My Sebaceous Cyst

Several years ago I noticed a bump on the top of my head. It was strange. It felt hard to the touch, and it was embarrassing when my hairdresser could feel it. It didn't hurt. It was just a weird bump on my head.

When I went to the doctor about something else a year and a half ago, I asked her to look at my bump. She said it was a sebaceous cyst. Nothing to worry about. She measured it. It was 1 cm in diameter.

Time passed, and the bump continued to grow. While it became more prominent, I became more self-conscious of it. Then, my employer warned that our insurance would be changing in a month. Premiums and co-pays would soon be significantly more expensive. I decided to have the bump re-evaluated; If it was going to cost more in a short matter of time, I'd rather go before the new plan took effect.

I saw my doctor who measured it again. It had grown to 1.5 cm. She referred me to dermatology. But if I was going to see the dermatologist, I'd have to wait 5 months! She scheduled me with the dermatology nurse practitioner instead...I could get in the next day. She might even be able to "take care of it" that day. I went in hopeful, but oops. They made a mistake in scheduling. The appointment was the following day. The next day, the nurse practitioner confirmed that it was, indeed, a sebaceous cyst. She offered to cut and drain it at the same visit, or schedule me with the doctor the following week to have it removed.

Drain it? Or remove it?

I asked for more information. She explained that a sebaceous cyst is a fluid-filled sac underneath the skin, containing a protein. It often forms following a skin trauma at the hair follicle. Skin cells that are normally found on the surface, find their way into the swollen area where they slowly continue to grow inside the sac. She asked if it had ever become infected, seeping out a foul-smelling yellowish fluid. No, thank goodness!

She said draining the cyst would get rid of the bump, but the sac would remain and could possibly re-fill. The other option, excision, would surgically remove the entire sac. And the cyst would not recur, although patients with a predisposition to cyst formation, may develop cysts near the same area in the future.

I didn't want the sac to re-fill! I decided to get rid of it altogether. She scheduled me for my "procedure" and I returned to the office the next week.

My dad came with me for support and waited in waiting room. The tech brought me to an operating room, had me lay on a bed with a bright light dangling over my head. She strapped electrodes to my calves (wish I had known that was coming...I would have shaved my legs), and had me point to the bump. She got out a razor and shaved a small section of hair around it.

The doctor came in and had the tech numb the area. It felt like liquid was running down the back of my head. He said that's a normal sensation, but that there was nothing there. He asked a few questions to make sure the area was numb, and he went to work. Slice. Open. Scrape. Remove. Close. Stitch the inside. Staple the outside (x7). Clean. The whole time, he talked to me and explained the procedure. By the size and texture, he said it looked like the cyst had been there for a long time...maybe 10 years. And even more interestingly, he said it wasn't just one cyst! There was a sizable cyst which was "attaching itself to surrounding structures" with a cluster of much smaller ones "like grapes hanging onto each other" all around it. I asked to see it when they were done, and that was a perfect description. They were grayish-white balls, and the largest one was mis-shapen like a candy corn.

In all, the visit lasted about 10 minutes. My dad took me home with a big white bandage on my head. I wouldn't be able to take it off for 24 hours (my students would surely notice). Each day, the area needed to be cleaned, and in 10 days I would return to have the 7 staples removed.

And now, a month later, I'm bump free. It's still scabbed over and healing, but I'm so glad that it's gone. And I just hope that I'm not one of those people who are "predisposed" to the sebaceous cyst.