Epidermal Inclusion Cyst Treatment & Management

Updated: Jun 30, 2017
  • Author: Linda J Fromm, MD, MA, FAAD; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

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.

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Surgical Care

Epidermoid cysts may be removed via simple excision or incision with removal of the cyst and cyst wall though the surgical defect. [36] 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. [37, 38] Minimal-incision surgery, with reduced scarring, has been reported. [39, 40]

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.

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Consultations

Lesions located in atypical locations warrant appropriate consultation.

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Complications

Complications are rare, but they can include infection, scarring from removal, and recurrence. Malignancies in epidermoid cysts are very rare.

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Prevention

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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