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What is the treatment for swollen area after laser removal of sebaceous cyst?

DOCTOR OF THE MONTH - Jan 2014
Jan 2014
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Dermatologist
Practicing since : 2002
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I had a sebaceous cyst removed from my scalp 2 weeks ago and the area is now swollen. What is the cause and what shall i do? The removal method used was by laser
Posted Wed, 22 Jan 2014 in Skin Hair and Nails
 
 
Answered by Dr. Kakkar S. 47 minutes later
Brief Answer: Need more information, It could be a Hematoma Detailed Answer: Hi. Thanks for posting your concern at XXXXXXX I would like to gather some more information from you, regarding your concern, in order to be able to help you better. If the cyst and the cyst wall was completely removed, i would like to keep a possibility of hematoma. >Is it painful/tender? >Has it increased or decreased in size? >Was the cyst removed completely along with the wall? Sebaceous cyst need to be removed along with the wall in order to prevent recurrence. Sebaceous cyst removal can be done either by: 1)Conventional wide excision OR by 2)Removal of cyst contents with a laser punch and then the cyst wall is removed entirely with minimal excision after about 1 month. After expulsion of the cyst contents through a laser punch hole, the capsule is gradually loosened and crumples to a smaller capsule with some fluid inside. Its complete removal is easy in the delayed operation (1 month later), which allows for dissection and excision under direct vision, providing for confident and complete removal of the cyst wall while minimizing scar length. take care regards
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Follow-up: What is the treatment for swollen area after laser removal of sebaceous cyst? 16 minutes later
The size has increased however it is not painful or tender. With regards to the cyst wall being removed i am not to sure. I will asked the Dermatologist tomorrow she did confirm that all the contents of the cyst was removed.
 
 
Answered by Dr. Kakkar S. 16 minutes later
Brief Answer: Possibility of hematoma. Detailed Answer: Hi. If the cyst and the cyst wall were both removed completely then the swelling could be due to a possible hematoma which will resolve by itself in another few days. Your treating dermatologist will tell you more about it. Hematoma can arise after cyst surgery because removal of a big cyst leads to creation of an empty space. The surrounding bleeding vessels can drain into this empty space because of the negative pressure created by this space. It is important to do a pressure dressing after cyst surgery in order to compress the bleeding vessels. take care regards
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Follow-up: What is the treatment for swollen area after laser removal of sebaceous cyst? 19 hours later
Hi Im seeing the dermatologist today becuase the lump is now causing me discomfort. It looks red and sore. Is it likely to be hematoma or an infection. Is it possible that the cyst has already returned. The swelling is definitely bigger. The cyst that was removed was not to big.
 
 
Answered by Dr. Kakkar S. 25 minutes later
Brief Answer: Possibility of Infection Detailed Answer: Hi. Redness, pain and swelling are signs and symptoms of developing infection. It should be treated with a course of an oral antibiotic. It could be due to infection of hematoma. Hematoma is self resolving but the infection need to be treated. Considering the present concern, i would have advised a week of oral antibiotics (penicillin group like Amoxycillin in combination with Clavulanic acid) for a week. Any obvious pus if present needs to be drained. Cyst if removed completely along with the cyst wall should not recur take care regards
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