From the Guidelines
Surgical excision is the most effective treatment for inguinal sebaceous cysts, as it prevents recurrence by removing the entire cyst wall. Inguinal sebaceous cysts are typically treated through several approaches depending on their size and symptoms. For small, non-inflamed cysts, warm compresses applied to the area for 10-15 minutes several times daily can help reduce discomfort and may promote drainage. If the cyst becomes infected, a doctor may prescribe oral antibiotics such as cephalexin (500mg four times daily for 7-10 days) or clindamycin (300mg three times daily for 7-10 days) 1. However, according to the most recent and highest quality study, incision, thorough evacuation of the pus, and probing the cavity to break up loculations is the effective treatment for inflamed epidermoid cysts, which are often erroneously labeled as sebaceous cysts 1.
Some key points to consider when treating inguinal sebaceous cysts include:
- Complete removal of the cyst wall to prevent recurrence
- Use of local anesthesia, such as 1-2% lidocaine, for surgical excision
- Minimally invasive techniques, like punch biopsy excision, may be used for smaller cysts
- Patients should seek medical attention if cysts become painful, rapidly enlarge, rupture, or show signs of infection, such as redness, warmth, or discharge. The 2005 study 1 provides the most recent and highest quality evidence for the treatment of inguinal sebaceous cysts, and its recommendations should be prioritized over older studies, such as the 1993 study 1.
From the Research
Treatment Options for Inguinal Sebaceous Cysts
- Surgical excision is a common treatment method for sebaceous cysts, which can be performed through various techniques, including traditional surgical excision, CO2 laser punch-assisted minimally invasive surgery, and minimal postponed excision 2, 3.
- CO2 laser punch-assisted surgery has been shown to be a convenient, effective, and minimally-invasive treatment option for sebaceous cysts, with minimal scarring and high patient satisfaction 2.
- A new procedure involving removal of the cyst content with a laser punch and the cyst wall with a minimal postponed excision has been proposed as a good alternative for eradication of uninfected cysts, especially large cysts or cysts located in areas of thick skin or cosmetic concern 3.
- In some cases, an intraoral approach can be used to excise sebaceous cysts located in the lip or cheek near lip commissure, avoiding a visible scar on the skin 4.
- For infected sebaceous cysts, a new approach involving suture closure after excision of the infected tissue has been shown to be effective, with quick recovery and no need for frequent dressing 5.
- A minimal-incision technique has also been described, which involves minimal surgical trauma and good cosmetic results, with a low recurrence rate of 0.66 percent during 18 months of follow-up 6.