EPIDERMAL & PILAR CYST REMOVAL

CLINICAL OVERVIEW & TREATMENT APPROACH

Epidermal inclusion cysts and pilar cysts are common benign growths that develop beneath the skin when keratin becomes trapped within a sac. These cysts are typically slow-growing and painless but may become inflamed, infected, or cosmetically bothersome over time.

Epidermal cysts can occur anywhere on the body and are commonly found on the face, neck, trunk, and extremities
Pilar cysts most often occur on the scalp and are frequently associated with hair follicles

While many cysts remain stable, others may rupture, drain, or enlarge, prompting medical evaluation.

WHEN TREATMENT IS RECOMMENDED

Treatment may be recommended when a cyst is:

Rapidly enlarging
Painful or tender, especially with movement or friction
Inflamed, infected, or draining
Recurrently traumatized (e.g., during shaving, grooming, or haircuts)
Interfering with daily activities or comfort
Cosmetically concerning to the patient
At risk for rupture or recurrent inflammation

Treatment decisions are individualized and based on cyst size, location, activity, and surrounding skin condition.

MEDICAL VS. COSMETIC CARE

Cyst removal is considered medically necessary when lesions are inflamed, infected, painful, enlarging, recurrently rupturing, or interfering with daily activities.

Stable, asymptomatic cysts may be removed electively for cosmetic reasons or patient preference. Treatment timing and method are selected to balance symptom control, recurrence risk, and cosmetic outcome.

PROCEDURES OFFERED AT IVSI

INCISION & DRAINAGE (I&D)

Incision and drainage may be offered for:

Inflamed or infected cysts
Ruptured cysts requiring decompression
Selected cases of cystic acne

For actively infected or ruptured cysts, drainage may require:

Temporary packing (e.g., iodoform gauze)
Daily or frequent dressing changes
Healing by secondary intention, which may result in a less favorable cosmetic scar

SURGICAL EXCISION OF NON-RUPTURED CYSTS

Complete surgical excision is the only definitive treatment that reliably removes the entire cyst wall and prevents regrowth.

Recommended for non-inflamed, intact cysts
Performed under local anesthesia
The cyst is removed in its entirety
The incision is closed with sutures to support optimal healing
Suture removal typically occurs 7–14 days after the procedure

Excision is generally postponed during active infection or inflammation to reduce scarring and improve cosmetic outcomes.

CO₂ LASER–ASSISTED INCISION & DRAINAGE (I&D)

For small cysts located anywhere on the body, an ablative CO₂ laser may be used to perform a precise puncture incision (approximately 1–2 mm). A curette is used to remove cyst contents, followed by laser energy to disrupt the cyst wall and reduce recurrence.

Typically performed with topical anesthesia
Minimal to no procedural bleeding
Mild redness and swelling may persist for 1–3 days
Downtime is generally limited

CO₂ LASER–ASSISTED I&D FOR CYSTIC ACNE (SELECT CASES)

For severe cystic acne, laser-assisted I&D may be used to:

Open deep inflammatory lesions
Drain purulent contents
Disrupt cyst wall structures
Reduce recurrent inflammation and scarring

This approach may improve response to medical acne therapy.
In select cases, I&D of severe cystic acne may be covered by insurance.

👉 Learn more about Acne Treatment Options

ROLE OF MEDICAL THERAPY

Antibiotic therapy may be prescribed when inflammation or infection is present to:

Reduce surrounding tissue inflammation
Improve conditions prior to surgical treatment
Support better cosmetic healing

Antibiotics do not eliminate the cyst and are not a definitive treatment.

IMPORTANT CONSIDERATIONS

Not all cysts require immediate removal
Actively inflamed cysts do not heal as well surgically
Definitive excision is best performed once inflammation has resolved
Cosmetic outcomes vary based on location, skin type, cyst behavior, and healing response

URGENT & SAME-DAY CARE

Inflamed, infected, rapidly enlarging, or painful cysts are commonly treated at IVSI.
When medically appropriate, same-day treatment may be available, including after-hours care in urgent situations.

Explore our Skin Surgery & CO₂ Laser Procedures for related treatments.

SCHEDULE AN EVALUATION

If you have a cyst that is painful, enlarging, inflamed, draining, or cosmetically concerning, a professional evaluation is recommended.

📞 Call (847) 518-9999

MEDICAL DISCLAIMER

This information is provided for educational purposes only and does not replace individualized medical evaluation. Treatment recommendations depend on clinical findings, diagnostic requirements, and patient-specific factors. Healing and cosmetic outcomes may vary.