Asymptomatic epidermoid cysts do not need to be treated. Intralesional injection with triamcinolone may hasten the resolution of inflammation. Oral antibiotics may occasionally be indicated.
Epidermoid cysts may be removed via simple excision or incision with removal of the cyst and cyst wall though the surgical defect.  If the entire cyst wall is not removed, the lesion may recur. Excision with punch biopsy technique may be used if the size of the lesion permits. [36, 37] Minimal-incision surgery, with reduced scarring, has been reported. [38, 39]
Incision and drainage may be performed if a cyst is inflamed. Injection of triamcinolone into the tissue surrounding the inflamed cyst results in faster improvement in symptoms. This may facilitate the clearing of infection; however, it does not eradicate the cyst.
Lesions located in atypical locations warrant appropriate consultation.
Complications are rare, but they can include infection, scarring from removal, and recurrence. Malignancies in epidermoid cysts are very rare.
When the cutaneous portion of a myocutaneous flap is to be buried, a dermatome should be used to remove the epidermis.
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