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.
About Sebaceous Cyst
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).
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 2mm to over 2cm. 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.
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.
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.
Cyst Removal Surgery Methods:
- Simple Excision Biopsy
- Punch Excision
- Incision & Drainage (for cyst filled with pus)
- Minimal Incision Surgery
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- Suliman MT. Excision of epidermoid (sebaceous) cyst: description of the operative technique. Plast Reconstr Surg. 2005 Dec. 116(7):2042-3.
- 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.
- Zuber TJ. Minimal excision technique for epidermoid (sebaceous) cysts. Am Fam Physician. 2002 Apr 1. 65(7):1409-12, 1417-8, 1420.