Dermoid Cyst Removal

A dermoid cyst is a sac-like growth that can appear on the face, inside the skull, on the lower back, or in an ovary.

A dermoid cyst is a sac-like growth that is present at birth.

It contains structures such as hair, fluid, teeth, or skin glands that can be found on or in the skin.

Dermoid cysts grow slowly and are not tender unless ruptured. They usually occur

• on the face,
• inside the skull,
• on the lower back, and
• in the ovaries.

Superficial dermoid cysts on the face usually can be removed without complications. Removal of other, rarer dermoid cysts requires special techniques and training. These rarer dermoid cysts occur in 4 major areas:  

• Dermoid cysts in the brain: Dermoid cysts occur very rarely here. A neurosurgeon may need to remove them if they cause problems.
• Dermoid cysts in the nasal sinuses: These are also very rare. Only a handful of cases involving dermoid cysts located here are reported each year. Removal of these cysts is extremely complicated.
• Ovarian dermoid cysts: These growths can develop in a woman during her reproductive years. They can cause torsion (twisting), infection, rupture, and cancer. These dermoid cysts can be removed with either conventional surgery or laparoscopy (surgery that uses small incisions and specially designed instruments to enter the abdomen or pelvis).
• Dermoid cysts of the spinal cord: A sinus tract, which is a narrow connection from a deep pit in the skin, usually connects these very rare cysts to the skin surface. This type of dermoid cyst can become infected. Removal is often incomplete, but the outcome is usually excellent.

Dermoid cysts are caused when skin and skin structures become trapped during fetal development. Their cell walls are nearly identical to those of the outer skin and may contain multiple skin structures such as hair follicles, sweat glands, and sometimes hair, teeth, or nerves.

A doctor should be contacted in the following situations:

• A cyst becomes painful or inflamed.
• A cyst grows or changes color.
• Removal is desired for cosmetic reasons.
• Typically, removing a dermoid cyst is not an emergency procedure. If a dermoid cyst ruptures, becomes inflamed, or causes pain or fever, a person should seek immediate medical advice.

Prior to the removal of superficial dermoid cysts on the face, a person should know the difference between cysts and other facial growths.

• Because dermoid cysts stem from birth and grow slowly, a person usually notices them during childhood or early adulthood.
• Dermoid cysts are firm and painless unless ruptured.
• Dermoid cysts are not attached to the overlying skin.

In rare cases, a dermoid cyst extends into a structure deeper than skin, such as a facial cavity or an orbit.

Some doctors recommend a CT scan or other imaging studies for these cases. This decision depends on the doctor's suspicion of a deep-level cyst and after a determination of risk versus benefit.

• Self-removal of facial cysts at home is not recommended because the cyst will grow back if not completely removed.
• Chances of infection, bleeding, and other complications increase for people who remove dermoid cysts themselves, especially since the person may not be able to differentiate between a harmless growth and other, more serious skin problems.

• To remove a dermoid cyst in an outpatient setting, the doctor will clean the area over the cyst, inject a local anesthetic, and make an incision directly over the cyst and attempt to remove it completely.
• Whether or not a dermoid cyst should be removed in an outpatient setting is determined by the treating physician after careful examination and any appropriate investigative testing.

Barring the possible complications associated with any operation, removal of a dermoid cyst usually results in complete recovery.