Dealing with a 2.5 cm Epidermoid Cyst on the Face: What to Do?

2 cm sebaceous cyst

There is a raised area about 2.5 cm on my right cheek.
The doctor diagnosed it as a sebaceous cyst, which has been inflamed in the past and has discharged a milky pus.
Currently, there is no inflammation.
I visited a plastic surgery department at a major hospital to discuss removal, but the doctor said, "This looks like it will leave a scar.
Right now, there is nothing inside to remove; we should wait for inflammation to manage it." However, I still feel like there is something present on my right cheek, and my right eye feels pressured.
What should I do?

Xi Xi, 20~29 year old female. Ask Date: 2016/04/02

Dr. Wu Yuxin reply Dermatology

Without actually seeing the lesion, it cannot be confirmed.
If it is very bothersome, it is recommended to seek medical attention.

Reply Date: 2016/04/02

More Info

Dealing with a 2.5 cm epidermoid cyst on the face can be a challenging situation, especially when it causes discomfort or aesthetic concerns. An epidermoid cyst, often referred to as a sebaceous cyst, is a benign growth that can occur when skin cells multiply and form a sac filled with keratin. These cysts can become inflamed or infected, leading to the discharge of pus, as you have experienced.

Given your situation, where the cyst has previously been inflamed and has caused symptoms such as a feeling of pressure on your right eye, it is understandable that you are seeking a resolution. The advice from the plastic surgeon you consulted, suggesting to wait for inflammation before proceeding with removal, is not uncommon. However, it is crucial to consider a few factors before making a decision.

1. Symptoms and Discomfort: If you are experiencing persistent discomfort, pressure, or any other symptoms that affect your quality of life, it is reasonable to seek further evaluation. The sensation of pressure on your eye could indicate that the cyst is affecting surrounding tissues, and this warrants further investigation.

2. Surgical Options: While the surgeon mentioned the potential for scarring, it is essential to weigh the benefits of removal against the risks. If the cyst is causing significant discomfort or aesthetic concerns, surgical excision may be the best option. A skilled surgeon can minimize scarring through careful technique, and in many cases, cysts can be removed without significant cosmetic impact.

3. Second Opinion: If you feel uncertain about the advice given, seeking a second opinion from another qualified dermatologist or plastic surgeon can provide you with more options and perspectives. They may offer different insights into the management of the cyst and whether immediate removal is advisable.

4. Monitoring: If you choose to wait, it is essential to monitor the cyst for any changes. If it becomes red, swollen, or painful again, or if you notice any changes in size or texture, you should seek medical attention promptly.

5. Follow-Up Care: Regardless of whether you choose to wait or proceed with removal, follow-up care is crucial. If the cyst is removed, your healthcare provider will give you instructions on how to care for the wound to promote healing and minimize scarring.

6. Understanding Risks: Every surgical procedure carries risks, including infection, scarring, and recurrence of the cyst. Discuss these risks with your surgeon to make an informed decision.

In conclusion, if the cyst is causing you significant discomfort or concern, it may be worth pursuing removal, even if it means accepting the possibility of scarring. If you are hesitant about the current recommendation, do not hesitate to seek a second opinion. Your comfort and peace of mind are paramount, and there are options available to address your concerns effectively. Always prioritize open communication with your healthcare provider to ensure that you receive the best possible care tailored to your needs.

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