A cyst that keeps growing, gets tender, ruptures, or simply bothers you doesn't have to stay. At Fayetteville Dermatology, Dr. James Prezzano removes cysts in a single office visit under local anesthetic — taking the entire sac, not just the contents, so the cyst doesn't come back. Every removed cyst is examined by pathology.
What Is a Skin Cyst?
Most skin cysts are epidermoid cysts (often called "sebaceous cysts") — a small sac under the skin that slowly fills with keratin, the soft protein your skin naturally produces. You'll often see a tiny central opening (a punctum) on the surface. Pilar cysts are a similar variety common on the scalp. Both are benign, and both tend to grow slowly over months to years.
Not sure whether your lump is a cyst? A soft, movable lump deeper under the skin may be a lipoma instead — the exam at your visit settles it.
When Removal Makes Sense
- The cyst is growing or has become noticeable
- It's had episodes of tenderness, redness, or swelling
- It has ruptured or been infected before — these tend to recur
- It catches on clothing, combs, or razors, or sits somewhere visible
- The diagnosis is uncertain and tissue confirmation is worthwhile
Why You Shouldn't Squeeze or Drain It Yourself
Squeezing a cyst pushes irritating contents into the surrounding tissue, which causes inflammation and sometimes infection — and because the sac stays behind, the cyst refills. A previously ruptured cyst also becomes harder to remove cleanly later. If it's bothering you, have it evaluated instead.
How We Remove Cysts
Cyst removal is done under local anesthetic in our Fayetteville office; the appointment usually takes 20-30 minutes. Dr. Prezzano removes the cyst intact through a small incision planned along the skin's natural lines, closes with sutures, and sends the tissue for pathology examination. Sutures come out in 1-2 weeks depending on the location.
One honest caveat: an acutely inflamed or infected cyst usually shouldn't be excised on the spot. It's typically calmed first — drainage, a steroid injection, or occasionally antibiotics — then removed a few weeks later once quiet. That two-step approach gives a smaller scar and a lower chance of recurrence.
Aftercare and Healing
- Days 1-2: Keep the site covered and dry.
- Until healed: Gentle daily cleansing, petrolatum, fresh bandage.
- 1-2 weeks: Sutures removed (or dissolve, depending on type used).
- Ongoing: Protect the site from sun for 2-3 months.
Spreading redness, increasing pain, or drainage? Call us at (315) 637-9116.
Why Fayetteville Dermatology for Cyst Removal
Three reasons: whole-sac technique so removals stay removed; closures planned by a fellowship-trained Mohs surgeon whose daily work is precise excisions and cosmetic repairs; and pathology on every specimen, so you get an answer, not just a procedure. Appointments are typically available within a week.
Frequently Asked Questions
A small line scar is unavoidable, but it's planned along the skin's natural lines and typically fades considerably over the first 6 months. If a scar heals more noticeably than expected, there are quick in-office procedures to improve its appearance.
Usually yes when the cyst is symptomatic — growing, tender, inflamed, or previously infected. Removal of a small cyst for purely cosmetic reasons may not be covered, but we'll give you the exact cost up front.
An acutely inflamed cyst is usually treated first — with drainage, a steroid injection, or sometimes antibiotics — and then removed once things settle, typically a few weeks later. Removing it while inflamed makes complete excision harder and the scar worse, so the two-step approach gives a better long-term result.
Not usually — the key is removing the entire sac, not just draining the contents. Drainage alone brings quick relief but the cyst almost always refills. Complete excision makes recurrence uncommon.
No — the area is numbed with local anesthetic first. You'll feel a brief pinch from the injection, then pressure but no pain. Most patients need nothing stronger than Tylenol afterward.
Schedule Your Mohs Consultation
If you've been diagnosed with a skin cancer — or your primary care provider or another dermatologist has recommended Mohs surgery — we typically have appointments available within the same week.
We accept most major insurance plans including Aetna, BCBS, Cigna, United Healthcare, and Medicare.
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