What is the treatment for a suspected sebaceous cyst in the left axilla, confirmed by ultrasound, in a 21-year-old female?

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From the Guidelines

For a suspected sebaceous cyst in the left axilla confirmed by ultrasound in a 21-year-old female, the recommended treatment is incision and drainage, as this approach is effective for inflamed epidermoid cysts, which are often mistakenly labeled as sebaceous cysts. According to the guidelines for the diagnosis and management of skin and soft-tissue infections 1, effective treatment of inflamed epidermoid cysts entails incision, thorough evacuation of the pus, and probing the cavity to break up loculations.

Key Considerations

  • The treatment approach should prioritize minimizing the risk of infection and promoting healing, as outlined in the guidelines 1.
  • Simply covering the surgical site with a dry dressing is usually the easiest and most effective treatment of the wound, although some clinicians pack it with gauze or suture it closed 1.
  • Gram stain, culture, and systemic antibiotics are rarely necessary, unless there are unusual exceptions such as the presence of multiple lesions, cutaneous gangrene, severely impaired host defenses, extensive surrounding cellulitis, or severe systemic manifestations of infection 1.

Treatment Approach

  • Incision and drainage should be performed under local anesthesia, such as 1-2% lidocaine with epinephrine, to minimize discomfort and promote effective drainage.
  • Warm compresses applied to the area for 15 minutes 3-4 times daily can help reduce inflammation before surgical intervention.
  • Following incision and drainage, the patient should be instructed to keep the wound clean and dry, and watch for signs of infection such as increasing pain, redness, swelling, or discharge.

From the Research

Treatment Options for Sebaceous Cyst

  • The treatment for a suspected sebaceous cyst in the left axilla, confirmed by ultrasound, in a 21-year-old female may involve various methods, including:
    • Incision and drainage, followed by excision of the cyst wall 2
    • Removal of the cyst content with a laser punch, followed by minimal postponed excision of the cyst wall 3
    • Incisional technique to reduce the size of the cyst, with possible excision of the remaining cyst later 4
    • Minimal surgery with low recurrence rate 5
    • One-stage excision of the inflamed sebaceous cyst, which may decrease antibiotic exposure, reduce morbidity, and be more economical 6

Considerations for Treatment

  • The choice of treatment may depend on the size and location of the cyst, as well as the presence of inflammation or infection 3, 6
  • The patient's overall health and medical history should also be taken into account when selecting a treatment option
  • It is essential to consult a healthcare professional to determine the best course of treatment for the individual case 2, 3, 4, 5, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Treating a sebaceous cyst: an incisional technique.

Aesthetic plastic surgery, 2001

Research

Sebaceous cyst excision with minimal surgery.

American family physician, 1990

Research

One-stage excision of inflamed sebaceous cyst versus the conventional method.

South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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