Cyst Removal

Overview

Epidermoid cysts are benign, encapsulated nodules that develop beneath the skin when keratin accumulates in a sac-like structure. Despite being commonly called sebaceous cysts, they do not actually involve the sebaceous glands. These cysts most frequently appear on the face, neck, and trunk, though they can develop anywhere on the body.

Cyst removal is typically performed as an outpatient procedure under local anesthesia. The choice of removal technique depends on the cyst's size, location, and whether it has previously been inflamed or infected. Complete removal of the cyst wall is essential to prevent recurrence.

When performed by a board-certified dermatologist, cyst removal can achieve excellent outcomes with minimal scarring. Modern minimally invasive techniques allow removal through smaller incisions, improving cosmetic results while maintaining low recurrence rates.

While many cysts can be left alone if asymptomatic, patients often seek removal due to cosmetic concerns, recurrent inflammation, discomfort, or interference with daily activities. A dermatologist can evaluate the cyst and recommend the most appropriate treatment approach.

What to Expect During Treatment

1. 1Initial consultation includes examination of the cyst, discussion of symptoms and history of any previous inflammation or drainage, and review of medical history.
2. 2The dermatologist evaluates the cyst characteristics to determine the most appropriate removal technique based on size, location, and condition.
3. 3If the cyst is currently inflamed or infected, the dermatologist may recommend antibiotics and/or drainage first, with excision scheduled at least 8 weeks later.
4. 4The treatment area is cleaned with antiseptic solution and marked to guide the procedure.
5. 5Local anesthetic (lidocaine with epinephrine) is injected around the cyst, avoiding injection into the cyst itself to prevent rupture.
6. 6The surgeon makes an incision appropriate to the chosen technique (elliptical for conventional, small punch for minimal excision).
7. 7The cyst is carefully dissected from surrounding tissue, with the goal of removing the entire cyst wall intact.
8. 8The wound bed is examined to ensure complete removal of cyst contents and wall fragments.
9. 9The incision is closed with sutures. Smaller incisions may be left to heal by secondary intention or closed with adhesive strips.
10. 10A sterile dressing is applied, and detailed aftercare instructions are provided.

Conditions We Treat

Cyst Removal can help address the following conditions:

• Sebaceous Cyst
• Epidermoid Cyst

How does Cyst Removal work?

• Conventional surgical excision involves making an elliptical incision around the cyst, then carefully dissecting the cyst wall from surrounding tissue using a combination of sharp and blunt dissection. The goal is to remove the cyst sac intact without rupturing it. To reduce scarring, a variant of this method involves creating the incision lines within the outline of the cyst, followed by careful dissection of the cyst wall from the surrounding tissue.
• Minimal excision technique uses a small 2-3mm incision through which the cyst contents are expressed by compression, followed by extraction of the cyst wall through the same opening. This approach results in smaller scars but is contingent on the ability to remove the sac wall, which may not always be accessible for complete removal via this technique. The minimal incision technique is more effective for smaller cysts.
• If a cyst ruptures during removal, the dermatologist will thoroughly cleanse the surgical site and ensure all cyst wall fragments are removed to minimize recurrence risk.
• The wound is closed with sutures placed to minimize tension and optimize healing. Smaller incisions from minimal excision techniques may or may not require sutures.

When It's Recommended

• Cyst causing cosmetic concerns due to visible bump or swelling
• Recurrent inflammation or tenderness at the cyst site
• Cyst interfering with daily activities or causing discomfort
• Cyst that is enlarging over time
• Patient preference for definitive removal to prevent future episodes

Recovery & Aftercare

• Initial healing typically occurs within 1-2 weeks
• Sutures are usually removed within 7-10 days, depending on location
• Avoid contact sports and strenuous activity during the initial healing period
• The surgical scar reaches maximum tensile strength (about 80% of normal skin) at approximately 8 weeks
• Most patients can return to normal activities within a day or two of the procedure
• Final scar appearance continues to improve over 6-12 months
• Sun protection is recommended during healing to prevent hyperpigmentation

Alternative Treatments

• Observation without treatment for asymptomatic cysts
• Incision and drainage for inflamed or infected cysts (temporary relief, does not prevent recurrence)
• Corticosteroid injection to reduce inflammation before planned excision
• Laser-assisted minimally invasive excision for select cysts

Frequently Asked Questions