Can You Leave a Ruptured Sebaceous Cyst Untreated?

Is it possible to leave a sebaceous cyst untreated?

Hello Dr.
Huang, I previously noticed a small protrusion in the center of my chest rib area, which I initially thought was a bone protrusion.
Recently, the small protrusion has started to become red and swollen.
I consulted a dermatologist who diagnosed it as a ruptured sebaceous cyst.
The doctor mentioned that after taking medication and applying topical treatment to reduce the cyst, surgical removal would be necessary.
I would like to know if it is problematic not to have it surgically removed.

Xiao Huang, 20~29 year old female. Ask Date: 2005/03/17

Dr. Huang Ruiyun reply Dermatology

It's not absolutely necessary, but there is a possibility of re-rupture or inflammation in the future.

Reply Date: 2005/03/17

More Info

A ruptured sebaceous cyst, also known as an epidermoid cyst, can often be left untreated, but there are several important considerations to keep in mind. First, it’s essential to understand what a sebaceous cyst is. These cysts are typically benign, filled with keratin and other debris, and can occur anywhere on the body. They are generally not harmful, but when they become inflamed or infected, as in your case, they can cause discomfort and other complications.

If a sebaceous cyst ruptures, the contents can spill into the surrounding tissue, potentially leading to inflammation and infection. This can result in symptoms such as redness, swelling, pain, and sometimes even fever if an infection develops. In such cases, your healthcare provider may recommend antibiotics to manage any infection and anti-inflammatory medications to reduce swelling.

Leaving a ruptured cyst untreated can lead to several outcomes:
1. Infection: If the cyst is ruptured and not treated, there is a risk of developing an infection. This can lead to more severe symptoms and may require more aggressive treatment, including surgical intervention.

2. Recurrence: Even if the cyst appears to heal on its own, there is a chance that it can recur. The cyst wall may still be present, and without complete removal, it can refill with keratin and debris, leading to another cyst forming in the same location.

3. Chronic Inflammation: If the cyst remains and is not completely removed, it may cause ongoing inflammation, leading to discomfort and possibly affecting the surrounding tissues.

4. Cosmetic Concerns: Depending on the location and size of the cyst, leaving it untreated may lead to cosmetic concerns, especially if it becomes larger or more noticeable.

5. Potential for Complications: In rare cases, untreated cysts can lead to complications such as abscess formation, which would require more extensive surgical intervention.

In your situation, since the cyst has already ruptured and is causing symptoms, it is advisable to follow your dermatologist's recommendation for treatment. Surgical removal is often the best option to ensure that the cyst does not recur and to prevent any potential complications. The procedure is typically straightforward and can be done under local anesthesia.

In summary, while it is possible to leave a ruptured sebaceous cyst untreated, it is not advisable due to the risks of infection, recurrence, and other complications. It is best to consult with your healthcare provider about the most appropriate course of action, which may include medication to manage inflammation and infection, followed by surgical removal to prevent future issues. Always prioritize your health and well-being by addressing any concerns with a qualified medical professional.

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