Epidermal cysts are common, slow-growing lumps that form beneath the skin when a hair follicle becomes blocked or damaged. While usually harmless, they can become bothersome—especially when located on the upper back, where friction from clothing or backpacks can irritate them. The removal of a medium-sized epidermal cyst is a straightforward procedure when performed by a medical professional, combining precision, care, and proper technique to ensure the best outcome.
The process begins with a physical examination to confirm that the lump is indeed an epidermal cyst. Once the diagnosis is clear, the area is cleansed thoroughly to maintain a sterile environment. The doctor then injects a local anesthetic around the cyst, numbing the skin and deeper tissue so the patient remains comfortable throughout the procedure. Within minutes, the upper back becomes fully numb, allowing the removal to proceed without pain.
Next, a small, carefully placed incision is made directly over the cyst. Because the cyst lies just beneath the skin, the doctor works slowly and gently, separating the thin sac wall from the surrounding tissue. This sac is filled with keratin, a thick, cheese-like material that sometimes has a distinct smell. The key to preventing recurrence is removing the entire sac intact. If just the contents are squeezed out while the capsule remains, the cyst can easily return.
Once the cyst is freed, the doctor lifts it from the incision in one piece, ensuring that no residue or capsule fragments are left inside. The area is then irrigated with a sterile solution to prevent infection. Depending on the size of the incision, the doctor may place a few small stitches to close the wound neatly, or in some cases use adhesive strips if the opening is minimal.
After the procedure, a sterile dressing is applied to protect the healing skin. Patients receive simple aftercare instructions: keep the area clean, avoid heavy stretching of the back, and watch for signs of infection such as redness or warmth. Mild soreness is normal and usually fades within a day or two.
Within about a week, stitches are removed, and the incision continues to fade over time, often leaving only a faint line. For most people, the removal brings immediate relief—eliminating discomfort, preventing future inflammation, and restoring smoothness to the skin. With proper care, recurrence is unlikely, making the procedure both effective and satisfying.
