“Epidermoid or “sebaceous” cysts are lumps or nodules under the skin that are typically filled with keratin derived from the squamous cells lining the wall of the cyst. Most cysts have an overlying pore or blackhead. Most cysts remain small and stable for years until pressure or some type of trauma causes rupture of the cyst wall with spillage of the keratin contents into the surrounding skin. This leads to a profound inflammatory response; and many people mistake the redness, swelling, tenderness and “pointing” or drainage through the surface as an infection. At this point, most are treated with simple I&D (incision and draining), steroid injections, and/or antibiotics.
Even after this, if not adequately treated, the cyst can recur and rupture again. In this case, or in most other cases with noninflamed cysts, excision by our highly trained Dermatologic surgeons is highly effective in eradicating the cyst with better cosmetic and long-term results.