Sebaceous cyst, what to do?

Un sebaceous cyst does not usually disappear spontaneously and the only definitive solution to remove it iscomplete surgical removalIn the dermatological surgery practice, this procedure is common, simple and quick, performed under local anesthesia. It allows the entire cystic pocket (the "shell") to be removed to prevent any recurrence, while ensuring the best possible aesthetic result.

This article, written by our team of specialist surgeons in Paris, answers the question in detail: Sebaceous cyst, what to do? and explains the diagnostic steps, surgical treatment and post-operative advice.

 

 

Sebaceous cyst: understanding and recognizing the lesion

The term sebaceous cyst is commonly used, although dermatologists and surgeons most often refer to it as epidermoid cyst or trichilemmal cyst (depending on the location and cellular origin). This is a very common benign skin tumor.

What is a Sebaceous Cyst?

Un sebaceous cyst is a small pocket under the skin filled with a pasty, smelly, whitish substance, composed of sebum (the fatty substance produced by the sebaceous glands) and dead skin cells (keratin).

Unlike a pimple or a simple bump, the cyst has a well-defined wall (the shell) which continues to produce this content, which explains its progressive growth.

Where are they located and what are the signs?

The sebaceous cysts can appear anywhere on the body, but are particularly common in areas rich in sebaceous glands:

• Le scalp (where they are often called trichilemmal cysts).
• Le face, especially the forehead, cheek and chin.
• Le of and the thump (back, chest).
• More rarely on the earlobe or genitals.

They usually manifest as:

• A lump under the skin (a nodule) whose size varies from a few millimeters to several centimeters.
• They are most often painless and elastic consistency or firm.
• They are usually movable under the finger, unless they are very deep or infected.
• We sometimes observe a small black dot (punctum) on the surface, corresponding to the obstructed canal which gave rise to the cyst.

What to do in case of a sebaceous cyst?

The first, essential step is to consult a specialist (dermatologist or dermatological surgeon) to confirm the diagnosisAlthough cysts are benign in the vast majority of cases, it is important to rule out any other skin lesions.

Mistakes to absolutely avoid

Facing a sebaceous cyst, it is crucial to avoid: ❌ Attempt to puncture or squeeze the cyst : This can lead to infection, inflammation of the cyst, and rupture of the shell under the skin. Once the shell ruptures, inflammation and pain increase, and the risk of unsightly scarring is increased. ❌ Wait for it to disappear on its own : A sebaceous cyst is a closed structure with an active wall. It will never completely resolve without intervention.

The sebaceous cyst is infected: The “hot” phase

If you sebaceous cyst becomes red, hot, very painful and swollen, he is infected. We are then talking about a abscess.

• Emergency treatment : In the abscess phase, the initial treatment consists of drain the cystThe surgeon will incise the abscess under local anesthesia to drain the pus and cystic material. Local or oral antibiotic treatment may be necessary.
• Beware of recidivism Drainage provides immediate relief, but it does not remove the shell. The cyst is therefore likely to reform.complete excision of the hull will be planned later, once the inflammation has completely resolved (in the “cold” phase).

Standard treatment: Definitive surgical excision

For a permanent solution and the best aesthetic result, thesurgical removal of the sebaceous cyst is the only recommended treatment.

The principle: remove the shell

The goal of surgery is to remove the cyst in its entirety, including the shell (the capsule) that holds it in place. Without this shell, recurrence is almost impossible.

The Intervention in the office

1. Pre-operative consultation : It is essential to confirm the diagnosis, assess the size and location of the sebaceous cyst, and plan the surgical technique to minimize the scar.
2. Local anesthesia : The procedure is performed under local anesthesia, making it completely painless. You can leave immediately after the operation.
3. Excision : The surgeon performs a minimal incision (often a small ellipse) around the cyst. Using microsurgical techniques, he gently detaches the cyst and extracts it in one piece, ensuring complete removal of the shell.
4. Sutures and analysis : The area is then closed with very fine suture threads to obtain the most discreet scar possible. The cyst is systematically sent for anatomopathological analysis to confirm its benign nature.

Post-operative care and healing

The after-effects are generally mild and the pain minimal, managed with simple analgesics.

• Scar care : Daily dressings with antiseptic are necessary for about a week.
• Removing the wires : The stitches are removed in the office 7 to 14 days after the procedure, depending on the location of the sebaceous cyst.
• Activities : Resumption of normal activities is quick, but it is advisable to avoid intense physical exertion, swimming pools and saunas during the initial healing period (approximately 3 weeks).

Our surgeons will provide you with specific advice for the scar management long term (massages, creams, sun protection) in order to optimize the aesthetic result.

Conclusion: why choose dermatological surgery

For sebaceous cyst, recourse to dermatological surgery is a guarantee ofefficiency and securityBy choosing a specialist, you benefit not only from an accurate diagnosis, but above all from the most suitable surgical technique for:

• Avoid recurrence by removing the entire shell.
• Getting the most discreet scar possible.
• Rule out the risk of malignancy thanks to the systematic analysis of the surgical specimen.

If you are faced with a sebaceous cyst, do not hesitate to contact our dermatological surgery center in Paris for consultation and expert support.