From the Guidelines
Sebaceous cysts, often mistakenly referred to as epidermoid cysts, should be treated with complete surgical excision if symptomatic, as this is the definitive treatment to prevent recurrence. According to the practice guidelines for the diagnosis and management of skin and soft-tissue infections 1, epidermoid cysts, which are similar to sebaceous cysts, contain skin flora in the cheesy keratinous material, even when uninflamed. When these cysts become inflamed, the inflammation and purulence occur as a reaction to rupture of the cyst wall and extrusion of its contents into the dermis, rather than as an infectious complication.
Key points to consider in the management of sebaceous cysts include:
- Complete surgical excision is the recommended treatment for symptomatic cysts to prevent recurrence
- Incision and drainage may provide temporary relief but is not a definitive treatment
- Antibiotics, such as cephalexin, may be prescribed if the cyst becomes infected, but surgical removal is still necessary 1
- Warm compresses can help relieve discomfort from inflamed cysts
- Never attempt to squeeze or pop a sebaceous cyst at home, as this can lead to infection and scarring
It's essential to note that sebaceous cysts are caused by blocked sebaceous glands, which normally release oils to lubricate hair and skin, and they're different from epidermoid cysts, though the terms are often used interchangeably. Effective treatment of inflamed epidermoid cysts, as described in the guidelines 1, entails incision, thorough evacuation of the pus, and probing the cavity to break up loculations, but this is not a substitute for complete surgical excision in the case of sebaceous cysts.
From the Research
Definition and Treatment of Sebaceous Cysts
- A sebaceous cyst is a benign, closed capsule or sac-like structure found under the skin, typically filled with a semi-solid, cheese-like, or oily material.
- Treatment options for sebaceous cysts vary, but surgical excision is a common approach.
Surgical Excision Methods
- One-stage excision of inflamed sebaceous cysts has been shown to be preferable to the conventional method, decreasing the duration of antibiotic exposure, reducing morbidity, and being more economical 2.
- This method involves primary resection of the inflamed sebaceous cyst, followed by antibiotic administration.
- Another approach involves excising the infected tissue along with a rim of healthy tissue and closing the wound with sutures in the same sitting, resulting in quick recovery and reduced need for frequent dressing 3.
Benefits of Surgical Excision
- Reduced morbidity and duration of antibiotic exposure 2.
- Cost-effective and time-saving 2, 3.
- Minimizes the risk of cross-infection by reducing the need for frequent dressing 3.
Considerations for Treatment
- Appropriate selection of cases is crucial for successful one-stage excision of inflamed sebaceous cysts 2.
- The choice of treatment method depends on various factors, including the size, location, and severity of the cyst, as well as the patient's overall health and preferences.