cyst distends with pus, and the overlying skin is red and inflamed.


Upon discovering one, a lot of people squeeze these without realizing that it’s a cyst that should be removed by a derm or surgeon. You can drain them with needles, a small incision, and gauze.

If you have a “pimple” by the ear, and you also have one of these holes, get it checked out by a derm. So, the pit won’t cause problems or get infected. Preauricular pit infections can cause a lot of pain, and the infection can also spread. The most common infection is staphylococcus aureus or staph aureus which is actually pretty common on the skin, but it can cause major difficulties within a preauricular pit. 

In the case of infection, it would need to be drained. Don’t try to pop it because that will likely make it worse. Moreover, popping isn’t going to get rid of it because you usually have to remove the little sac. Overall, it's important to speak to a doctor, get a diagnosis, and determine the type of cyst.

#2 What are ganglion cysts?

Ganglion cysts usually happen on the wrist, but they can happen elsewhere. They’re usually caused by inflamed joints. Hands contain many bones and muscles which make up the wrist, and sometimes the joints connecting these can get irritated.

Photocred: American Academy of Orthapaedic Surgeons 

Joints have cartilage for padding, and they also have joint fluid.A ganglion cyst starts when the fluid leaks out of a joint or tendon tunnel. From there, swelling forms beneath the skin.The cause of the leak is generally unknown, but it can be due to trauma or underlying arthritis. Although rare, it can be painful if it presses on a nerve. In a few cases, the cyst can interfere with joint movement. Sometimes they go away on their own, and sometimes they have to be drained. 

#3 Pilonidal Cysts

Pilonidal cysts don’t cause a lot of problems, and they’re mostly cosmetic. Because our hands have a lot of nerves, if the cyst presses on a nerve, that could cause problems in the hand and in the wrist. But for most people, it’s just cosmetic. 

Pilonidal cysts are often confused with acne, but these are basically cysts that happen a little above the anus, and likewise, they may cause a bit of pain. They can even cause infection for some people. In ages 14 to 28, pilonidal cysts are more common, and people with more body hair are more prone to them as well. Pilonidal cysts are more likely to happen in hairy areas, and so they may have a higher likelihood of appearing in men. That's  why the name “pilonidal cysts” derives from the prefix “pilo” which denotes “hair.” 

Many of the cysts have ingrown hair in them. Thus, the skin becomes infected or inflamed. At times, pilonidal cysts can get very severe and form cellulitis, an infection of the skin that spreads. But most of the time, it’s just hair, and it can be scraped out. In some instances, they can require surgery. Surgeons can extract the cyst and sew the skin back together.

However, when some people see a pilonidal cyst, they assume it’s just a pimple, folliculitis, or pseudofolliculitis, but acne or folliculitis normally happens on the rear end’s cheek whereas pilonidal cysts occur more on the tailbone. Pilonidal cysts are not rare, and they can be very large,  profound, and require drained. Once again, a pilonidal cyst happens as a result of inflammation or the infection of a hair follicle. Trauma or sitting a lot are two other reasons that pilonidal cysts might occur. 

Remember though, it’s best not to assume anything. So, overall, it’s always important to see a doctor, get a diagnosis, and a clear understanding as to why the cysts has formed.

Coverphoto cred: StyleCraze