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bml
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from Singapore asked a question

What non-surgical methods are there to remove a neck cyst? (photo)

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Skin, Hair & Nails Ear, Nose & Throat

Hi doctors, my mum has had an inflamed neck cyst for 2 years. What are the best non-surgical treatments to removing the cyst? Thanks. Cheers!

DOCTOR’S ANSWER (4)

Dear cjw,

Based on the photo provided, it looks like your mother has an infection of a collection of hair follicles (medically known as carbuncle) or and infected cyst. I would strongly suggest that your mother visits a GP as soon as posible to get it assessed and get a course of antibiotics.

If the clinical examination suggests that there is a collection of pus (medically known as an abscess) under the skin, it needs to be drained surgically. At this size/extent, this can likely be performed under local anaesthesia by a surgeon  (ENT Surgeon, general surgeon or a surgeon with training in the head & neck region).

Although you mentioned that your mother has this for 2 years, it is likely that it has been fluctuating in size and appearance as cysts and infected hair follicles can flare up from time to time. During a flare up, there is usually pain and increased swelling. If your mother has been experiencing recurrent infections, it may be better to have the cyst/infected follicles removed. 

Hope this helps and all the best!

Consult Doctor
0 856 views 0 Doctors agree 14 Sep 2018

Dear cjw,

Oh dear, the inflamed cyst on your mum’s neck looks rather painful!

The simple answer is unfortunately, there is no non-surgical method to treat these cysts. They are  skin cysts which are called sebaceous cysts. They originate from skin glands which secrete sebum to moisturise the skin but if their drainage outlet becomes blocked, then a cyst forms with risk of becoming infected like your mum’s

In the first instance, most of my patients would have a course of antibiotics to treat any acute infection then they undergo simple removal of the cyst, usually under local anaesthesia (injection to numb the area). This is a straightforward, short and safe procedure to perform for your mum, especially as she has been suffering from recurrent infections in this area for the past 2 years!

To prevent recurrence of the cyst, it is extremely important that the entire cyst and its lining are completely removed. Otherwise, there is a risk that any remaining cyst material can continue to become infected again in future.

If your mum is diabetic, it is even more essential that the infected cyst is aggressively treated with antibiotics and surgical removal  because diabetes carries a risk of more complicated infections such as more serious cellulitis/spreading skin infection which may need hospital admission for an antibiotic drip.

We also worry about a life-threatening skin condition in diabetics called necrotising fasciitis: This is a rapidly progressive condition that may start off as a simple infected skin cyst but which goes on to spread quickly to affect deeper soft tissues which don’t heal and instead break down and lose their blood supply, very scary indeed.

Consult Doctor
0 750 views 0 Doctors agree 17 Sep 2018

Dear Cjw, 

Thank you for asking these questions for the benefit of other patients.

I do not disagree with the surgical treatments proposed by the other doctors.

The face and neck has good blood supply, there might be a chance a patient can be treated with repeated needle aspirations and oral antibiotics. For example, go to a clinic daily for drawing out and flushing out the pus every day. 

Otherwise, if it is too big, or too troublesome to do so, a minor surgery to remove it might be a faster option.

Consult Doctor
0 847 views 0 Doctors agree 15 Sep 2018

Hello

Sorry to hear your mum has been suffering from a inflamed neck cyst for 2 years. Unfortunately there is no good non- surgical solution to this problem. Some people try to squeeze out the contents but this runs the risk of worsening the infection and it will invariably recur even if it does settle temporarily. 

We do treat such cysts regularly in outpatient clinics. For uninfected cysts, we will cut out the cyst including the cyst wall after a quick numbing injection. The numbing injection takes less than a minute, and the entire procedure usually takes 20-30 minutes, leaving a small scar.

For inflamed cysts, we will cut out the area, including all the underlying inflamed skin tissue. This can be done under numbing injection as well. 

Such minor skin procedures can be done at our minor surgery procedure room after an initial consultation. If the cyst becomes quite large, eg more than 2cm, then it is best to seek help from a general/ENT surgeon to perform.

Hope this helps!

Warmest regards 

Dr Stephanie Ho, Dermatologist 

Consult Doctor
0 828 views 0 Doctors agree 15 Sep 2018
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