Infected Epidermoid Cyst (Incision and Drainage)
You have an epidermoid cyst. This is a small, painless lump under your skin. An epidermoid cyst is often called an epidermal cyst, epidermal inclusion cyst, epithelial cyst, keratin cyst, or incorrectly, a sebaceous cyst. It forms slowly under the skin. It can be found on most parts of the body. But it's most often found on areas with more hair, such as the scalp, face, upper back, and genitals.
Some facts about epidermoid cysts:
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A cyst is a sac filled with material that is often cheesy, fatty, oily, or stringy. The material inside them can be thick or. a thin liquid.
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The area around the cyst may smell bad. If the cyst breaks open, the material inside it often smells bad too.
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You can usually move the cyst slightly if you try.
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The cyst can be smaller than a pea or as large as a few inches.
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The cyst is usually not painful, unless it becomes inflamed or infected.
Your cyst became inflamed or infected and your health care provider drained 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:
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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.
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If a gauze packing was placed inside the opening of the cyst, it will need to be removed. Your provider will usually do this after 2 days. If it falls out sooner, don't 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.
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If you were prescribed antibiotics, take them as directed until they are all used up.
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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 gastrointestinal bleeding, talk with your provider before using these medicines.
Prevention
Once the inflammation has healed, follow these tips to prevent another flare-up:
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Keep the cyst opening clean by showering daily.
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Don't wear tight-fitting clothing in the cyst area.
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Watch for the signs of inflammation so treatment may be started early.
Follow-up care
Follow up with your provider, or as advised. If a gauze packing was put in your wound, it should be removed as advised by your provider. Check your wound every day for the signs of infection listed below.
When to contact your doctor
Contact your provider or get medical care right away if:
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Pus continues to come from the cyst 2 days after the incision and drainage.
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Redness increases around the wound.
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You have increasing local pain or swelling.
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You have a fever of 100.4°F (38ºC) or higher, or as advised by your provider.