“Safe and Effective Cyst Removal from the Forehead: A Step-by-Step Approach to Clear, Healthy Skin Dr. Pimple Popper

There are a number of different types cysts. Some are typically found on specific areas of the body. If you have a cyst on your forehead, it is likely an epidermoid cyst, an acne cyst or a pilar cyst.

Epidermoid Cyst

Here are some characteristics of an epidermoid cyst:

• filled with dead skin cells
• typically grows slowly
• typically not painful
• might have tiny hole in center (punctum)
• tender if infected
• drains grayish — and sometimes smelly — material, if infected
• also called epidermal cyst, epidermal inclusion, epithelial cyst, follicular infundibular cyst, or keratin cyst

Pilar Cyst

These are traits of a pilar cyst:

• forms from hair follicle
• round
• smooth
• firm
• filled with cytokeratin
• does not have tiny hole in center (punctum)
• most commonly found on scalp
• also called trichilemmal cyst, isthmus-catagen cyst, or a wen

Acne Cyst

Here are some attributes of an acne cyst:

• formed on the inner layers of skin
• soft red bump
• pus filled
• painful
• often felt beneath the skin before seen
• does not come to a head like a pimple
• also called cyst acne or cystic acne

The term sebaceous cyst refers to either an epidermoid cyst or a pilar cyst.

Unless your cyst is bothering you, chances are your dermatologist will recommend you leave it alone.

If it is bothering you physically, or if you feel it is uncomfortably conspicuous, suggested treatment might include:

• Injection. The cyst is injected with steroid medication to decrease redness and swelling.
• Drainage. An incision is made in the cyst and the contents are drained.
• Surgery. The entire cyst is removed. There might be stitches.
• Laser. The cyst is vaporized with a carbon dioxide laser.
• Medication. If infected, doctor may prescribe oral antibiotics.

If the cyst is acne related, your doctor might also recommend:

• isotretinoin
• oral contraceptives (for women)

There are two primary medical complications with cysts:

• They can become infected and may form abscesses.
• If not completely removed by surgery, they may return.

Is it a cyst or a lipoma?

Because at first look both cysts and lipomas can appear quite similar, often one is mistaken for the other.

A lipoma is a benign fatty tumor located just under the skin. They are typically dome-shaped, feel soft and rubbery, and move slightly when you press your finger on them.

Lipomas generally do not get larger than 3 centimeters in length and, in most cases, are not painful.

There are a few differences between a cyst and a lipoma. For example, cysts:

• have a more defined shape than a lipoma
• are firmer than a lipoma
• don’t move like a lipoma
• can grow larger than 3 centimeters
• can be painful
• often leave the skin red and irritated, while lipomas typically don’t

1. Preoperative Preparation:

• Consultation: The patient will first undergo an evaluation where the healthcare provider confirms that the growth is indeed a benign cyst (such as an epidermoid or sebaceous cyst).
• Cleaning: The area around the cyst on the forehead is cleaned with an antiseptic solution to reduce the risk of infection.
• Anesthesia: A local anesthetic (usually lidocaine) is injected into the area around the cyst to numb the forehead and ensure the patient does not feel pain during the procedure.

2. Incision:

• Once the area is numb, the surgeon makes a small incision directly over the cyst. This is usually done in a natural skin fold or hairline to minimize visible scarring.
• The size of the incision will depend on the size of the cyst. It may only need to be small if the cyst is relatively small, but larger cysts may require a slightly bigger incision.

3. Cyst Excision:

• The surgeon carefully excises (removes) the cyst, including its capsule or sac, to prevent it from returning.
• The contents of the cyst, such as keratin (a thick, yellow substance), are gently squeezed or scooped out.
• The surgeon must ensure the entire cyst sac is removed to avoid recurrence.

4. Closure:

• After the cyst is completely removed, the surgeon closes the incision using dissolvable or non-dissolvable stitches (sutures). If dissolvable sutures are used, the patient typically doesn’t need a follow-up appointment for suture removal.
• A sterile dressing or bandage is applied to the area to help protect the wound and prevent infection.

5. Post-Operative Care:

• The patient will be given aftercare instructions, such as how to clean the wound and keep it dry.
• Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen may be recommended.
• Follow-up Care: The patient will need to follow up with the doctor in 1-2 weeks for a check-up and possible removal of sutures if they are not dissolvable.
• Scar Care: Scarring is usually minimal, especially if the cyst was small and the incision is in a discreet area. The patient may be advised to use sunscreen to protect the scar as it heals.

6. Risks and Complications:

• While the procedure is generally safe, there are potential risks, such as infection, scarring, or recurrence if the cyst sac wasn’t fully excised.
• If the cyst is infected (abscess), additional care, including drainage, may be needed before the excision.

Recovery:

• The healing process typically takes 1-2 weeks for the sutures to dissolve or be removed. The incision will heal, leaving a minimal scar, and the patient should avoid pressure on the treated area during the healing period.

Post-Procedure Tips:

• Keep the wound clean and dry, as instructed.
• Avoid picking or scratching at the incision site.
• Use sunscreen once the wound has healed to protect the scar from UV damage.