From the Guidelines
Treatment for a cyst should prioritize watchful waiting for small and asymptomatic cases, with consideration of aspiration, surgical removal, or other medical procedures for larger, symptomatic, or problematic cysts, as recommended by the most recent and highest quality study 1. When considering treatment options for a cyst, several factors come into play, including the type, location, size, and symptoms of the cyst.
- For many cysts that are small and asymptomatic, watchful waiting is recommended as they often resolve on their own without intervention, with a study suggesting that most pineal cysts (> 80%) do not change in size over time 1.
- Home treatments can include warm compresses applied to the area for 10-15 minutes several times daily to reduce inflammation and promote drainage.
- Over-the-counter pain medications such as ibuprofen or acetaminophen can help manage discomfort.
- For infected cysts, a doctor may prescribe oral antibiotics.
- Medical procedures include aspiration, where a needle is used to drain the cyst; injection of corticosteroids to reduce inflammation; or surgical removal (excision) for recurring or problematic cysts, with complete surgical excision offering the lowest recurrence rate but leaving a scar 2.
- Minimally invasive procedures like laser therapy may be options for certain cyst types.
- Patients should seek medical attention if a cyst becomes painful, grows rapidly, recurs after treatment, or shows signs of infection such as redness, warmth, or discharge. The management of cysts should be individualized, taking into account the specific characteristics of the cyst and the patient's overall health, with the goal of minimizing morbidity, mortality, and improving quality of life, as suggested by a study on the management of pineal parenchymal tumors 1.
From the Research
Treatment Options for Cysts
- The treatment for cysts can vary depending on the type and location of the cyst, as well as the severity of symptoms.
- For simple abscesses, incision and drainage is often the recommended treatment, with or without the use of systemic antibiotics 3, 4.
- However, the use of systemic antibiotics in addition to incision and drainage has been shown to not significantly improve the percentage of patients with complete resolution of their abscesses 3.
- For infected urachal cysts, surgical excision is often recommended, with or without preoperative antibiotics 5.
- For preauricular sinus tract infections, fine-needle aspiration or antibiotic treatment may be associated with a lower rate of recurrence compared to incision and drainage 6.
- For breast cysts, the management strategy depends on the sonographic findings, with simple cysts often requiring no further imaging or treatment, while complicated or complex cysts may require further evaluation and sampling 7.
Considerations for Treatment
- The decision to use antibiotics or other treatments should be based on the individual patient's needs and the severity of their symptoms.
- Surgical excision may be necessary for some types of cysts, such as infected urachal cysts or preauricular sinus tract infections.
- Imaging tests, such as ultrasound, may be necessary to diagnose and classify breast cysts, and to guide treatment decisions 7.