eSurgery

There are few varieties of these including sebaceous cysts, epidermal cysts and pilar cysts.

What are these?
These are lumps under the skin. Occasionally one can find a small punctum(opening) on the overlying skin(You might be able to see more easily this if you pinch the skin to dimple it). The cyst is lined by wall and it contains white cheesy material. Common sites include the body and scalp. There can be more than one present.

What happens to the cyst?
The cyst will usually enlarge with time – the largest I have seen on the scalp measured about 15cm wide!!  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. Rarely, the cyst can become infected primarily. It is best not to lance the cyst as this will cause scarring and make the surgery to excise the cyst completely more complicated

What other conditions can mimic a cyst?

Lipoma – esp if the overlying skin is thick, can sometimes be hard to distinguish

Other soft tissue tumour

What treatment is needed?
Surgery is usually recommended.  Local anaesthesia is injected around the cyst. An incision is made over the skin. The cyst wall is carefully dissected(often best with an artery forceps) and the cyst 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.
What are the risks of surgery ?

1. Wound problems – scarring, infection, breakdown

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