What to Do If Your Cyst Wound Turns Black: Expert Advice

What should I do if a sebaceous cyst wound turns black?

Hello: I originally had one sebaceous cyst (during my college years), but over the past two years, it seems to have developed into two cysts.
I consulted a doctor, and the clinic physician mentioned that the two cysts appear to be connected.
I once fell on the stairs and injured the area where the cysts are located.
Since that fall, the wound has frequently become inflamed.
The wound is now healing, but the appearance has turned black.
What can I do to make the black discoloration disappear? Could this be related to the corticosteroid injections administered by the clinic doctor? If the cysts are surgically removed, will the wound be depressed? (This is concerning because the clinic doctor previously injected corticosteroids into the cyst area.)

Miss Wang, 20~29 year old female. Ask Date: 2022/12/02

Dr. Wu Yuxin reply Dermatology

The dark coloration is not related to steroid use, but rather due to post-inflammatory hyperpigmentation resulting from repeated inflammation, which typically resolves over time.
After the cyst removal surgery, there may be a localized indentation, but over time, most of these areas will flatten out.

Reply Date: 2022/12/02

More Info

When dealing with a cyst wound that has turned black, it is essential to understand the underlying causes and appropriate management strategies. The black discoloration of a wound can be concerning, as it may indicate necrosis (tissue death), bruising, or even an infection. In your case, where the cysts have been inflamed and the wound has changed color after an injury, it is crucial to approach the situation with care.

First and foremost, it is advisable to consult a healthcare professional, preferably a dermatologist or a surgeon, who can assess the wound's condition accurately. They can determine whether the black area is due to dead tissue, blood pooling, or another issue. If the blackened area is necrotic tissue, it may need to be debrided (surgically removed) to promote healing and prevent infection.

In terms of management, here are some steps you can take:
1. Keep the Wound Clean: Gently clean the area with mild soap and water. Avoid using harsh chemicals or scrubbing the wound, as this can further irritate the skin.

2. Avoid Picking at the Wound: It can be tempting to try to remove the blackened area, but this can lead to further injury or infection. Allow the wound to heal naturally.

3. Moisture Management: Keeping the wound moist can promote healing. Consider using a non-adherent dressing or a hydrogel to maintain moisture without sticking to the wound.

4. Monitor for Signs of Infection: Watch for increased redness, swelling, warmth, or discharge from the wound. If you notice any of these signs, seek medical attention promptly.

5. Follow-Up Care: If the wound does not improve or if you have concerns about the appearance of the skin, follow up with your healthcare provider. They may recommend treatments such as topical antibiotics or corticosteroids, especially if inflammation persists.

Regarding your concern about the potential effects of corticosteroid injections on the cysts, it is possible that these injections can alter the skin's appearance, leading to changes in pigmentation. However, the exact impact can vary based on individual skin types and the specifics of the treatment.

As for the question of whether the wound will leave a depression after surgical removal of the cyst, this depends on several factors, including the size of the cyst, the surgical technique used, and your skin's healing response. In some cases, cyst removal can result in a slight indentation, but skilled surgeons often employ techniques to minimize this effect.

In conclusion, while the black discoloration of your cyst wound may be concerning, it is essential to approach the situation with caution and seek professional medical advice. Proper wound care, monitoring for infection, and following up with your healthcare provider will be crucial in ensuring optimal healing and addressing any cosmetic concerns you may have.

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