Effective Strategies for Treating Scars from Long-Term Cysts

How to improve scars left by cysts that have persisted for many years?

Hello, doctor.
I have multiple epidermoid cysts growing on my buttocks, and they become quite inflamed (ranging from 2 to 5 cm) each time.
The scars are red, flat, and indented, and they have persisted for over 8 years.
Each time I visit the doctor, I am prescribed topical retinoids, anti-inflammatory ointments, and oral medications.
During inflammation, I may undergo drainage or injections.
I have previously taken oral retinoids without improvement (one pill daily for 2 months).
The doctor later recommended surgery to remove the cysts to reduce the chance of recurrence.
I found online that epidermoid cysts cannot be completely cured, and they may grow wherever there are hair follicles.
I would like to ask the doctor:
1.
Does having multiple cysts affect the surgery to remove the cysts?
2.
I understand that the improvement of the indented scars is minimal; I just want to address the discoloration.
Would using laser treatments or skincare products be effective?
3.
In the case that epidermoid cysts cannot be cured, does scar removal have no significance?
4.
I am still using the topical ointment prescribed by my doctor; will this conflict with skincare products?
5.
Currently, there is no inflammation at the wound site; should I continue taking the oral medication?
Thank you.

Nìmíng, 20~29 year old female. Ask Date: 2018/02/17

Dr. Wu Yuxin reply Dermatology

1.
Yes.
2.
There are skincare products and ointments that lighten pigmentation.
3.
The earlier scar treatment is initiated, the better the outcome.
4.
Generally, it will not.
5.
Generally, it is not necessary.

Reply Date: 2018/02/17

More Info

When dealing with scars from long-term cysts, particularly sebaceous cysts (commonly referred to as "lipomas" or "pilar cysts"), it's essential to understand both the nature of the cysts and the treatment options available for the associated scarring. Here are some insights based on your questions:
1. Impact of Multiple Cysts on Surgical Removal: The presence of multiple cysts can complicate surgical intervention. If the cysts are numerous and located close together, the surgeon may need to consider the best approach to minimize scarring while ensuring complete removal of the cysts. It is crucial to discuss with your surgeon the potential risks and benefits of surgery, as well as the likelihood of recurrence after removal. While surgery can significantly reduce the chance of new cysts forming, it does not guarantee that new cysts will not develop in the future.

2. Improving Pigmentation and Scarring: For the red, flat, and depressed scars you described, treatments such as laser therapy can be effective in reducing pigmentation and improving the overall appearance of the skin. Laser treatments, such as fractional laser resurfacing or pulsed dye lasers, target the pigment in the skin and can help to even out skin tone. Additionally, topical products containing ingredients like vitamin C, retinoids, or hydroquinone may assist in lightening hyperpigmented areas. However, it is essential to consult with a dermatologist before starting any new treatments to ensure they are appropriate for your skin type and condition.

3. Significance of Scar Treatment When Cysts Cannot Be Cured: While it is true that sebaceous cysts can recur, treating the scars can still be worthwhile. Improving the appearance of scars can enhance your overall confidence and quality of life. Even if the cysts cannot be entirely prevented, managing the scars can provide a more aesthetically pleasing outcome. It is important to have realistic expectations regarding the results of scar treatments, as complete resolution may not be possible.

4. Interaction Between Prescription Ointments and Skincare Products: If you are currently using prescription topical medications, it is crucial to discuss any new skincare products with your healthcare provider. Some over-the-counter products may contain active ingredients that could irritate the skin or interfere with the effectiveness of your prescribed treatments. For example, if you are using topical retinoids, combining them with certain exfoliating agents or acids could lead to increased irritation. Always follow your doctor's advice regarding the use of skincare products alongside prescribed treatments.

5. Continuation of Oral Medications: If your current condition shows no signs of inflammation, it may not be necessary to continue oral medications indefinitely. However, this decision should be made in consultation with your healthcare provider. They can assess your overall health, the status of your cysts, and any potential risks associated with stopping the medication. Regular follow-ups are essential to monitor your condition and adjust treatment as needed.

In summary, while sebaceous cysts can be persistent, there are effective strategies for managing both the cysts and their associated scars. Surgical removal may reduce recurrence, and various treatments can help improve the appearance of scars. Always consult with a qualified dermatologist or surgeon to tailor a treatment plan that addresses your specific needs and concerns.

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