Laser-Aided Sebaceous Cyst Excision in Nalgonda: Indications, Procedure & More

Sebaceous are yellowish-white lumps that move easily under your skin. They are dome-shaped and filled with mushy protein. Sebaceous cysts originate from the sebaceous glands (glands found under the skin that secrete sebum, the oily substance that keeps your skin moisturized) and are found anywhere on the body except palms and soles. Sebaceous cysts develop when there is an infection, ingrown hair, or clogging of the sebum. They are harmless and cause no trouble, except when infected or if extremely large in size.
Laser-aided sebaceous cyst excision is a minimally invasive procedure that uses a laser to remove the cyst. The cyst is drained through a small hole made by the laser. Laser-aided excision of the sebaceous cyst has minimal scarring and high patient satisfaction rates.

Sebaceous cysts originate from the sebaceous glands. These cysts develop when the sebum gets blocked or if there is any infection or ingrown hair. Small sebaceous cysts are painless and do not cause any harm. Large cysts can cause pain and discomfort. Your doctor may give you medications to deal with pain and infection. Steroid medications may be injected into the cyst to reduce the swelling. Under the effect of local anesthesia, the cyst can be punctured, and the sebum squeezed out. 
The cyst is excised to prevent recurrence. Excision can be done in several ways, all of which are done under local anesthesia.

• Laser excision- This procedure involves using a laser to make a hole through which the sebum is drained. The cyst wall is then removed with a hemostat (an instrument that compresses the blood vessel and prevents blood flow).
• Conventional wide excision- Here, the surgeon will make a wide cut along the length of the scar and then surgically remove it.
• Minimal excision- As opposed to wide excision, this procedure involves a smaller incision on the surface of the cyst. The scar formed is relatively smaller.
• Punch excision- The surgeon uses a scalpel that resembles a cookie-cutter and surgically removes the cyst and some normal tissue surrounding it.

Laser-aided sebaceous cyst excision is a minimally invasive procedure to remove a large sebaceous cyst from your skin. The procedure is done under local anesthesia. It is a quick 30-minute procedure that gives good results and low recurrence rates of the cyst. The surgeon in Nalgonda uses a CO2 laser to make a hole in the cyst to drain out the pus. The cyst wall is then clamped at the base using a hemostat (an instrument that compresses the blood vessel and prevents the flow of blood). The wall of the cyst dies due to a lack of blood flow. A month after the procedure, the healed area is then cut again with a small 2 to 4-mm incision. The cyst wall is then removed completely. The new incision generally closes by natural healing. 

In cases of large cysts, complete removal of the cyst's contents and the cyst wall is not always possible. The surgery also leaves behind visible scars. With the help of a laser-aided technique, one can expect successful removal of the cyst contents and the cyst wall. This ensures that the cysts do not recur.

The scar is also barely visible. These reasons make laser-aided sebaceous cyst excision a successful and preferred method of cyst removal.

Sebaceous cysts are usually harmless and cause no symptoms. A cyst excision becomes essential in the following situations-

• The cyst has become infected and is swollen, tender, and painful
• The cyst is causing aesthetic problems 
• The cyst is causing hair loss
• The cyst causes discomfort and interferes with clothing.

Laser-aided sebaceous cyst excision is a minimally invasive procedure done under local anesthesia.

Here is how you can prepare for the procedure.

• Discuss the benefits and risks of the procedure with your surgeon. You will be given an informed consent form to sign, allowing the surgeon to proceed with the procedure.
• You will be advised to undergo certain tests, which include an ultrasound test to determine the cyst's contents (solid or liquid), a punch biopsy to look for signs of cancer, and a CT scan, which helps the surgeon look for abnormalities in the cyst.
• Discuss all the medications you are taking, including herbs and supplements.
• Mention allergies towards medicines, if any.
• You will be asked to quit smoking and drinking, as they affect healing.
• Do not wear makeup or pop the cyst before the surgery.

A dermatologist or a plastic surgeon in Nalgonda performs a laser-aided sebaceous cyst excision. The procedure takes 30 minutes and is performed by a dermatologist in Nalgonda(a doctor specializing in the disorders of skin, hair, and nails), a general surgeon (a doctor who specializes in the surgical treatment of body tissues to treat medical conditions) or a plastic surgeon (a doctor specializing in the repair, reconstruction, and restoration of the body).

• The surgeon will numb the area of the surgery with local anesthesia.
• Using a CO2 laser, a tiny hole is created in the cyst. 
• The contents of the cyst are squeezed out through this hole. If needed, the surgeon may use a small curette to scrape out the contents.
• The inside of the cyst is washed with 0.9% sodium chloride solution to clean the cyst completely.
• The base of the cyst is clamped with a hemostat (an instrument that compresses the blood vessel and prevents the flow of blood) during this procedure.
• Once the cyst is cleaned, the laser-made hole is closed with a single suture or held together with glue.
• Antibiotic ointment is applied as well as prescribed orally.
• A month after this procedure, the healed wound is incised with a 3-4 mm incision, and the cyst wall is excised.
• The new incision is left open to heal. Natural healing occurs within a week.

Once the procedure is complete, you can go home. You will be given a comprehensive list of dos and don’ts and instructions on how to care for the wound post-surgery.

After the surgery

• Once you are back home, rest the whole day and avoid scratching or rubbing your surgical site.
• Keep your surgical site clean and dry by changing the dressing every 2 days until it heals. This is usually done by a nurse at your doctor’s clinic.
• Do not soak your surgical wound; avoid swimming, saunas, and tub baths for at least 2 to 3 weeks.
• Avoid direct exposure to sun or dust for the initial few days following the excision.
• It is normal to experience some discharge from the surgical wound, which will resolve as it heals.
• You will be asked to limit physical activities for a couple of days till the wound heals.
• Complete healing and recovery may usually take around 2 to 4 weeks, depending on the size and location of the cyst.

As with all procedures, laser-aided sebaceous cyst excision too comes with its share of benefits and risks.

Benefits of laser-aided sebaceous cyst excision

• Suitable for large cysts located in areas of thick skin
• Good cosmetic results
• Complete removal of cyst wall
• No recurrence of the cyst
• Less bleeding
• Minimal, inconspicuous bleeding.

Risks of laser-aided sebaceous cyst excision

• Infection at the site of incision
• Reaction to anesthesia
• Noticeable scar immediately after the procedure

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