[Hinews] [Physician's Column] By Hwanig Kim, Cube Plastic Surgery

At first glance, it might resemble a pimple—a small, painless lump often overlooked due to a busy schedule or perceived insignificance. However, if the lump is an epidermoid cyst, timely treatment becomes essential. While often benign, delayed care can lead to infection, recurrence, or the need for more invasive surgery, particularly for cysts on visible areas such as the face, neck, or back, where a cosmetically mindful treatment plan is important.

Epidermoid cysts—commonly but inaccurately referred to as sebaceous cysts—are benign, slow-growing lumps that develop when skin cells and keratin become trapped beneath the epidermis. They typically arise from blocked hair follicles or trauma that disrupts normal skin shedding. These cysts are usually painless and small, making them easy to ignore. However, they can become inflamed or infected over time, often filling with pus.

Photo: Hwanig Kim, Director of Cube Plastic Surgery in Sindorim.
Photo: Hwanig Kim, Director of Cube Plastic Surgery in Sindorim.


Attempting to squeeze or drain the cyst at home is strongly discouraged. While online “cyst-popping” videos may seem satisfying, such actions increase the risk of infection and recurrence. Without removing the cyst capsule, the lump is likely to return within weeks or months.
The standard treatment for epidermoid cysts is surgical excision. For non-infected cases, complete removal of the cyst wall or capsule is crucial to prevent recurrence. Surgeon expertise plays a key role in minimising incision size and scarring. Modern techniques—such as CO₂ laser excision or punch excision—are often used to enhance cosmetic results, especially for cysts on the face. If the cyst is inflamed or infected, oral antibiotics are typically prescribed to reduce swelling before proceeding with surgery.

Although epidermoid cysts are benign, it is important not to overlook them. In rare cases, similar-looking lumps may be mistaken for malignant lesions such as sebaceous carcinoma, underscoring the importance of professional evaluation. Larger cysts may also require more invasive surgery, potentially resulting in deeper or more prominent scars.

If you notice an unfamiliar lump on your skin, avoid self-diagnosis. Seeking medical evaluation ensures an accurate diagnosis and timely treatment, reducing the risk of complications. What may seem like a minor issue today could result in more extensive scarring if left untreated.

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