best epidermal cystic removal in singapore

Sebaceous Cyst Removal

Sebaceous cyst or epidermoid cyst are common skin lesions

More common in men , they can enlarge in size and get infected on occasion.

sebaceous cyst removal surgery

what is a Sebaceous Cyst

Sebaceous cyst are very common lumps that develop underneath the skin. They are harmless in most cases, but can get infected and inflammed under certain conditions. Cyst removal surgery to remove the capsule and the cystic contents is curative. Punch excision is a excellent technique to remove the cyst leaving smaller scars and faster healing times.

How does a Sebaceous Cyst form?

The Sebaceous Cyst (aka epidermoid cyst, epidermoid inclusion cyst, infundibular cyst) is one the most common skin cyst seen in our daily practice. It commonly occurs on the face, scalp, body but can grow just about anywhere. Although twice in common in men, the sebaceous cyst tends to be more apparent as we get older. It is a harmless skin cyst, and does not have a risk of cancer transformation. Cyst removal surgery is the definitive way of removing the capsule and its contents completely.

The sebaceous cyst develops as the result of the elements of the epidermis (the top layer of the skin) growing within the dermis (the deeper layer of the skin). There are several reasons why a sebaceous cyst develops, but the exact mechanism remains unknown. Blocked pores, skin injury, infection and even sun exposure are cited a potential factors contributing to cyst formation.

You know that you have a sebaceous cyst when you feel a lump underneath your skin, and see an opening (technically called a punctum). This opening looks like a black dot, and you may even express cheesy smelly substance if you press onto your cyst. This is because the cyst is encased in a sac that is lined by skin cells actively producing macerated keratin (wet skin cells).

what does a Sebaceous Cyst look like?

You know that you have a sebaceous cyst when you feel a lump underneath your skin, and see an opening (technically called a punctum). This opening looks like a black dot, and you may even express cheesy smelly substance if you press onto your cyst. This is because the cyst is encased in a sac that is lined by skin cells actively producing macerated keratin (wet skin cells).

When infected, the skin overlying the skin can turn red, feel hot and tender. In later stages of infection, pus and blood may ooze out from the skin.

sebaceous cyst punctum
Punctum (black dot) is seen at the top of the cyst

what is Steatocystoma Multiplex?

Steatocystoma Multiplex is considered a rare skin condition. In affected individuals, multiple cysts start appearing during the adolescent stage. While the condition may run in families, it may also occur out of nowhere. It is suspected that the condition arises due to a genetic mutation in a gene controlling certain skin elements. 

The size of individual cysts in affected individuals with steatocystoma multiplex may range from 3mm to over 3cm. These skin cysts can number from a dozen to almost a hundred, and are commonly distributed on the face, chest, back and arms.

While this condition is benign, most individuals may prefer removal of some cyst in cosmetically apparent areas such as the face. A modified incisional technique to remove the cysts that we have developed leads to  better cosmetic effect, faster healing times and with minimal chance of recurrence. Learn more here.

Know when to seek Help

While most cyst can be left alone as it is harmless. On occasion the cyst may rupture or get inflammed resulting in pain, swelling, redness and even pus formation. When this happens, there is inflammation to the surrounding skin, and this causes great disomfort. You need to see a doctor when your cyst becomes painful because you may need treatment in the form of either oral antibiotics, or a surgical drainage if there is lots of pus.

infected sebaceous cyst
Infected sebaceous cyst

Cyst Removal Surgery

As the sebaceous cyst resides deeper into the skin, lined by a sac of skin cells, taking antibiotics and regular pressing of the cyst contents are not curative. Cyst removal surgery is the preferred method to remove the cystic contents, the cystic sac and the overlying punctum. Most cyst removal surgery can be done under local anaesthesia. The overlying skin and cyst are carefully removed, ensuring that no fragments are left behind.

A minimal excision technique for cyst removal surgery makes use of an instrument known as a punch biopsy tool (see picture). The punch biopsy tool is entered into the skin over the opening of the cyst, and subsequently the cyst contents and cystic sac are then dissected out. This procedure gives a good cosmetic outcome, a smaller scar and faster healing time.

sebaceous cyst removal surgery

Cyst Removal Surgery Options:

  1. Excision Biopsy – best chance of removing the cyst wall and its contents. Specimen is sent for histological examination.
  2. Punch Excision
  3. Incision & Drainage (for cyst filled with pus)
  4. Minimal Incision Surgery

The procedure is performed under local anaesthetic. It is a virtually painless procedure.

As with most surgical procedures, there is a risk of bleeding, infection, scarring, hair loss and recurrence. Fortunately, these are uncommon and most can be managed easily.

Most individuals heal within 1-2 weeks. Stitches are removed between 7-14 days depending on the site of surgery.

After removal of tyour sebaceous cyst, it is very important to keep the wound site clean with daily anti-septics, topical antibiotics and dressings. 

Yes, there will be a small linear scar. The appearance of the scar will improve over time. If scarring is visible, laser resurfacing can soften the appearance of your scars.

Dr Moses Ng dermatologist

cyst removal surgery

Cyst removal surgery is one of the most common procedures I undertake. When I examine an epidermal cyst for the first time, I want to check for signs of inflammation. Any redness, swelling, and pain may mean an underlying infection, and should be treated either with antibiotics or an Incision & Drainage procedure if pus is present.

schedule a consultation for sebaceous cyst removal in singapore

Although harmless, many patients may want their sebaceous cyst removed due to its appearance history of recurrent infections. Contact us today to schedule a consultation, so that Dr. Ng can develop a personalized treatment approach for resolving your skin concerns and helping you to achieve long-term improvements in the appearance of your skin.

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More information:
  • Cutaneous cysts and pseudocysts, DermNet NZ. Click here.
  • Epidermal Inclusion Cyst, Medscape Resource. Click here.
References:
  1. Suliman MT. Excision of epidermoid (sebaceous) cyst: description of the operative technique. Plast Reconstr Surg. 2005 Dec. 116(7):2042-3.
  2. Lieblich LM, Geronemus RG, Gibbs RC. Use of a biopsy punch for removal of epithelial cysts. J Dermatol Surg Oncol. 1982 Dec. 8(12):1059-62.
  3. Zuber TJ. Minimal excision technique for epidermoid (sebaceous) cysts. Am Fam Physician. 2002 Apr 1. 65(7):1409-12, 1417-8, 1420.