The Hidden World Beneath the Skin
The skin, our body’s largest organ, is often underestimated in the role it plays. It shields us from infections, maintains hydration, regulates temperature, and serves as the first barrier against external threats. But beneath its surface, things can sometimes go wrong. Cysts, boils, and abscesses are reminders of how the body reacts to blockages, infections, or trapped cells. The image shown illustrates a dramatic case—a swollen, raised lump protruding near the knee with two visible exit points.
At first glance, the skin around the area is stretched thin, shiny, and slightly reddened. This indicates inflammation. The swelling beneath suggests that a pocket of material—keratin, pus, or debris—has built up over time. One of the openings reveals a dark, hardened plug, while the other displays a lighter, cream-colored substance resembling keratin or sebaceous buildup. Together, these two points hint at the nature of the mass: a large epidermoid cyst that has reached the surface.
What is an Epidermoid Cyst?
An epidermoid cyst, sometimes mistakenly called a sebaceous cyst, is a sac-like structure under the skin filled with keratin—the same protein that makes up hair, nails, and skin. These cysts form when surface skin cells, instead of shedding naturally, get trapped and grow inward. Over time, they multiply and form a wall around themselves, creating a sac. Inside, keratin accumulates into a thick, cheese-like material that has a strong odor when released.
In most cases, epidermoid cysts are small, harmless, and slow-growing. However, some can become quite large, irritated, or infected. When this happens, the skin becomes inflamed, tender, and often painful. If bacteria invade, the cyst may transform into an abscess, filled with pus rather than keratin.
The Appearance of the Cyst in the Image
The cyst in the image seems to have grown significantly, stretching the skin over the knee. The location is important—the knee is an area frequently subjected to friction, bending, and minor injuries. These factors could irritate a cyst, cause inflammation, and accelerate its enlargement.
Two exit points are visible. The dark plug could represent dried keratin or oxidized sebum, resembling a giant blackhead. The lighter opening, with a pale-yellow mass protruding, likely shows keratin material being forced outward by internal pressure. This suggests the cyst is “ripe” for removal—meaning its wall is under strain and could rupture or be surgically opened.
Why Cysts Become So Large
Several factors contribute to the enlargement of epidermoid cysts:
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Neglect and slow growth: Many people ignore cysts until they become bothersome. What starts as a small bump can, over years, evolve into a large lump.
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Repeated irritation: Constant pressure or friction, such as on the knee, can inflame the cyst, stimulating growth.
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Blockage of drainage: Sometimes, the cyst tries to expel keratin but fails, causing backflow and accumulation.
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Infection: Once bacteria enter, pus formation begins, increasing swelling and pain.
The Process of Removal
Videos of cyst removals, like the one advertised in the image (“Swipe up to watch this video”), are both educational and strangely fascinating to millions of viewers online. People are drawn to the relief of watching pressure build-ups being released.
The typical removal involves:
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Cleaning and numbing: The area is sterilized, and a local anesthetic is applied.
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Incision: A small cut is made over the cyst, usually directly above the central punctum.
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Expression: Pressure is applied to squeeze out the keratinous material. Sometimes, thick, white, cheesy chunks emerge, while in other cases, a more liquid, pus-like substance flows out.
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Sac extraction: For permanent removal, the cyst wall (sac) must be carefully excised. If left behind, the cyst can regrow.
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Closure and aftercare: Depending on the size, the wound may be stitched or left open to heal naturally. Antibiotics may be prescribed if infection was present.
Why People Watch These Removals
Cyst and abscess removal videos have become a strange but popular genre online. Psychologists suggest that watching these procedures offers:
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Relief: Seeing built-up pressure released satisfies a deep psychological need for resolution.
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Empathy: Viewers feel the patient’s relief, almost as if it’s their own.
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Curiosity: Many people are simply fascinated by the inner workings of the human body.
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Sensation-seeking: For some, it’s akin to watching horror films—repulsive yet impossible to look away from.
Risks of Not Treating a Large Cyst
Leaving a cyst of this size untreated can lead to serious complications. The stretched skin can rupture, leaving an open wound prone to infection. The cyst may also become increasingly painful, restrict movement (especially around a joint like the knee), or even cause systemic infection if bacteria spread into the bloodstream.
Furthermore, repeated inflammation can cause scarring or discoloration, making surgical removal more difficult later. In rare cases, cysts can be misdiagnosed, masking more serious growths.
Emotional and Social Impact
Large visible cysts can also affect self-esteem and confidence. Many patients report embarrassment, hiding the lump under clothing or avoiding social situations. The knee, while not as visible as the face, is still a prominent part of the body—especially in warmer climates where shorts or skirts are common.
The anticipation of removal can bring immense emotional relief. Patients often describe feeling lighter, freer, and more at ease once the cyst is gone.
Closing Thoughts
The image captures a dramatic but treatable condition: a large epidermoid cyst on the knee, visibly filled with keratin and possibly infected. While unsettling to look at, it also tells a story of the human body’s resilience, its capacity to wall off irritants, and the relief that comes when the problem is finally addressed.
Behind the “swipe up” call to action lies a reality that is both medical and deeply human—the mix of pain, patience, and healing. What starts as a small, ignored lump can grow into something that demands attention, teaching us the importance of not dismissing our body’s signals.
For the person in the photo, the journey likely ends in a doctor’s office, with a skilled pair of hands carefully removing the cyst and restoring comfort. For the viewer, it’s another reminder of the strange satisfaction we find in witnessing the triumph of cleanliness, health, and release over infection, swelling, and blockage.
