Epidermal cyst removal in Taichung: small laser opening, recovery

In short

• Stop squeezing it: squeezing removes the contents, not the sac around them. Pressing hard can burst the sac and lead to redness, swelling and pus.
• Red and swollen now? You can still come: if the inflamed area is small, the sac can be removed at the same visit. If it is large or full of pus, it is drained and the inflammation treated first; the sac is removed after it settles.
• Easier when it is calm: a small cyst that does not bother you can be watched, but cysts usually do not go away by themselves. When it is not inflamed and moves freely, the sac is easier to take out whole through a small opening.
• Shower and work on the day: local anaesthesia in the clinic. Several cysts can be removed in one session, with no limit on the number. Usually 3–4 visits: assessment, surgery, a check on day 7, and stitch removal on day 14 if there are stitches.
• Who and where: Dr. Chao-An Chen or Dr. Kai-Wu Yang operates, and you can choose. Costs are explained at the consultation. You can also ask about costs on LINE before you come.

What is an epidermal cyst?

The medical name is epidermal cyst. After an injury or for other reasons, cells from the top layer of the skin grow down into the deeper skin (dermis) or the tissue under it. They form a sac (capsule) that produces keratin. As keratin and oil build up inside, a raised lump appears.

Many people think it is a pimple and squeeze it. This can easily burst the sac and cause strong inflammation and bacterial infection. Squeezing a cyst yourself often leads to infection and scarring. The medical treatment is surgery to remove the whole sac (complete excision), which lowers the chance that it comes back.

Why squeezing does not work

Squeezing only pushes out the material near the surface. It cannot clear the sac that holds it. If the sac is not fully removed, the cyst comes back easily. Squeezing can also cause serious bacterial infection and make the sac stick to the tissue around it, which makes later surgery harder.

Think of the cyst as a rubbish bag buried in your skin. Squeezing tears the bag and pushes some rubbish out. It looks smaller for a while, but the bag is still there, and the skin soon fills it again. In laser minimally invasive surgery, the doctor goes in through a small hole and takes out the bag together with the rubbish. The cleaner the bag is removed, the less likely it is to fill up again.

Which doctor treats it, and is it really a cyst?

An epidermal cyst sits in and under the skin. Dermatology, general surgery, plastic surgery and urology can all treat it. A lump in the groin or near the scrotum must first be told apart from a hernia or a lymph node. The doctor examines it by touch first, and adds a soft-tissue ultrasound scan when needed.

Cysts are most common on the face, chest, shoulders and back, but they are also common on the scrotum and the female vulva. This clinic treats cysts in the groin, pubic area, skin of the scrotum, perineum (the area between the genitals and the anus), female vulva, buttocks and armpits. For cysts on the scalp, face, neck or back, you can also come to a consultation first.

Lumps in the groin, armpits or buttocks that keep coming back, leak pus, appear one after another, or have already left scars or tunnels under the skin may not be simple cysts. They may be hidradenitis suppurativa, a long-term skin condition. In that case you are referred to dermatology for long-term treatment. If you are not sure, book on LINE and let the doctor take a look.

Epidermal cyst or lipoma?

The two can feel alike. If it is unclear, a soft-tissue ultrasound at the clinic helps show whether it is a sac or fatty tissue. Not every lump under the skin is a cyst: a lipoma, a fibroma (a benign lump of fibrous tissue) and others can look very similar. A doctor needs to see and feel it to decide.

Lipomas can also be removed at this clinic. How it is done, and how large the opening is, depend on the size and depth; the doctor explains after the examination. After lipoma removal, bleeding, infection, scarring and regrowth are also possible.

Laser minimally invasive removal: five steps

In traditional surgery the cut is about as long as the cyst is wide. With the laser method the opening is smaller. This can help shorten recovery and make the wound less visible, but it still depends on the size and position of the cyst and on whether it is inflamed.

The procedure is done in the clinic under local anaesthesia:

1. Anaesthetic injection. Local anaesthetic is injected around the cyst to reduce discomfort.
2. Laser opening. A CO2 laser makes a small hole at the top of the cyst. There is little bleeding.
3. Emptying. Gentle pressure around the cyst pushes out the keratin and oil inside.
4. Removing the sac. The sac is separated from the tissue with instruments and pulled out whole. This is the key step to lower the chance of recurrence. If the sac is stuck and will not come out, the doctor makes the cut longer during the same procedure and then removes it.
5. Closing. A small wound usually needs one stitch, or it is sealed with tissue glue and no stitch. Scar size still depends on your skin type and where the cyst is.

The aim is to take out the whole sac. How large a cyst can come out through a small hole depends mainly on how much it sticks to the tissue around it:

• Squeezed before, inflamed before, or stuck to nearby tissue: if it cannot be pulled out through the small hole, the doctor makes the cut longer, looks clearly, and then frees and removes the sac. The scar will be longer than a small hole.
• Red and swollen now, small area: it can be removed at the same visit. Inflamed tissue is swollen and the sac breaks easily, so the opening may need to be longer than for a calm cyst.

When to have it removed

• Reasons to have it assessed early: the cyst keeps getting inflamed; it is slowly growing and gets in the way of daily life or clothing; or it is red and painful, or affects how you look.
• Inflamed, small area: after assessment, the doctor can remove the sac at the same visit.
• Inflamed, large area or already full of pus: the doctor first cuts it open to drain the pus and prescribes antibiotics. When the inflammation has gone down and the sac has shrunk, laser minimally invasive surgery is arranged to remove the sac. The waiting time depends on how fast it settles.

From assessment to stitch removal

How long the operation takes, and how large the opening is, depend on the size of the cyst. From assessment to stitch removal, you usually come 3–4 times:

After surgery, keep the area clean and dry.

Risks and limits

Laser removal and traditional excision are usually done under local anaesthesia. Both still leave a wound, and both can lead to scarring, bleeding, infection and recurrence.

• Bleeding and infection. Bleeding or wound infection can still happen after surgery. A few people need extra visits for wound dressing, or medicine.
• Scarring. The opening leaves a scar. In a few people the scar is slightly sunken. If the cut has to be made longer, the scar is longer.
• Incomplete removal and recurrence. If the cyst has been inflamed, has burst, or is badly stuck to nearby tissue, the doctor makes the cut longer during the procedure. Even so, the sac sometimes cannot be removed completely, and the chance that it grows back may be higher. The less sac is left behind, the lower the chance of recurrence.
• A lump again in the same place: tell us directly on LINE.

Tell us before surgery

• Blood thinners (anticoagulant or antiplatelet medicines): do not stop them yourself. Whether to stop, and for how long, is decided by the doctor who prescribed them.
• Diabetes: bring an HbA1c (glycated haemoglobin) report from the 3 months before surgery. At 8.5% or higher, we advise controlling blood sugar first and then arranging surgery.
• Also tell us at the consultation if you take immunosuppressants or steroids long term, have ever been allergic to local anaesthetics, or tend to form thick, raised scars.
• Keloids: if you form keloid scars easily, it is better not to have this procedure. If you still want it treated, discuss it at the consultation first.

Bleeding or wound problems after surgery

If the wound bleeds, opens, or becomes swollen and painful, at any hour: keep pressing on it with clean gauze, and at the same time tell us on the clinic’s official LINE. The doctor replies directly and arranges care.

What studies show

Results differ between studies:

• Small cysts without complications often need no treatment, and occasionally go away by themselves. Removing the whole cyst wall lowers recurrence. A sac that has burst is harder to remove whole, and what is left behind can grow again (DermNet).
• In 120 people with burst cysts on the face, followed for 12 months, scars were 0.30 cm with the laser and 1.23 cm with traditional excision. Recurrence was 8.3% with the laser and 3.3% with traditional excision; the difference was not statistically significant. The authors warn that the laser method may leave part of the cyst wall behind (Kim 2019).
• In 33 cysts removed through a laser opening, 2 of the 12 infected cysts grew back, and none of the 21 uninfected cysts did (Wang 2020).
• With small-opening removal by a punch tool (not a laser), 3.6%–8.3% grew back (Mehrabi 2002).

Frequently asked questions

Appointments and access

Consultations are conducted in Mandarin, and can also be conducted in English.

If you feel a lump that came back after squeezing, or one that is red and swollen now, send a message on LINE to book. The doctor looks at it, feels it, and explains whether it is a cyst and when to remove it. You do not need to explain why you are here in the waiting area; the clinic has private consulting rooms.

昭安泌尿科診所 (Morning Urology Clinic)
No. 98, Boguan 2nd St., West District, Taichung City 403, Taiwan（403 臺中市西區博館二街98號）
Consulting hours: Monday to Saturday (closed Sunday). Online booking is open 24 hours.

This page was produced by 昭安泌尿科診所 (Morning Urology Clinic). Medical content last updated: October 2026 (same as the Traditional Chinese version). English version published: 5 November 2026. Medically reviewed by Dr. Chao-An Chen, urologist.

Sources: DermNet: Epidermoid cyst / DermNet: Lipoma / DermNet: Hidradenitis suppurativa / Song SW, et al. Arch Plast Surg 2014 / Kim KT, et al. Arch Craniofac Surg 2019 / Lee HE, et al. Dermatol Surg 2006 / Wang ZC, et al. Lasers Surg Med 2020 / Mehrabi D, et al. Dermatol Surg 2002 / Jun GB, et al. S Afr J Surg 2010 / Gwak H, et al. Medicine 2026.

This page provides general medical information and does not replace an individual diagnosis or treatment plan.