From the Guidelines
Sebaceous cysts should be treated with incision, thorough evacuation of the pus, and probing the cavity to break up loculations, as this is the most effective treatment for inflamed epidermoid cysts, which are often mistakenly referred to as sebaceous cysts. According to the practice guidelines for the diagnosis and management of skin and soft-tissue infections 1, this approach is recommended for the treatment of cutaneous abscesses and inflamed epidermoid cysts. The treatment involves:
- Incision to drain the pus
- Thorough evacuation of the pus
- Probing the cavity to break up loculations This approach is usually sufficient, and 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. It's also important to note that simply covering the surgical site with a dry dressing is usually the easiest and most effective treatment of the wound.
In terms of prevention of recurrence, complete surgical excision of the cyst sac may be necessary, as incision and drainage may only provide temporary relief. However, the study by 1 does not specifically address the prevention of recurrence, but it does emphasize the importance of proper treatment of inflamed epidermoid cysts to prevent further complications.
It's worth noting that sebaceous cysts are often mistakenly referred to as epidermoid cysts, and the treatment approach may vary depending on the specific diagnosis. However, based on the available evidence from 1, the recommended treatment approach for inflamed epidermoid cysts, which are often mistakenly referred to as sebaceous cysts, is incision, thorough evacuation of the pus, and probing the cavity to break up loculations.
In general, it's recommended to avoid attempting to squeeze or pop a sebaceous cyst at home, as this can lead to infection, scarring, and does not remove the cyst wall, making recurrence likely. Instead, it's best to consult a healthcare provider for proper diagnosis and treatment.
From the Research
Treatment Options for Sebaceous Cysts
The treatment for sebaceous cysts can vary depending on the size, location, and whether the cyst is infected. Some common treatment options include:
- Surgical excision: This is a traditional method where the cyst is completely removed, but it can be complicated and may cause scarring 2, 3, 4.
- CO2 laser punch-assisted minimally invasive surgery: This method involves removing the cyst contents and wall through a small hole created by a CO2 laser, resulting in minimal scarring and high patient satisfaction 2.
- Incision and drainage: This is often used for infected sebaceous cysts, where the infected tissue is removed and the area is drained 3, 5.
- Suture closure: A new approach where the infected tissue is excised and the area is closed with stitches, resulting in quick recovery and minimal need for dressing 5.
Considerations for Treatment
When deciding on a treatment option, factors such as the size and location of the cyst, as well as the patient's overall health and preferences, should be taken into account. For example:
- For multiple sebaceous cysts on the scrotum, removal of all cysts may be necessary due to the unusual presentation and potential for infection 6.
- For inflamed sebaceous cysts, one-stage excision may be preferable to conventional treatment, as it can reduce morbidity and antibiotic exposure 3.
- For patients who want to minimize scarring, CO2 laser punch-assisted surgery or minimal-incision techniques may be a suitable option 2, 4.