Skin Cysts: When to Worry and Surgical Options - Dermatology

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When it comes to skin cysts, particularly sebaceous cysts (also known as epidermoid cysts), it’s important to understand their nature, potential complications, and when surgical intervention may be necessary. Based on your description of having multiple small lumps under the skin of your neck and armpits for five years, it seems you may be dealing with benign cysts that are generally harmless. However, your concerns are valid, and it’s crucial to address them.

Sebaceous cysts are typically non-cancerous lumps that form when the sebaceous glands become blocked. They can occur anywhere on the body but are most commonly found on the face, neck, and torso. These cysts are usually painless and may not require treatment unless they become inflamed, infected, or cause discomfort.

When to Worry
1. Changes in Size or Shape: If the cysts suddenly grow larger, change shape, or become painful, it could indicate an infection or other complications. In such cases, it’s advisable to seek medical attention.

2. Signs of Infection: Symptoms such as redness, warmth, swelling, or drainage of pus from the cyst may suggest an infection. If you experience these symptoms, it’s important to consult a healthcare provider promptly.

3. Persistent Symptoms: If you notice persistent discomfort or if the cysts interfere with your daily activities, surgical removal may be considered.

4. Cosmetic Concerns: If the appearance of the cysts is bothersome to you, even if they are not causing physical symptoms, you might want to discuss removal options with a dermatologist.


Surgical Options
If surgical intervention is deemed necessary, the timing is crucial. Here are some guidelines regarding when to consider surgery:
1. Non-Inflamed Cysts: Ideally, cysts should be removed when they are not inflamed or infected. This minimizes the risk of complications and promotes better healing.

2. Post-Inflammation: If a cyst has been inflamed or infected, it’s often recommended to wait until the inflammation subsides before proceeding with surgical removal. This allows for a clearer surgical field and reduces the risk of recurrence.

3. Surgical Techniques: The most common method for cyst removal is excision, where the entire cyst is cut out. This is usually performed under local anesthesia. In some cases, drainage may be performed if the cyst is infected, but complete excision is necessary to prevent recurrence.


Post-Surgical Care
After surgery, there are several important considerations:
- Wound Care: Keep the surgical site clean and dry. Follow your doctor’s instructions regarding dressing changes and bathing.

- Watch for Infection: Monitor for any signs of infection, such as increased redness, swelling, or discharge.

- Avoid Strain: Try to avoid strenuous activities that could stress the surgical site during the healing process.

- Follow-Up: Attend any scheduled follow-up appointments to ensure proper healing and to address any concerns.


Conclusion
While sebaceous cysts are generally benign and may not require immediate action, it’s essential to monitor them for any changes. If you have concerns about the cysts on your neck and armpits, especially given their duration, it would be wise to consult a dermatologist. They can provide a thorough evaluation and discuss the best course of action tailored to your specific situation. Remember, it’s always better to err on the side of caution when it comes to your health.