Most cysts are painless. They’re fluid-filled sacs that can form almost anywhere in the body, and many people have them without ever knowing. But certain types of cysts are more likely to hurt than others, and even a painless cyst can become painful if it gets infected, ruptures, or presses on a nerve.
Why Some Cysts Hurt and Others Don’t
A cyst on its own is just a closed sac filled with fluid, air, or semi-solid material. It has no reason to cause pain unless something changes. The most common triggers that turn a quiet cyst into a painful one are infection, rupture, growth, and pressure on nearby structures.
Infection is probably the most frequent cause of cyst pain, especially for skin cysts. Bacteria get into the sac, and the surrounding tissue becomes inflamed, red, swollen, and tender. A ruptured cyst can also cause sudden, sharp pain because its contents leak into surrounding tissue and trigger an inflammatory response. For ovarian cysts, rupture can cause severe lower abdominal pain and internal bleeding. And when a cyst grows large enough to push against a nerve, you may feel not just pain but tingling, numbness, or muscle weakness in the area.
Pain Profiles by Cyst Type
Different cysts behave differently when it comes to pain. Here’s what to expect from the most common types:
- Sebaceous (epidermal) cysts: These skin cysts range from completely painless to very red and painful, depending on whether they’re inflamed or infected. They typically appear on the face, neck, chest, stomach, or back. When calm, they feel like a small, firm, round lump under the skin.
- Ganglion cysts: Most ganglion cysts are painful, and the pain tends to get worse with movement. They form on top of joints or tendons, most often on the hand or wrist but sometimes on the knees or feet. Pain and other symptoms like tingling or numbness occur when the cyst presses on a nearby nerve.
- Ovarian cysts: Small ovarian cysts are extremely common and usually cause no symptoms at all. A large one can produce a dull ache or sharp pain on one side of the lower abdomen. If an ovarian cyst ruptures, it may cause anything from no symptoms to severe pelvic pain requiring medical attention.
- Baker’s cysts: These fluid-filled cysts form behind the knee. They cause a feeling of tightness and stiffness that can make it hard to fully bend or straighten the leg. Pain gets worse with activity and after standing for long periods.
- Dermoid cysts: Typically painless. These show up near the eyebrows, on the scalp, chest, or collarbone as a bump you can feel but that doesn’t hurt.
Cyst Pain vs. Abscess Pain
If a lump under your skin is intensely painful, hot to the touch, and visibly red or pink, it may not be a cyst at all. It could be an abscess, which is a pocket of pus caused by a bacterial infection. The key differences: a cyst is typically firm and round, while an abscess is soft and squishy. An abscess is almost always painful and raised from the skin with obvious redness. A cyst can sit under the skin for months or years without causing any trouble.
That said, an infected cyst can look and feel a lot like an abscess. If you’re not sure which you’re dealing with, the distinction matters because treatment differs.
What to Do About a Painful Cyst at Home
If a cyst that was previously painless starts to hurt, there are a few things you can safely do while deciding whether to see a provider. Apply warm, wet washcloths to the area for 20 to 30 minutes, three to four times a day. A hot water bottle or heating pad over a damp towel works too, as long as the heat isn’t above bath temperature. Keep the area clean with soap and water, and if it starts draining, cover it with a bandage and change it daily.
One thing you should absolutely not do: squeeze it, pop it, or try to drain it yourself. Puncturing a cyst can push an existing infection deeper into the skin, cause severe bleeding, or make the inflammation significantly worse.
When a Painful Cyst Needs Medical Attention
A cyst that becomes painful, red, swollen, or starts draining fluid warrants a visit to your provider. The same goes for any cyst that’s growing quickly or has reached a diameter larger than about 5 centimeters (roughly 2 inches). For ovarian cysts, sudden sharp abdominal pain is a reason to seek care promptly, since it could signal a rupture or ovarian torsion, a condition where the cyst causes the ovary to twist and lose blood flow.
How Painful Cysts Are Treated
Treatment depends on the type, size, and whether the cyst is infected. There are two main approaches for skin cysts. Drainage involves a provider opening the cyst and removing the fluid or material inside. This relieves pain quickly but isn’t permanent, since the cyst can refill and come back. Surgical removal takes out the entire cyst including its outer lining, which significantly lowers the chance of recurrence.
Recovery after cyst removal is generally straightforward. Small cysts that don’t need stitches heal within a few days to a couple of weeks. Larger cysts with bigger incisions can take several weeks or even months to fully heal. Expect mild pain and swelling afterward, typically manageable with over-the-counter pain relievers. If stitches are placed, you’ll usually have a follow-up visit seven to ten days later to have them removed.
For a ruptured ovarian cyst that isn’t complex, recovery often happens at home with pain medication. The pain typically resolves within a few days. More severe ruptures with significant bleeding may require closer monitoring or intervention.