How to remove a sebaceous cyst?

Most commonly appearing on the face, back, chest, or even the scalp, sebaceous cysts present themselves as a hard, rounded lump under the skin, which can measure up to 5 cm in diameter. The sebaceous cysts occur due to the rupture of the pilosebaceous follicles, the structures in the dermis where hair originates and where sebum is secreted. The rupture of the pilosebaceous follicles causes an accumulation of sebum and keratin, a fibrous protein of the skin, in the sebaceous duct, which results in its blockage. Initially benign, the sebaceous cysts can become infected if they are handled or pierced. That's why it is often recommended to manage them as soon as they appear.

The removal of a sebaceous cyst necessarily involves a dermatological consultation.

Indeed, although it may seem easier to burst one's own sebaceous cyst, this approach is a misguided solution that increases the risks of infection and scarring. However, when a sebaceous cyst is inflamed or infected, it becomes impossible to remove: one must wait for the cyst to return to a cold phase, that is, non-inflamed, and for the infection to have been contained. The procedure to remove it is then quite straightforward and is performed under local anaesthesia.

The dermatological surgeon begins by outlining the cyst before injecting a local anaesthetic into the skin covering the cyst using a fine needle. An incision is then made at the sebaceous cyst, and it is carefully separated from the underlying fatty tissues. The skin is finally closed using absorbable sutures, which gradually dissolve and do not need to be removed, and a clean, dry dressing is applied to the wound. The removal of a sebaceous cyst is a relatively painless procedure lasting about twenty minutes. The patient can resume their activities immediately afterwards but must ensure to protect their scar in the following weeks to prevent its permanent pigmentation.

In the event of a sebaceous cyst infection, antibiotics are typically prescribed to be taken for five to seven days. Concurrently, if the cyst is in an inflammatory phase, it is recommended to wash it at least once a day and cover it with a clean dressing to be changed after each wash. Dressings help to limit friction that can maintain inflammation and be sources of pain. When an inflammatory episode occurs, it is generally necessary to wait six to eight weeks before removing the sebaceous cyst, so that it can return to a non-inflammatory phase. Indeed, the inflammation of the sebaceous cyst makes local anaesthesia ineffective and prevents its clean dissection as the skin tissues are clumped together.