Cysts in the skin are also known as sebaceous cysts or epidermoid cysts. They usually present as swellings underneath the skin and are very common. They can be unsightly and uncomfortable and will frequently grow. They are not cancers and are nothing to worry about but they can cause problems and so it is not uncommon for patients to want to have them removed.
Unusual features include:
- a rapid increase in size - although they may increase in size rapidly when infected
- pain associated with the cyst - benign cysts are painless, although they may be uncomfortable - again, there will be pain if the cyst is infected
- hardness - a benign cyst is smooth and has a firm consistency, if your cyst is hard, has irregular edges or feels craggy, then you should get it checked out.
If you are worried, then you should get your cyst checked by your doctor. Once it is confirmed that your cyst is nothing more sinister, then you can leave it, as long as it does not cause any problems. However, cysts can frequently case problems.
What problems can cysts cause?
Cysts can be unsightly particularly if they are in cosmetically sensitive areas such as the face - the overlying skin is usually normal in colour, but it may have a bluish tinge, particularly if the cyst is tense and close to the surface of the skin. Cysts can also be uncomfortable as they can cause pressure effects on surrounding structures. However, probably the main problem that cysts can cause is infection.
What is the best way to treat an infected cyst?
If a cyst becomes infected, then it grows in size and becomes very painful. Antibiotics can help in this situation, especially if there is redness and tenderness around the cyst, however, antibiotics are not the main treatment. The main treatment of an infected cyst is to drain the infected contents. Often the cyst will burst spontaneously and, although this can be messy, it offers tremendous relief. If the cyst doesn't burst spontaneously, then the treatment is to 'lance' or drain the cyst. This involves making a cut in the cyst to allow the pus and infected material out of the cyst. This can be done under local anaesthetic in the clinic, although local anaesthetic is often less effective in the presence of infection and so the procedure can be uncomfortable, although the instant relief that it affords can be dramatic. If you present to your doctor when your cyst is infected, it will only be possible to have a course of antibiotics and to have the cyst lanced if appropriate.
Why can't I have my cyst removed when it is infected?
It will not be possible to have the cyst removed when it is infected because this would risk spreading the infection further. It is important to let the infection fully settle before coming back to have your cyst removed fully.
What will it look like after my cyst is removed?
There will be a scar from where the cyst was removed. As plastic surgeons, we always aim to minimise scarring and to place scars where they will be hidden. Cysts will very often have a punctum which is a small hole overlying the cyst and is connected with the cyst. The punctum will be removed with the cyst and this means that the scar will need to be placed over the cyst. The scar will be about as long as the diameter of the cyst and will be red and obvious to start with, although it will fade in time. It is important to plan the orientation of the scar as the best scars are placed in line of natural skin creases which blend in, especially on the face. This is why plastic surgeons have a reputation for leaing minimal scarring when performing facial plastic surgery.
If the cyst is very large or has been there for a long time, it may have caused pressure on the surrounding structures, and so when it is removed, it can leave a dent from where it came. This usually settles in time and should not present too much of a problem in the long term.
Will my cyst come back?
It is important that the whole of the cyst wall is removed because if any of the cyst wall is left behind, then the cyst may recur. This is why when an infected cyst has been drained and may appear to have been removed, it will tend to recur. The aim with surgical excision of a cyst is to remove the wall totally and so surgical removal is the most effective way to make sure that your cyst is removed for good. If your cyst has already been removed once and has now recurred, or if your cyst has been infected in the past, then there is likely to be scar tissue around the cyst and this makes it more difficult to confidently remove the cyst wall in total with a greater chance for recurrence in the future.
How do I go about getting my cyst removed?
Cyst removal can be performed on the day of consultation by prior arrangement. The surgery is performed in the state of the art minor operating theatre that is attached to the outpatient suite and you will only be at the hospital for a couple of hours. My clinics on Monday afternoon in Solihull and Wednesday afternoon in Droitwich are set up to have a 'see and treat' service to allow treatment on the day of consultation.
Please call me on 0121-647 3594 or fill in an online enquiry form to make a booking.