Subcutaneous Cysts: Causes, Treatment, and Recurrence Risks - Surgery

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Subcutaneous cysts, particularly the type known as epidermoid or pilar cysts, are common benign growths that can occur anywhere on the body, including areas like the earlobe and the junction of the cheek. These cysts are typically filled with keratin, a protein found in skin, hair, and nails, and they arise from hair follicles or skin cells. The term "潛毛性囊腫" (pilar cyst) you mentioned is indeed a type of subcutaneous cyst, often associated with hair follicles.


Causes of Subcutaneous Cysts
The exact cause of these cysts can vary, but they often develop due to:
1. Blocked Hair Follicles: When hair follicles become clogged with dead skin cells and oils, cysts can form.

2. Genetic Factors: Some individuals may be genetically predisposed to developing these cysts.

3. Trauma: Injury to the skin can sometimes lead to cyst formation.


Symptoms
Subcutaneous cysts are usually painless and may appear as small, round lumps under the skin. They can sometimes become inflamed or infected, leading to redness, swelling, and discomfort. In your case, the cyst has recurred multiple times, which can happen if the cyst is not completely excised or if the underlying cause is not addressed.


Treatment Options
Treatment for subcutaneous cysts typically includes:
1. Observation: If the cyst is not causing any symptoms, it may simply be monitored.

2. Drainage: If the cyst becomes infected or painful, a healthcare provider may drain it to relieve symptoms.

3. Surgical Removal: This is the most definitive treatment. However, as your doctor mentioned, surgical excision may not always be feasible depending on the cyst's location, size, and proximity to nerves or blood vessels.


Recurrence Risks
The recurrence of cysts can be frustrating. Factors contributing to high recurrence rates include:
- Incomplete Removal: If the cyst wall is not fully excised during drainage or surgical removal, it can regrow.

- Location: Certain areas of the body may be more prone to cyst formation due to skin characteristics or hair follicle density.


Why Surgery May Not Be Possible
In some cases, surgical removal may not be advisable due to:
- Anatomical Considerations: The cyst's location may be near critical structures such as nerves or blood vessels, making surgery risky.

- Size and Depth: If the cyst is deeply embedded or large, the surgical approach may be complicated.

- Potential for Scarring: In cosmetic areas, the risk of scarring may deter surgical intervention.


Can the Cyst Be Completely Eradicated?
While many cysts can be completely removed, some may recur despite treatment. If your cyst is recurrent and causing concern, it may be beneficial to seek a second opinion from a dermatologist or a surgeon specializing in skin conditions. They can provide insights into alternative treatment options or advanced techniques that may be available.


Conclusion
Subcutaneous cysts are generally benign, but their recurrence can be a source of frustration. Understanding the nature of your cyst, the reasons for its recurrence, and the available treatment options is crucial. If surgical removal is not an option, discussing other management strategies with your healthcare provider can help you find a suitable approach to manage your condition effectively. Always ensure that any treatment plan is tailored to your specific situation and health needs.