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dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 3900
Experience:  30 years practice in general and cosmetic dermatology
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I had a blackhead on my back that would keep coming back even

Resolved Question:

I had a blackhead on my back that would keep coming back even though I cleaned often and managed to remove it over and over. It turned into a pea-size hard mass and wouldn't go away. It stayed this was for about 3 years. Lately It seems to have gotten larger and feels sore. It is right where my bra straps and is extremely uncomfortable. I cannot sit back without feeling a slight pain. Is there anything I can do to draw it out?
Submitted: 2 years ago.
Category: Dermatology
Expert:  dermdoc19 replied 2 years ago.

dermdoc19 :

Good evening

Customer:

Thank you for reading my question

dermdoc19 :

What you have is an follicular cyst, sometimes referred to as an epidermal inclusion cyst, infundibular cyst, keratinaceous cyst and often, erroneously as a "sebaceous cyst". The term sebaceous cyst is a misnomer since the cyst does not contain sebaceous glands at all or produce sebum. Instead, it produces keratin. This forms, as yours did, when the pore of the follicle becomes blocked and then fills with keratin.

dermdoc19 :

The last thing you want to do is squeeze this. You can cause the cyst to rupture. When the cyst ruptures the keratin breaks through the wall of the cyst and produces an intense foreign body reaction which will look like an infection. This will leave a scar and require a few office visits before it is under control. Also, it is quite possible the cyst will reform when this happens and you will be left in the same position you were originally. There is also the possibility that you can cause an infection into the cyst.

dermdoc19 :

The only OTC thing that sometimes helps is Dome Boro compresses. Put a tablet of Dome Boro into 1/2 pint of warm water and compress this twice a day for 15-20 minutes. Occasionally this will cause the cyst to resolve.

dermdoc19 :

Otherwise, you should consult a physician. Some physicians will inject the cyst with steroid and place you on an oral antibiotic. This occasionally works to bring the cyst down and eliminate it. The problem with this treatment is that, if done too often, the area around the cyst becomes fibrotic ( scarred down) and makes it more difficult to remove the cyst. Thus, most physicians will opt to remove the cyst in its entirity the first time. This is a simple, in office procedure done under local anesthesia.

dermdoc19 :

Happy to answer further questions or clarify any of the above.

Customer:

When you say that Dome Boro may cause the cyst to resolve. Do you mean diminish or go away completely? AND even if it happens to go away, will it come back? What if I do nothing? Will it keep getting bigger? How long can I wait to get the removal procedure done?

dermdoc19 :

It may shrink downso it is not noticeable; the pore may still be widened. However, this usually does NOT work, but certainly can be tried since such treatment is painless and inexpensive.

Customer:

I am both a math teacher and a graduate student. How much does this procedure usually cost? (Round-abouts...)

dermdoc19 :

That last question is hard to answer. Some physicians will say to ignore it since, only very rarely can those have cancer in them( I've had one case in 31 years and my patient is near 90 now and fine). However, the larger they grow the more difficult they are to take out. You leave a large empty spot when you excise them...nature abhors a vacuum and fills up with material so the larger the cyst the more difficult is the post healing. The cost runs about $90-120...maybe double that if you see a plastic surgeon ( someone has to pay for the fancy decor and fountains).

dermdoc19 :

It is covered by insurance.

Customer:

Honestly, I think it's sore because I've been messing with it. I will save my pennies and sick days and see a doctor in the summer. I'll try the compress. As for the fountains and fancy decor, they'll have to suffer without my contribution. (heehee)

dermdoc19 :

Try not to mess with it.

Customer:

Thank you so much for your comforting words. I really appreciate your advice. God bless you for choosing to be a doctor.

dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 3900
Experience: 30 years practice in general and cosmetic dermatology
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