Recurrence of Sebaceous Cysts After Excision: What to Do Next? - Dermatology

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Recurrence of sebaceous cysts after excision can be a frustrating experience for patients. It is essential to understand the nature of sebaceous cysts, their treatment options, and what steps to take if they recur.
Sebaceous cysts, also known as epidermoid cysts, are benign growths that can occur anywhere on the body, including the armpits. They are typically filled with keratin and can become inflamed or infected, leading to discomfort or pain. Surgical excision is the most common treatment for these cysts, especially if they are symptomatic or recurrent.

In your case, it appears that you have experienced a recurrence of cysts after surgical removal. The presence of bruising and delayed wound healing could indicate a few possibilities. First, it is not uncommon for the surgical site to have some bruising post-operation, especially if the procedure was extensive or if there was manipulation of surrounding tissues. However, if the wound has not healed properly and you are noticing new cysts forming, it is crucial to follow up with your original surgeon or a dermatologist.

Here are some steps you should consider:
1. Follow-Up Appointment: It is advisable to return to the doctor who performed the initial excision. They can assess the current state of your wound and the new cysts. They may perform a physical examination and possibly imaging studies to determine the best course of action.

2. Possible Re-excision: If the cysts are confirmed to be sebaceous cysts, your doctor may recommend re-excision. This procedure involves removing the cysts entirely, which is essential to prevent recurrence. The cost of the procedure can vary widely based on your location, the complexity of the surgery, and whether it is performed in an outpatient or inpatient setting. In the United States, the cost could range from a few hundred to several thousand dollars, depending on these factors.
3. Insurance Coverage: Most health insurance plans, including Medicare and Medicaid, typically cover medically necessary procedures, including the excision of sebaceous cysts. However, coverage can vary, so it is essential to check with your insurance provider regarding your specific plan and any potential out-of-pocket costs.

4. Post-Operative Care: After re-excision, proper wound care is crucial for healing. Follow your surgeon's instructions regarding cleaning the wound, applying dressings, and monitoring for signs of infection (such as increased redness, swelling, or discharge).

5. Consideration of Other Factors: If you are experiencing pain or pressure in the area, it is essential to communicate this to your doctor. They may consider other underlying issues that could be contributing to your symptoms, such as infection or complications from the previous surgery.

6. Preventive Measures: While it is not always possible to prevent the recurrence of sebaceous cysts, maintaining good hygiene and avoiding skin trauma in the affected areas can help. If you have a tendency to develop cysts, discussing preventive options with your dermatologist may be beneficial.

In summary, it is crucial to seek further evaluation from your healthcare provider regarding the recurrence of sebaceous cysts after excision. They can provide tailored advice and treatment options based on your specific situation. Remember, timely intervention can help manage symptoms and prevent further complications.