At Lumine Dermatology & Laser Clinic, we frequently address concerns related to epidermal cysts, commonly called sebaceous or epidermoid cysts. These benign skin growths develop under the skin. They grow gradually and are typically filled with a whitish, thick substance that may have an unpleasant odour. Although they can arise on any part of the body, they are more prevalent in areas prone to friction or pressure, such as the groin, underarms, and back.
In most cases, epidermal cysts are painless and do not cause health problems. Complications may occur when a cyst becomes swollen, red, or painful, particularly if it ruptures or becomes infected. If epidermal cysts are an aesthetic concern, rupture, and become inflamed or infected, they can be removed or drained by a dermatologist.
Our skin comprises three layers: the epidermis, dermis, and hypodermis. The epidermis is the outer layer of the skin; it acts as a protective barrier and is made up of skin cells that shed to be replaced by new skin cells.
Epidermal cysts develop due to a problem in the normal shedding of cells from the epidermis. In these cases, skin cells embed deeper into the inner layers of the skin, creating a pocket of epidermal cells within the skin. These pockets fill with skin secretions, notably keratin – a sturdy, whitish substance. When keratin becomes trapped, it forms the bulk of the cyst.
Epidermal cysts are commonly situated near hair follicle openings. They form when these openings become obstructed or inflamed, often due to harm inflicted on the hair follicles, such as scrapes or wounds.
The symptoms of epidermal cysts vary depending on the severity. In general, the symptoms of epidermal cysts include:
Epidermal cysts may not be painful, especially if they are small. However, if they become inflamed, they can cause significant swelling and discomfort. They may also rupture and get infected.
If you are in pain or discomfort due to an epidermal cyst, do not squeeze the cyst on your own. It is important to seek medical attention. Consulting with a dermatologist can help accurately diagnose the issue and allow for appropriate treatment to alleviate your symptoms.
Epidermal cysts can affect individuals of any age, gender, or race. In Singapore, no specific group is at a higher risk of developing epidermal cysts. They often develop due to skin trauma or clogged hair follicles. In general, risk factors for epidermal cysts are:
Epidermal cysts are typically diagnosed by a dermatologist. The process usually includes the following:
At Lumine Dermatology & Laser Clinic, the right treatment option for cysts involves considering various factors, including the cyst’s size, location, and history of previous inflammation or surgery. Equally important are your expectations regarding scarring, recovery time, and how treatment may impact your lifestyle.
We approach cyst removal via the following methods:
Recognising that treatment does not end with surgery, Lumine Dermatology & Laser Clinic offers effective aftercare options. Our laser technologies, including the pulsed dye laser, picosecond lasers, and fractional carbon dioxide laser, are available to help remodel scars from the moment stitches are removed, ensuring the best possible cosmetic outcome.
Can I remove an epidermal cyst myself?
It is not advisable to squeeze or pop an epidermal cyst at home, as it may become infected or lead to more complications, such as scarring. Consult a dermatologist to remove an epidermal cyst. At Lumine Dermatology & Laser Clinic, we are experienced and can provide you with the right advice and treatment.
How long does an epidermal cyst last?
Due to its structural nature within the skin, an epidermal cyst is unlikely to resolve independently or with topical medications. Surgical intervention is often the most direct approach to resolving these cysts.
Many find that epidermal cysts remain a small, manageable size for years, causing little to no discomfort.
However, it is not uncommon for these cysts to gradually increase in size. When situated in areas of the body such as the skin folds (prone to frictional forces) or pressure-dependent areas (buttocks, back), cysts have a higher chance of becoming inflamed or ruptured.
Are epidermal cysts hard or soft?
Epidermal cysts are typically firm lumps under the skin. When infected with pus accumulation, they will be tender to touch and feel slightly boggy with digital pressure. If a subcutaneous skin lump feels soft to the touch, it is more likely to be a lipoma. If it is bony and hard to touch, it is more likely to be an osteoma or bony origin.
Does epidermal cyst removal hurt?
Epidermal cyst removal is performed under local anaesthesia, which numbs the area around the cyst, making the procedure virtually painless. General anaesthesia is typically not required. This procedure is often done in a dermatology clinic without utilising an operation theatre.
Patients may feel slight pressure during the surgery but no significant pain. Post-procedure discomfort is minimal and usually does not require over-the-counter pain medication. Patient feedback consistently indicates that the procedure is far less daunting than anticipated, with minimal discomfort and quick recovery times.
What are the risks of epidermal cyst removal?
While epidermal cyst removal is generally safe, as with any surgical procedure, there are some associated risks. These include recurrence, infection, bleeding, and scarring. However, these risks are low, especially when the procedure is performed by skilled dermatologists using sterile techniques. At Lumine Dermatology & Laser Clinic, we provide detailed post-operative care instructions to minimise these risks and ensure a smooth recovery.
What is the recovery time for epidermal cyst removal?
Recovery time can vary depending on the size and location of the cyst but is typically brief if a minimal incision technique or elliptical excision is performed. Most patients can resume normal activities within a few days, and the incision site usually heals within a week. A discrete, waterproof dressing is often applied for 1-2 weeks after surgery. Avoiding strenuous activities for a short period post-surgery is recommended to aid healing.
What are the post-removal care instructions for an epidermal cyst?
Proper aftercare is crucial for a smooth recovery following epidermal cyst removal. Key steps include keeping the area clean and dry, applying the prescribed antibiotic ointment, and changing the bandage as directed. Patients should also avoid direct sunlight on the treated area and refrain from strenuous activities that could disrupt the healing process. Any signs of infection, such as increased redness, swelling, or pus, should prompt an immediate consultation with a dermatologist.
