Mucus Cyst
Mucous cysts are small, fluid-filled sacs that tend to develop in the mouth or on the fingers and toes. They are not harmful, but they can be uncomfortable. There are several options for removing them.
Mucous cysts can also develop in other areas of the body besides the mouth.
Digital cysts appear as firm sacs near the joints of the fingers or toes. This type of cyst forms as an extension of the joint. It is also possible for them to develop away from the joint, such as near the base of a fingernail or toenail.
Digital mucous cysts are more common in older adults, typically in people who are more than 70 years of age.
HAND & WRIST ANATOMY
DISEASE EXPLAINED
SYMPTOMS
Small round or oval bumps
Up to 1 centimeter (cm) in size (0.39 inch)
Smooth
Firm or fluid-filled
Not usually painful, but the nearby joint may have arthritis pain
Skin-colored, or translucent with a reddish or bluish tinge and often looks like a “pearl”
Slow-growing
CAUSES
The cyst forms when the synovial tissue around the finger or toe joint degenerates. This is associated with osteoarthritis and other degenerative joint diseases.
Sometimes a small bony growth formed from degenerating joint cartilage (an osteophyte) may be involved.
The cyst forms when the fibroblast cells in the connective tissue produce too much mucin (an ingredient of mucus). This type of cyst doesn’t involve joint degeneration.
TREATMENT
TREATMENT OPTIONS
Nonsurgical
Infrared coagulation.
This procedure uses heat to burn off the cyst base. A 2014 review of the literature showed the recurrence rate with this method to be 14 percent to 22 percent.
Cryotherapy.
The cyst is drained and then liquid nitrogen is used to alternately freeze and thaw the cyst. The objective is to block any more fluid from reaching the cyst. The recurrence rate with this procedure is 14 percent to 44 percent. Cryotherapy may be painful in some cases.
Carbon dioxide laser.
The laser is used to burn off (ablate) the cyst base after it’s been drained. There’s a 33 percent recurrence rate with this procedure.
Intralesional photodynamic therapy.
This treatment drains the cyst and injects a substance into the cyst that makes it light-sensitive. Then laser light is used to burn off the cyst base. A small 2017 study (10 people) had a 100 percent success rate with this method. There was no cyst recurrence after 18 months.
Repeated needling.
This procedure uses a sterile needle or knife blade to puncture and drain the myxoid cyst. It may need to be done two to five times. The cyst recurrence rate is 28 percent to 50 percent.
Injection with a steroid or a chemical that shrinks the fluid (sclerosing agent). A variety of chemicals may be used, such as iodine, alcohol, or polidocanol. This method has the highest recurrence rate: 30 percent to 70 percent.
Surgical
Surgical treatments have a high success rate, ranging from 88 percent to 100 percent. For this reason, your doctor may recommend surgery as a first-line treatment.
Surgery cuts the cyst away and covers the area with a skin flap that closes as it heals. The size of the flap is determined by the size of the cyst. The joint involved is sometimes scraped and osteophytes (bony outgrowths from the joint cartilage) are removed.
Sometimes, the surgeon may inject dye into the joint to find (and seal) the point of fluid leakage. In some cases, the flap may be stitched, and you may be given a splint to wear after surgery.
In surgery and in nonsurgical methods, scarring that cuts the connection between the cyst area and the joint prevents more fluid from leaking to the cyst. Based on his treatment of 53 people with mucus cysts, one researcher has argued that the scarring can be accomplished without the need for cyst removal and a skin flap.
CONTACTING DR. PERLMUTTER
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