In contrast, a cutaneous cyst (such as an epidermoid or pilar cyst) is a pocket-like sac beneath the skin lined with cells. This sac slowly fills with keratin, a protein that has a thick, cheese-like consistency. Because the cyst is contained within a physical sac, simply squeezing it will not cure it. If the sac wall remains under the skin, the cyst will eventually refill with keratin and return. ## How Dermatologists Safely Drain and Remove Cysts Dermatologists use two primary surgical methods to treat cysts: incision and drainage, and complete surgical excision. The choice of procedure depends on whether the cyst is currently inflamed, infected, or quiet.
### 1. Incision and Drainage (I&D) This method is typically used when a cyst is actively inflamed, painful, or infected. * **Preparation:** The dermatologist cleans the skin with an antiseptic solution and injects a local anesthetic to numb the area. * **The Incision:** Using a sterile scalpel or a punch tool, the doctor makes a small cut in the surface of the skin directly over the cyst. * **Expression:** The dermatologist gently expresses the keratin and pus from the cyst cavity. * **Rinsing and Packing:** The empty cavity is flushed with sterile saline. If the cyst is large or deeply infected, the doctor may pack it with sterile gauze ribbon to keep it open, allowing it to continue draining safely over the next few days. While incision and drainage provides immediate pain relief, it often leaves the cyst wall behind, meaning the cyst may recur in the future. ### 2. Complete Surgical Excision Excision is the definitive treatment for cysts that are not actively inflamed. This procedure aims to remove the entire cyst, including the surrounding sac, to ensure it does not grow back.
* **Anesthesia:** The area is numbed with a local anesthetic. * **Excision:** The dermatologist makes an incision and carefully dissects the entire intact cyst wall away from the surrounding tissue. * **Closure:** Once the sac is successfully removed, the dermatologist closes the wound with sutures (stitches). * **Evaluation:** The removed tissue is often sent to a laboratory for evaluation to confirm the diagnosis. ## Why You Should Avoid Popping Cysts at Home Attempting to pop a cyst at home carries significant risks: * **Infection:** Squeezing introduces bacteria from your hands and fingernails into the open wound, which can lead to a painful bacterial infection. * **Increased Inflammation:** Pressing on a cyst can rupture the sac beneath the skin, causing the keratin to spill into the surrounding tissue. This triggers a severe inflammatory response, making the area red, swollen, and painful. * **Scarring:** Home extraction attempts damage the surrounding skin tissue, often resulting in permanent, dark, or pitted scars. * **Recurrence:** Without removing the cyst wall, the cyst will almost certainly return.
## What to Expect During Recovery After a professional cyst removal, proper wound care is essential to ensure optimal healing and minimize scarring. * **Keep the Area Clean:** Wash the wound gently with mild soap and water as directed by your dermatologist. * **Apply Ointment:** A thin layer of petroleum jelly or prescribed ointment helps keep the wound moist, which speeds up healing. * **Cover the Wound:** Keep the area covered with a sterile bandage to protect it from dirt and bacteria. * **Avoid Picking:** Allow any scabs that form to fall off naturally. If the dermatologist used sutures, you will need to return to the office in 5 to 14 days to have them removed, depending on the location of the cyst.
## When to See a Dermatologist You should schedule an appointment with a dermatologist if you notice a lump under your skin that is growing, becomes painful, turns red, or feels warm to the touch. A professional evaluation ensures an accurate diagnosis, as some skin lumps may require different treatments.
