Cyst Removal in Vancouver

A skin cyst is a sac that develops beneath the skin and may gradually increase in size. Cysts are usually benign and may remain painless for years, although they can become uncomfortable, inflamed, infected or begin to drain. Two common types are epidermoid cysts, often referred to as sebaceous cysts, and pilar cysts, which commonly occur on the scalp. Not every lump beneath the skin is a cyst, and not every cyst needs to be removed. An assessment can help determine what the lump is and whether surgical removal is appropriate.

The decision to remove a cyst depends on its location, size, symptoms, history and clinical appearance. Many cysts can simply be observed. Patients commonly consider removal when a cyst:

• is gradually getting larger
• causes discomfort or pressure
• repeatedly becomes inflamed
• has recurrent drainage or odour
• catches on clothing, hair or equipment
• creates a visible or bothersome lump
• has returned after previous drainage

What many patients call a sebaceous cyst is often an epidermoid cyst. These cysts contain keratin within a lining or capsule beneath the skin. They may remain stable for long periods or gradually enlarge. Some become inflamed, tender or begin to drain. When definitive removal is appropriate, the goal is to remove not only the cyst contents but also the surrounding cyst wall or sac.

Pilar cysts commonly occur on the scalp. Patients may notice a firm lump beneath the hair that gradually becomes larger or becomes uncomfortable when brushing or styling their hair. Larger scalp cysts can also separate surrounding hair follicles and make the contour more noticeable. Scalp cysts can usually be removed surgically under local anaesthetic when appropriate. Because the scalp behaves differently from other areas of the body, closure and postoperative care may also differ. Pilar cysts often feel firmer and more rounded than epidermoid cysts, but clinical assessment is still important because not every scalp lump is a pilar cyst.

This is an important distinction. Draining a cyst releases its contents but generally leaves the cyst lining or sac behind. Because that lining remains, the cyst can refill. Surgical cyst excision aims to remove both the cyst contents and the capsule. Removing the capsule as completely as possible lowers the likelihood that the same cyst will return, although recurrence can never be completely eliminated.

A cyst is generally easier to remove completely when it is not actively inflamed, draining or infected. Inflammation can make the cyst wall more difficult to separate from the surrounding tissue. If a cyst is acutely inflamed or infected, treatment of the inflammation or infection may need to occur first, and definitive removal may be delayed until the area has settled. In some situations an infected cyst itself requires surgical treatment, so timing depends on the individual clinical situation. Previous rupture, infection or drainage can also create scar tissue around the cyst, make subsequent removal more complicated and increase the chance of recurrence.

For appropriate cysts, removal is performed under local anaesthetic while you are awake. The skin is numbed and an incision is made over or near the cyst, depending on its size and location. A small opening or punctum may sometimes be visible on the skin and can be included with the excision when appropriate. The cyst sac is carefully separated from the surrounding tissue with the goal of removing it as completely as possible. The incision is then closed with sutures. The size and location of the cyst, previous inflammation and the amount of surrounding scar tissue all influence the incision and closure required.

Yes. Surgical cyst removal requires an incision and therefore leaves a permanent scar. The appearance of the scar depends on the location and size of the cyst, skin tension, previous inflammation or infection and how the individual patient heals. Previous drainage, rupture, inflammation or infection can make dissection and closure less predictable because of surrounding scar tissue.

As a plastic surgeon, Dr. Ho considers the incision, tissue handling and closure as part of the treatment plan. The goal is not a “scarless” procedure, but a carefully planned removal and closure followed by appropriate scar care.

Recovery depends on the cyst location and the type of closure required. Many patients can return to normal non-strenuous activities relatively quickly. Heavy exercise is generally avoided for approximately one week so that unnecessary tension is not placed across the incision. Depending on the treatment area, some external sutures may be removed at approximately five to seven days, while other areas may be closed with absorbable sutures. Scalp cysts are often managed differently, and absorbable sutures may gradually loosen and fall out over approximately two to three weeks. Specific wound care, activity and scar instructions are provided after the procedure. For more detail about wound care, stitches, exercise and healing, read Cyst Removal Recovery: Stitches, Exercise and Aftercare.

The cost of cyst removal depends on the size and location of the cyst, whether it has been previously inflamed or treated, and the complexity of the removal and closure. Cyst removal starts at $800, depending on the treatment plan. A specific quote can be provided after assessment.

Yes, a cyst can recur, although the chance is lower when the entire cyst capsule can be removed. Recurrence may be more likely when a cyst has previously ruptured, become inflamed or infected, or been drained, because scar tissue can make the capsule more difficult to separate completely. Occasionally, a new cyst may develop beside a previous cyst-removal site. This does not necessarily mean that the original cyst has returned. Some patients develop multiple cysts, and a smaller nearby cyst may not have been apparent when the original cyst was removed. Less commonly, epidermoid cysts can also develop in areas of previous trauma or surgery.

• Royal College-certified plastic surgeon with experience in surgical removal and soft-tissue closure.
• Personalized lesion assessment that considers the history, location, size, symptoms, previous inflammation and whether the clinical appearance is consistent with a straightforward cyst.
• Scar-conscious surgical planning with attention to incision placement, tissue handling, closure tension and the expected location of the final scar.
• Clear wound-care, activity, suture and scar-management guidance, with close follow-up care.

If you have a skin or scalp lump that may be a cyst, a consultation can help clarify the diagnosis, whether removal is appropriate, and what to expect in terms of scarring and recovery. If you have already had an ultrasound of the area, please bring the report to your consultation. In some cases, we may recommend ultrasound before assessment depending on the size, location or characteristics of the lump.

Prefer to contact us directly?
604-806-3650 | info@dradelynho.com

Medically reviewed by Dr. Adelyn Ho, MD, MPH, FRCSC | Plastic and Reconstructive Surgeon | Last reviewed: August 2026