What causes an epidermoid cyst?
Epidermoid cysts develop when epidermal cells proliferate within the dermis and produce keratin that accumulates inside a cyst wall. They may sometimes develop after injury or trauma to the skin, although many occur without an obvious cause.
A typical cyst appears as a round, smooth lump beneath the skin. Some have a small central opening or punctum.
What are the symptoms of an epidermoid cyst?
Small cysts may remain asymptomatic for years. Others can gradually increase in size.
If the cyst becomes inflamed or infected, it may become red, swollen, painful and tender. It may also discharge thick, whitish, foul-smelling material.
Importantly, inflammation does not always mean that the cyst is infected. A ruptured cyst can produce a significant inflammatory reaction even without bacterial infection.
How is an epidermoid cyst removed?
The definitive treatment for a troublesome or recurrent epidermoid cyst is usually complete removal of the cyst wall.
Depending on the size, location and clinical situation, a dermatologist may perform:
Complete surgical excision: The cyst and its surrounding wall are carefully removed through an incision. Removing the entire cyst wall reduces the chance of recurrence.
Minimal-incision or punch excision: For selected smaller cysts, a smaller opening may be used to remove the cyst and its wall. The suitability of this technique depends on the individual cyst.
If the cyst is acutely inflamed, immediate complete excision may be more difficult. In such cases, the dermatologist may first control the inflammation and plan definitive removal later.
Should you squeeze an epidermoid cyst?
It is best not to squeeze or repeatedly puncture the cyst yourself. This can cause rupture, inflammation, infection and scarring while leaving the cyst wall behind, allowing it to recur.
If you have a persistent lump, painful swelling or a recurrent cyst, a dermatologist can confirm the diagnosis and discuss the most appropriate method of removal.
At DermcareMD Skin & Hair Clinic, Kothrud, Pune Dr Neha Athalye provides dermatological evaluation and surgical procedures for suitable benign skin lesions, including epidermoid cyst excision.
