Cysts
Annoying sometimes painful benign (not bad) growths
What causes Cysts?
Genetics, blocked hair follicles, and smoking are major causes
The most common cyst is the Epidermal inclusion cyst (EIC) – think Dr. Pimple popper and a bump that has a bunch of cheesy material in it.
Epidermal inclusion cysts are slow growing and often painless, so they rarely cause problems or need treatment. You might choose to have a cyst removed by a doctor if its appearance bothers you or if it’s painful, ruptured or infected.
I think of an EIC as a hair follicle that becomes blocked – then the stuff that a hair follicle makes (namely dead skin cells and oil) fill the blocked hair follicle and stretch it into a
sort of “balloon”.It is really the outside of the balloon that creates the material, which is why this must be removed to “cure” the cyst.
Other common cysts include: Pilar Cysts (typically on the scalp), Steatocystoma (sebaceous cyst) – typically on the central chest and genetically induced, Dermoid cyst (present at birth), etc.
How do I get rid of an EIC (Epidermal inclusion cyst)?
This requires surgery. Usually low risk. We numb the area with injected numbing medication (lidocaine). Then we open the skin and remove the cyst wall and contents.
If a cyst is inflamed, we do not recommend removal. Sometimes draining a cyst, injecting anti-inflammatory medication (steroid), and/or taking some antibiotics (rarely) can help reduce the inflammation and help make the cyst ready for removal. Usually, only steroid injection and/or draining is needed to get the cyst ready for removal.
Why did the cyst become inflamed and painful?
When the “balloon” of the cyst gets stretched too much it may leak without cause. Alternatively, the cyst may it rubbed or bumped which may cause it to leak. When this happens the contents of the cyst (dead skin cells and oil) leak under the skin. This stuff is not supposed to be here. Your immune system is called to action to “clean up” all the debris which causes a massive immune reaction. You may interpret this as an infection but it is typically not.
When the area is inflamed or painful I do not recommend attempting surgical removal. This leads to much more likelihood for recurrence and the surgery is much more difficult, larger, painful, and leads to a worse scar.
What is the surgery for a cyst like?
Well there are a ton of videos online of what they are like. Size and location make a difference, but every surgery is pretty much the same. We will discuss risks and benefits of the surgery, clean the skin, numb the skin with a needle/lidocaine, clean the skin again, open the skin, gently remove the cyst, and then expertly stitch the skin back together to reduce appearance of a scar. This all typically takes about 20 - 30 minutes depending on the location and type of cyst.
Sutures are typically placed underneath the skin and on top of the skin – or in two layers underneath the skin depending on location, skin quality, patients medical status, and other factors.
Source: Mayo Clinic (https://www.mayoclinic.org/diseases-conditions/epidermoid-cysts/symptoms-causes/syc-20352701)
Good video of how it is done - https://www.youtube.com/watch?v=pEtdAarcqzI