From the Guidelines
Treatment for a sebaceous cyst, more accurately referred to as an epidermoid cyst, typically involves incision, thorough evacuation of the contents, 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.
Key Considerations
- The primary goal is to remove the cyst's contents and prevent further inflammation or infection.
- Simply covering the surgical site with a dry dressing is usually the easiest and most effective treatment of the wound.
- Gram stain, culture, and systemic antibiotics are rarely necessary unless there are unusual exceptions such as multiple lesions, cutaneous gangrene, severely impaired host defenses, extensive surrounding cellulitis, or severe systemic manifestations of infection.
Treatment Approach
- For inflamed or infected cysts, incision and drainage may be necessary to relieve pain and pressure.
- Warm compresses can help reduce inflammation and promote drainage.
- It's crucial not to squeeze or attempt to drain cysts at home to avoid infection and scarring.
Important Notes
- Epidermoid cysts, often mislabeled as sebaceous cysts, contain skin flora in the cheesy keratinous material, and cultures of inflamed cysts yield the same organisms, suggesting that inflammation occurs as a reaction to rupture of the cyst wall rather than as an infectious complication 1.
- Complete surgical excision is the definitive treatment for symptomatic or bothersome cysts, involving removing the entire cyst wall to prevent recurrence.
From the Research
Treatment Options for Sebaceous Cysts
- Surgical excision is a common treatment method for sebaceous cysts, with studies showing that one-stage excision can be preferable to conventional methods 2
- Incision and drainage, followed by elective surgical excision, is another approach, although it may require longer antibiotic exposure and have higher morbidity 2
- A new approach involves excising the infected tissue along with a rim of healthy tissue and closing the wound with sutures, which can lead to quick recovery and reduced need for frequent dressing 3
- Minimal surgery techniques have also been described, with low recurrence rates and good cosmetic results 4
Considerations for Treatment
- The selection of treatment method depends on the individual case, with factors such as the size and location of the cyst, as well as the presence of inflammation or infection, influencing the decision 2, 3
- In some cases, sebaceous cysts can be mistaken for other conditions, such as angiosarcoma, highlighting the importance of proper diagnosis and management 5
- Excision of the cyst and histopathological examination can confirm the diagnosis and rule out malignant changes 6