SEBACEOUS CYSTS (EPIDERMOID CYSTS/PILAR CYSTS)

These are lumps under the skin. Occasionally one can find a small punctum on the overlying skin. The cyst is lined by wall and it contains white cheesy material. Common sites include the body and scalp. The can be more than one present.

Natural Progression

The cyst will enlarge with time. Sometimes, the lining will burst. This will lead to an inflammation in the surrounding tissue and overlying skin. This is often mistaken for an infection and treated with antibiotics.

Surgery

Local anaesthesia is injected around the cyst. (care is taken as sometimes the LA can squirt out of the punctum and hit the face of the doctor/nurse!)

An incision is made over the skin. The cyst wall is carefully dissected(often best with an artery forceps) and the cyst wall removed with its contents.

The wound is closed with sutures - usually non-absorbable. These are left in for 7-14 days. A waterproof dressing is usually used to cover the wound.

Risks of Surgery

1. Wound problems - scarring, infection, breakdown, pain in scar/reflex sympathetic dystrophy, nerve damage/numbness

2. Recurrence - sometimes a fragment of the cyst wall is stuck down in the surrounding scar tissue and the cyst may regrow.

Answers to Frequently Asked Questions:

1. There is usually no need to shave the hair around the cyst if it is on the scalp