Doctors for Sebaceous Cyst Removal

A sebaceous cyst is a skin-colored lump that grows under the skin when the sebaceous glands are damaged or obstructed due to an ingrown hair. It is filled with yellow or white-colored fluid (sebum), which is produced by the sebaceous glands. Typically, they can appear anywhere on the body where sebaceous glands are present, but they are commonly found on the head, neck, trunk, and back of the ears.

Sebaceous glands are present in the hair follicles, and they secret sebum that protects the skin from dryness by forming a protective layer. When these glands suffer damage, the sebum produced gets trapped under the skin, which leads to the formation of these fluid-filled lumps. They are dome-shaped, painless, move freely when touched, grow slowly, and often have a central punctum.

In some cases, these cysts remain the same without causing any pain or discomfort, whereas, in other cases, the cyst may grow bigger and may also get infected.

Sebaceous cysts are very common, and anyone can get them. If you find out that you have a sebaceous cyst, you should get it checked right away and consult an expert.

To accurately diagnose a sebaceous cyst, the doctor usually gathers a detailed medical history of the patient and asks about their symptoms. Then, the cyst is physically examined, and the doctor will evaluate its size, appearance, location, and texture. To confirm the diagnosis, the following tests may also be recommended:

• A complete blood test is done to check if the cyst is infected.
• An ultrasound test is done to evaluate the cyst’s content.
• A CT Scan is done to check if the cyst has different characteristics than a regular sebaceous cyst and also helps to determine the right approach for cyst removal.
• A punch biopsy is done to take a small sample of the tissue from the cyst. The sample is examined in a lab for signs of cancer.

Though sebaceous cysts are generally not cancerous, it is important to rule out the possibility of malignancy. The above tests will confirm the diagnosis and also help to determine the most suitable treatment approach for sebaceous cysts.

In the early stages, sebaceous cysts are often left untreated if it doesn’t cause any discomfort, pain, or other symptoms. However, some people may have cosmetic concerns due to the appearance of the cyst and may choose to get it removed. Regardless of the reason for removal, the following treatment options may be considered for sebaceous cysts:

• Steroid Injections: This is the first line of treatment for sebaceous cysts, which involves injecting cortisone or corticosteroid to reduce inflammation in the cyst and reduce its size.
• Drainage: If the sebaceous cyst is infected, the doctor may recommend draining the cyst content using a syringe.
• Surgical Removal: Surgery is only recommended when the cyst becomes large enough to cause significant physical and cosmetic concerns. There are various surgical techniques available that can be used to remove the cyst, along with its cyst wall. The most appropriate surgical method for sebaceous cyst removal is chosen based on the severity of the condition and the patient’s preferences.

The most suitable option for sebaceous cyst removal is chosen after evaluating the cyst and discussing the options with the patient.

The doctor usually recommends surgery only if drainage doesn’t provide the expected results and the cyst recurs. The various surgical methods that can be used are listed below:

• Conventional Wide Excision: This is a slightly invasive method of sebaceous cyst removal compared to other techniques. It involves making a wide incision above or on the side of the cyst to drain the cyst and remove the cyst wall in its entirety.
• Minimal Excision: In this method of removal, a tiny incision is made to access the cyst. It minimizes the scarring and allows the surgeon to remove the cyst precisely.
• Punch Excision: This method involves using a circular punch device that removes the skin overlying the cyst along with its content and wall. It is preferred for smaller cysts.
• Laser-aided Excision: It involves using a laser probe to make a hole instead of an incision around the cyst to drain its contents.

You should understand that a sebaceous cyst is not treated when it is infected or inflamed. The doctor will address the infection first and then carry out the removal procedure later.

On the day of surgery, you will have to sign a consent form to proceed with the treatment. Once the OR (operating room) is prepared, you will be taken to the OR, and the removal procedure will be carried out in the following steps:

• The doctor will administer local anesthesia to numb the area to be treated. Generally, local anesthesia with sedation is used, but in some cases, general anesthesia may be considered to put the patient to sleep.
• Once the anesthesia takes effect, the surgeon will make an incision over or across the cyst. The size and placement of the incision are determined based on the method chosen for cyst removal.
• If laser-aided excision is done, the laser will be used to create a small hole in the cyst punctum to drain its content and then remove its lining.
• If a conventional wide excision is done, a long incision is made on the top of the cyst for proper access and removal.
• If minimal excision is done, a smaller incision is made right above the cyst to access it. This approach reduces scarring and damage to the surrounding tissues.
• If punch excision is done, a special device in the shape of a cookie-cutter or circular punch is used to take out the cyst entirely along with the top layer of the skin.

The surgeon then carefully extracts the cyst content and its lining/wall to prevent the recurrence of the cyst. If the cyst is severely infected, the doctor will only drain the content and treat the infection. The cyst wall or lining will be removed later.

After the removal, the incision will closed using sutures, adhesive tape, or glue. Then, it is covered with dressing or bandages.

You will be transferred to an observation room, where your vitals will be monitored until the effects of anesthesia wear off. After that, you will be transferred to the recovery room.

The procedure typically takes around 30 to 45 minutes and is performed on an outpatient basis. It means that after the procedure, you can go home on the same day. Before discharge, you will also be given a recovery guide, diet tips, and a follow-up schedule.

Getting proper treatment for sebaceous cysts is always beneficial. Leaving it untreated for a long time increases the chances of developing severe infections, which may affect your quality of life. The key benefits include the following:

• Symptom Relief: Sebaceous cysts that cause pain, tenderness, or discomfort can be effectively treated through surgery. By getting the cyst removed, you will experience relief from symptoms and will be able to engage in daily activities without hindrance.
• Aesthetic Improvement: Sebaceous cysts can cause cosmetic concerns, particularly when they develop on noticeable parts of the body, such as the face, neck, and backside of the ears. Surgical removal helps restore a smoother and more aesthetically pleasing appearance, enhancing self-confidence and self-image.
• Prevention of Complications: While sebaceous cysts are generally benign, they can become inflamed, infected, or lead to hair loss in some cases. By surgically removing the cyst, potential complications can be minimized or avoided altogether, promoting overall skin health.
• Reduced Recurrence: Complete removal of the cyst during surgery significantly reduces the chances of recurrence. By addressing the underlying cyst and its associated sac, the likelihood of future cyst formation in the same area is minimized.

You will receive several instructions from your doctor and his/her team to prepare for sebaceous cyst removal, which include the following:

• Do not try to pop the cyst at home, as it can cause inflammation and infection.
• Do not trim the hair around the cyst before the surgery.
• On the day/night of surgery, take a bath with antibacterial soap to lower your risk of infection.
• Depending on the technique used, a specific type of anesthesia may be used (either general or local anesthesia with sedation). Based on the type, you might have to practice fasting for several hours before the procedure.
• Avoid smoking 2-3 weeks before the surgery, or quit entirely to improve the body’s healing abilities.
• Don’t drink alcohol 2-3 days before the procedure, as it can increase the risk of dehydration.
• Wear loose clothes to the clinic/hospital and avoid using skin care products, makeup, or wearing any accessories.
• Ask a friend or family member to accompany you on the day of surgery to take you home safely and also help at home doing regular chores for the first few days.

By following these preparation tips, you will be able to improve your overall health and reduce the risk of complications during or after the surgery.

During or after sebaceous cyst surgery, the following risks and complications can occur:

• Anesthesia Reactions: In rare cases, patients may experience anesthesia reactions, such as malignant hyperthermia.
• Surgical Injury: There is a slight risk of injury during the surgical procedure, which may include damage to surrounding tissues or structures.
• Numbness or Tingling Sensation: Temporary numbness or a tingling sensation in the operated area may occur due to nerve irritation during surgery.
• Infection: While efforts are made to maintain a sterile surgical environment, there is a potential risk of infection following sebaceous cyst surgery.
• Swelling and Bruising: Following surgery, it's typical to suffer bruising and swelling near the surgical site. This is a natural response of the body and usually resolves gradually within a few days or weeks.
• Scarring: Sebaceous cyst surgery may result in some degree of scarring. However, skilled surgeons employ techniques to minimize scarring and optimize cosmetic outcomes. Scars typically lighten and disappear over time.
• Delayed Healing: In some cases, the surgical site may take longer to heal completely. Factors such as the size and location of the cyst, individual healing abilities, and underlying medical conditions can contribute to delayed healing.
• Cyst Recurrence: While complete cyst removal aims to prevent recurrence, there is a small possibility of cyst recurrence. This can happen if a portion of the cyst wall or its contents is inadvertently left behind during surgery.

Generally, the doctor provides instructions and takes several measures to reduce the chance of developing these complications. You will also have to be very careful during the recovery period and follow all post-op care instructions for an optimal recovery and successful outcome.

The complete recovery after sebaceous cyst removal may take around 2 to 4 weeks. The exact duration varies for each patient, depending on the method used and the individual’s healing abilities.

Initially, after the surgery, you will feel slight discomfort and have swelling, bruising, and redness in the treated area. The doctor will advise you to take proper rest after going home and avoid all activities that can strain the treated area. You will be given detailed post-op instructions to help you recover quickly and smoothly. Some common instructions include the following:

• Use ice packs multiple times a day in the first few days to reduce swelling and bruising around the incision site.
• Keep the treated area clean and dry, and change dressings as instructed by the doctor.
• Do not drive or perform any activity that requires constant focus as long as you are taking pain medications.
• Take the prescribed medications, including painkillers, antibiotics, anti-inflammatory medicines, etc., as directed by the doctor.
• Avoid strenuous activities, including running, jogging, and other exercises, as they can cause strain and may tear up the stitches.
• Eat a healthy diet and drink plenty of water to improve the body’s healing abilities and keep it hydrated.
• Avoid smoking and drinking alcohol during the recovery period, as they can impair healing.
• Don’t take a shower, go swimming, or use hot tubs until the incision heals and the doctor approves.

As the incision heals, you will start to feel better, the surgery's side effects will start to dissipate, and you will be able to resume most activities. Most patients feel comfortable resuming work and other activities after the first week. But the complete recovery will take longer, and you need to be careful throughout this period.

*Note: The recovery period is very critical in determining the success of the removal procedure. Therefore, it is crucial that you follow all instructions given by the doctor and take regular follow-ups to monitor your recovery.

The cost of sebaceous cyst removal ranges from Rs. 30,000 to Rs. 50,000. It is only an estimate, and the actual cost range may vary for each patient depending on the following factors:

• The number, size, and location of the cyst (severity)
• Diagnostic tests and evaluations
• The technique used for cyst removal
• Surgeon’s and anesthetist’s fee
• The choice of hospital/clinic and related expenses
• Post-op care and follow-ups

The overall cost of the removal procedure is determined based on the above-listed factors. If your condition is severe, the removal may cost more than the range given above. To get a specific estimate, it’ll be best to get in touch with an expert.

If the sebaceous cyst is symptomatic and causing medical concerns, you can get it covered by health insurance and pay the entire expense. However, if you choose to get the cyst removed solely due to cosmetic concerns, the insurance company won’t provide approval to get a claim.

To get the treatment procedure covered by health insurance, you will have to provide clinical evidence signed by a certified doctor supporting the medical necessity of the procedure. Besides this, there may be some other terms and conditions of the policy, such as co-pays, deductibles, waiting periods, or other clauses. Therefore, it’ll be best to talk to the insurance provider and understand the terms and conditions of the policy in detail.