Epidermoid Cyst (Sebaceous Cyst), Infected (Incision and Drainage)

You have an epidermoid cyst. This is a small, painless lump under your skin. An epidermoid cyst (often called a sebaceous cyst, epidermal cyst, or epidermal inclusion cyst) is a term most often used for 2 similar types of cysts:

  • Epidermoid cysts. These cysts form slowly under the skin. They can be found on most parts of the body. But they are most often found on areas with more hair such as the scalp, face, upper back, and genitals.

  • Pilar cysts. These are similar to epidermoid cysts. But they start from a different part of the hair follicle. They are more likely to be on the scalp.

Some general facts about these cysts:

  • A cyst is a sac filled with material that is often cheesy, fatty, oily, or stringy. The material inside them can be thick. Or it can be a thin liquid.

  • You can usually move the cyst slightly if you try.

  • The cysts can be smaller than a pea or as large as a few inches.

  • The cysts are usually not painful, unless they become inflamed or infected.

  • The area around the cyst may smell bad. If the cyst breaks open, the material inside it often smells bad too.

Your cyst became inflamed or infected and your healthcare provider wanted to drain it. Gauze packing may have been inserted into the cyst opening (cavity). This keeps the cyst open so it doesn’t seal up before it has time to drain more. No matter how well it was cleaned out, no cleaning is perfect. The packing will need to be removed.

Once the pus is drained, antibiotics may not be needed unless the infection has spread into the skin around the wound. The wound will take about 1 to 2 weeks to heal, depending on the size of the abscess.

Home care

The following will help you care for your wound at home:

  • The wound may drain for the first 2 days. Cover the opening with a clean dry bandage. If the dressing becomes soaked with blood or pus, change it.

  • If a gauze packing was placed inside the opening of the cyst, it will need to be removed. Your healthcare provider will usually do this after 2 days. If it falls out sooner, do not try to put it back inside the wound. Once the packing is removed, you should wash the area carefully in the shower once a day, until the skin opening has closed. This could take up to 5 days depending on the size of the cyst. It is good to direct the shower spray directly into the opening if this is not too painful.

  • If you were prescribed antibiotics, take them as directed until they are all used up.

  • You may use over-the-counter pain medicine to control pain, unless another medicine was given. If you have chronic liver or kidney disease or ever had a stomach ulcer or GI bleeding, talk with your provider before using these medicines.

Prevention

Once this infection has healed, use these prevention tips to avoid another infection:

  • Keep the cyst opening clean by bathing or showering daily.

  • Avoid tight-fitting clothing in the cyst area.

  • Watch for the signs of infection listed below so that treatment may be started early.

Follow-up care

Follow up with your healthcare provider, or as advised. If a gauze packing was put in your wound, it should be removed as instructed by your healthcare provider. Check your wound every day for the signs listed below.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Pus continues to come from the cyst 2 days after the incision and drainage

  • Increasing redness around the wound.

  • Increasing local pain or swelling

  • Fever of 100.4°F (38ºC) or higher, or as directed by your provider

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