Cyst 

A cyst is a fluid or paste filled sac. Sebaceous or epidermoid cysts are cysts arising in sebaceous glands of the skin. They are common everywhere, but particularly where there are more of these glands, as for instance in and around the earlobe. Those arising in the scalp are associated with hair follicles and are called Pilar cysts. Those of the eyelids are called chalazions.

The problem arises in the channel (duct) leading from the gland to the outside which becomes usually blocked by an overgrowth of the lining cells. The gland continues to secrete sebum, which builds up creating a distended cyst. In themselves, they are ugly, but not dangerous. Many however become infected and this in itself is a good reason to remove it. Infection makes it more difficult to remove with more scarring, even if the infection is cured.

Acne cysts are promoted by hormone imbalance and readily become infected causing a rupture. Scarring is a severe consequence.

Pilar cysts of the scalp are often multiple and inherited as a dominant gene. They become more prominent as hair thins. Fortunately, they can be easily removed under local anaesthesia.

It can be tempting to stick a pin in a cyst to squeeze out the contents. This is a bad mistake. If you are lucky it will just reform. Usually, however, it will become infected making surgical removal more difficult with increased scarring.

We advise removal of all cysts surgically under local anaesthesia. Don’t wait until it is infected. It will heal better with less scarring. Sadly the NHS will only treat cysts which have become infected.

Acne cysts are a special case. The treatment, in the first case, is medical, usually with the drug ro-accutane. Larger cysts will need surgery.

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