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What is a sebaceous cyst

Sebaceous cysts or wens are formations underneath the skin, filled with white, fatty, and semi-solid material, called keratin. They usually appear on scalp, neck, behind or on ears, on the back or on upper arms. Men can have them on scrotum as well. They can appear anywhere on the body except on palms and soles of the feet. They tend to appear on hairy parts of the body and in time they cause hair loss on the part of the skin just above the cyst. They are usually round, smooth and can be of different sizes.

Sebaceous cysts can be caused by a blocked sebaceous gland or hair follicles or by overproduction of testosterone.

Generally, these cysts are not considered to be dangerous and they usually do not require treatment. However, if they are painful, if they grow or get infected, or simply if they are unsightly, they can be surgically removed.

Surgery for sebaceous cysts

Surgery for sebaceous cysts is simple and safe and it is performed in order to remove completely the cyst and its contents.

The procedure can be done by wide excision, minimal excision or punch biopsy excision.

This surgery is usually done in a clinic as a outpatient case, which means that there is no need for the patient to stay overnight. In most cases it is done with local anesthetic, injected in the area close to the cyst.

The surgeon opens the lesion with a scalpel, using different types of incisions, depending on the size of the cyst and the part of the body. He or she then squeezes out the keratin, which is the material made mostly of sebum and dead skin cells. When the surrounding area is clean of keratin, the surgeon holds the incision open and uses finger or an instrument to pull the cyst out, being careful not to break it. If the cyst is extracted without breaking, there is 100 percent chance it will not come back.

After the cyst is extracted, the incision is sterilized and then stitched or sewn. It usually leaves a scar.

If, however, the cyst breaks while it is being pulled out, or if it is fragmented and cannot be pulled out integrally, the surgeon needs to clean the lesion thoroughly in order to prevent the recurrence of the cyst. It is usually done by curettage or scraping and the fragments may be burned by electro-cauterization. In this case the cyst may or may not come back.

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