From the Guidelines
Treatment of sebaceous cysts, more accurately referred to as epidermoid cysts, typically involves incision, thorough evacuation of the pus, and probing the cavity to break up loculations, as outlined in the practice guidelines for the diagnosis and management of skin and soft-tissue infections 1. When dealing with sebaceous cysts, it's essential to differentiate between infected and uninflamed cysts.
- Infected cysts often require incision and drainage to alleviate symptoms and prevent further complications.
- Uninflamed cysts can usually be left alone, but if they become problematic, surgical removal may be considered. Key points to consider in the treatment of sebaceous cysts include:
- Avoiding unnecessary use of systemic antibiotics, as they are rarely necessary 1.
- Not attempting to squeeze or pop the cyst at home, as this can lead to infection and scarring.
- Seeking medical attention if the cyst becomes red, painful, or starts draining pus, as these are signs of infection. In terms of specific treatment options,
- Warm compresses can help reduce inflammation and promote drainage for minor cysts.
- Oral antibiotics may be prescribed if the cyst is infected, but this is not typically the first line of treatment.
- Complete surgical removal is often recommended for definitive treatment to prevent recurrence, and this can usually be done under local anesthesia in a doctor's office 1.
From the Research
Treatment Options for Sebaceous Cysts
- Conventional wide excision, minimal excision, and punch biopsy excision are three main techniques used to excise sebaceous cysts 2
- A new method involving a two-step process has been proposed, where a laser is used to make a small hole for removal of the content, followed by removal of the cyst wall with a minimal excision about 1 month later 2
- This method offers a good alternative for eradication of uninfected cysts, especially large cysts or cysts located in areas of thick skin or cosmetic concern 2
One-Stage Excision of Inflamed Sebaceous Cysts
- One-stage excision of inflamed sebaceous cysts has been shown to decrease the duration of antibiotic exposure, reduce morbidity, and is more economical compared to conventional treatment 3
- This study suggests that primary resection of inflamed sebaceous cysts has advantages over conventional treatment, provided cases are appropriately selected 3
Histopathological Examination of Excised Lesions
- Routine histopathological examination (HPE) of clinically diagnosed benign skin and subcutaneous lesions, including sebaceous cysts, may not be necessary in the absence of red flag signs 4
- The frequency of malignancy in sebaceous cysts is extremely low, and clinical diagnosis has been shown to be accurate in 72.7% of cases 4