Surgical Dermatology - Removal of Cysts & Lipomas


Cutaneous Cysts are cystic lesions that are filled with cream colored material with a pasty consistency. They tend to have a thin wall and thus rupture is very common. Once it ruptures, it produces a painful inflammatory response. Cysts can occur anywhere on the body including the scalp, at which point they are known as pilar cysts. Cysts can be removed by a surgical excision before they become infected. Once they become infected, drainage, Kenalog injection or oral antibiotics may be necessary to reduce the inflammation and the size of the lesion.

Do I need to get it removed?

Typically, cysts are not removed unless they become inflamed. When cysts do become inflamed and infected, they become very large, big and painful. These typically occur on the buttocks area or on the back. When this occurs, please see a dermatologist right away. At the dermatologist office, cysts can be drained, relieving a lot of the pressure and reducing the pain. Simultaneously when the cyst is drained, it is also injected with some intralesional Kenalog (a steroid) in order to reduce some of the pain. If the cyst is infected, antibiotics are also prescribed. Typically, the patient is seen back in a week. In most cases, the cyst has completely calm down and is not painful at the follow-up visit.

Unfortunately, the cyst cannot be removed at the time of inflammation or infection. Thus it is necessary for the patient to return to clinic in about 2 weeks to completely remove the cyst. When surgically removing the cyst, it is very important to completely remove the cyst well otherwise the cyst may return.

How is a cyst removed?

Typically, the cyst is numbed with lidocaine and then an excision is performed to remove the whole cyst, including the cyst wall. The area is then sutured up.

Is not draining a cyst enough to get rid of it?

No. Draining the cyst is not sufficient to completely get rid of the cyst. The reason is because the cyst sac or wall still remains within the skin. In order to completely remove a cyst, the cyst sac and wall must be completely removed. This is typically done by a dermatology surgeon who knows who to cut, open, and remove the cyst sac.

If I have a cyst on my face that is inflamed, what can I do about it?

If there is an infected cyst on the face, we will first gently drain it and then inject the area with some steroid. Draining the inflamed cyst will relieve the pressure and some of the pain. Injecting the cyst with steroid will reduce the inflammation. The patient may also be placed on oral antibiotics. The combination of drainage, injection with steroid and oral antibiotics will help get rid of the infection and inflammation.  This is a very common procedure performed in our office.

I have cyst on my scalp, what should I do about it?

Cyst on the scalp, also known as pilar cyst, are typically removed by a surgical excision. Please come to clinic for evaluation.

At Castle Dermatology, Dr. Peyman Ghasri and Dr. Pedram Ghasri have the training and expertise to perform cyst excisions with minimal discomfort, scarring, and downtime.


Lipomas are non-cancerous growths of fatty tissue that can be felt just below the surface of the skin. They have a soft, almost doughy consistency and usualyl aren’t tender to the touch. Since they don’t cause pain and are a slow-growing soft tissue condition, often they are not discovered for a long time after they first develop. When they finally reach a size that makes their appearance noticeable or they become irritating due to their location, they generally are addressed, although treatment is not necessary.

Lipoma removal:

Individuals may also require lipoma removal if the growth:

  1. Becomes painful
  2. Becomes frequently inflamed or develops an infection
  3. Has an unusual or malodorous drainage
  4. Interferes with function or movement
  5. Grows too large

Since a lipoma does not affect surrounding tissue, the procedure to remove one is considered rather straightforward, and patients can go home the same day to recover. Surgical excision is the most common form of lipoma removal. When patients come to Castle Dermatology for surgical removal, our dermatologists will initially inject the area around the lipoma with a local anesthetic. The physician then makes a small incision into the skin and removes the growth. Finishing the procedure requires closing the incision with sutures and applying a dressing.

Recovery after lipoma removal is generally minimal, and most patients can return to work the next day or so following the procedure. Stitches will be in place for 1 to 2 weeks. During this time it is important to follow the instructions of a physician to minimize the amount of scarring that occurs.

At Castle Dermatology, Dr. Peyman Ghasri and Dr. Pedram Ghasri have the training and expertise to perform lipoma excisions with minimal discomfort, scarring, and downtime.