Recurring cysts almost always come down to how your skin handles a protein called keratin. Keratin is the tough material that makes up your outer skin layer and hair. When it gets trapped beneath the surface, usually because a hair follicle is damaged, blocked, or inflamed, it accumulates inside a small pocket and forms a cyst. Some people are simply more prone to this process than others, and the reasons range from genetics and hormones to friction and diet.
How Cysts Actually Form
Most skin cysts people deal with repeatedly are epidermoid cysts, not true “sebaceous cysts” as they’re commonly called. They don’t actually involve your oil glands or contain oil. Instead, they originate from the upper part of a hair follicle. When that follicle gets damaged, irritated, or plugged, skin cells that normally shed outward get pushed inward. Those displaced cells create a sac lined with the same tissue as your skin’s surface, and that sac steadily fills with layers of keratin. The result is a firm, slow-growing lump just under the skin.
The other common type, pilar cysts, forms from cells found in hair roots and shows up almost exclusively on the scalp. Both types grow slowly and are usually painless unless they rupture or become infected.
Why Some People Get Them Over and Over
If you’re someone who keeps developing cysts in different spots, several overlapping factors are likely at play.
Follicle damage and friction. Anything that repeatedly irritates hair follicles can set the stage. Shaving, waxing, tight clothing, backpack straps, and even habitual rubbing or picking at the skin create micro-injuries. On areas without hair follicles, skin trauma can push surface cells into the deeper layer of skin, where they form a keratin-collecting pocket. If your daily life involves regular friction in the same spots, cysts will keep appearing in those areas.
Accumulated sun damage. Years of sun exposure thins the outer skin layer and makes it more fragile. This leads to changes in hair follicles, including plugging and thickening of the follicle lining, which can trigger cyst formation. This is one reason older adults sometimes notice cysts appearing in sun-exposed areas where they never had them before.
Acne-related follicle plugging. In acne-prone skin, the lining of hair follicles overproduces keratin, creating plugs. Combined with excess oil production and bacterial overgrowth, this process can lead to deep, cyst-like nodules. If your recurring cysts tend to show up on your face, chest, or back alongside breakouts, the underlying mechanism is likely the same one driving your acne.
Hormones and Cyst-Prone Conditions
Hormonal imbalances, particularly excess androgens, are a major driver of recurrent cysts in several forms. Polycystic ovary syndrome (PCOS) is one of the clearest examples. PCOS causes ovarian cysts through disrupted ovulation, but its hormonal effects also increase oil production and follicle plugging in the skin, contributing to cystic acne and other skin issues.
There’s also a strong link between PCOS and hidradenitis suppurativa (HS), a condition that causes painful, recurring lumps in areas like the armpits, groin, and under the breasts. People with HS are roughly twice as likely to also have PCOS compared to the general population. Both conditions involve androgen excess, and the overlap suggests that if you’re dealing with recurring painful lumps in skin folds, a hormonal evaluation is worth pursuing.
Genetic Causes of Multiple Cysts
When cysts appear in unusually high numbers, genetics may be the explanation. A condition called steatocystoma multiplex causes dozens to hundreds of small cysts, typically appearing during adolescence on the torso, neck, upper arms, and upper legs. These cysts originate in oil glands and are filled with sebum. The condition is caused by a mutation in the KRT17 gene, which provides instructions for building a structural protein in skin cells. When that protein is defective, it disrupts how oil gland cells grow and organize, leading to widespread cyst formation.
Steatocystoma multiplex follows an autosomal dominant inheritance pattern, meaning you only need one copy of the mutated gene from one parent to develop the condition. If a parent had clusters of small cysts, particularly on their chest or arms, this is worth mentioning to a dermatologist. A related condition called pachyonychia congenita involves the same gene and also produces steatocystomas alongside thickened nails.
How Diet Plays a Role
Diet doesn’t directly cause the kind of epidermoid cysts that sit under your skin for months. But if your recurring cysts are acne-related (deep, inflamed, and concentrated on your face, jawline, chest, or back), what you eat can influence how many you get. High-glycemic diets, those heavy in refined carbohydrates, fast food, sugary drinks, and white bread, raise hormone levels associated with acne. These hormonal spikes increase oil production and follicle plugging, creating more opportunities for cystic breakouts.
Switching to a lower-glycemic diet that emphasizes vegetables, whole grains, legumes, and fruit has been shown to reduce blemishes and inflammation in some people. The benefit appears strongest in those with insulin sensitivity, since the diet works by helping regulate the hormones that drive breakouts. It won’t eliminate cysts on its own, but it can meaningfully reduce how often new ones form.
Reducing New Cyst Formation
Preventing cysts entirely isn’t always possible, especially when genetics or hormones are the primary driver. But you can lower the frequency by addressing the triggers you can control.
- Minimize skin trauma. Avoid picking, squeezing, or repeatedly rubbing areas where cysts tend to form. If clothing or equipment creates friction in a specific spot, use padding or switch to looser-fitting alternatives.
- Keep follicles clear. Gentle exfoliation helps prevent the keratin buildup that plugs follicles. For acne-prone skin, topical retinoids (applied nightly to the face) are an effective first-line option for keeping follicles open and reducing comedonal and inflammatory acne. They work best for mild to moderate cases and are typically not sufficient alone for deep cystic acne.
- Address hormonal contributors. If your cysts correlate with your menstrual cycle, appear alongside other signs of androgen excess (irregular periods, excess hair growth, thinning scalp hair), or cluster in skin folds, a hormonal workup can identify treatable underlying conditions.
- Protect against sun damage. Consistent sunscreen use slows the skin thinning and follicular changes that make cysts more likely with age.
Signs a Cyst Needs Attention
Most skin cysts are harmless and can sit unchanged for years. A cyst that becomes red, warm, swollen, or painful is likely infected or has ruptured beneath the skin, spilling its keratin contents into surrounding tissue and triggering inflammation. This usually requires drainage and sometimes antibiotics.
For ovarian cysts, which can also recur frequently in people with PCOS or other hormonal conditions, the warning signs are different and more urgent. Sudden, severe pelvic or abdominal pain, especially with fever, vomiting, rapid breathing, or lightheadedness, can indicate a ruptured cyst or ovarian torsion (where a large cyst causes the ovary to twist). Both are medical emergencies.