Dermoid Cyst

What is a dermoid cyst?

A dermoid cyst is sac-like growth located on or in the skin. It contains fluid or semisolid material. Dermoid cysts occur during fetal development and are typically present at, or shortly after, birth. A dermoid cyst is benign, meaning it is not cancerous. The cyst occurs when layers of specialized cells do not grow together properly, and cells that should be on the outside of the body become trapped inside the body — for example, cells from skin, sweat glands or hair. Over time, these cells continue to collect inside the cyst and the cyst grows. Dermoid cysts are usually found on the head, neck and face, but can occur anywhere on the body.

Symptoms of dermoid cysts

The cyst typically appears as a small, firm, painless lump. In most cases, the mass can be easily moved beneath the skin. It may be skin-colored or have a slight yellow tinge. A pit (tiny opening) may be present on the cyst. The pit may have a tiny hair or a small amount of yellow or white drainage.

However, each child may experience symptoms differently. The symptoms of a dermoid cyst may resemble other neck masses or medical problems. Always consult your child’s physician for evaluation and management.

Diagnosis of dermoid cysts

Dermoid cysts are diagnosed by physical examination. If the cyst is located between the eyes or on the nose, there is a small chance that the cyst connects to other tissues within in the face and head. For this reason, your doctor may recommend an MRI to further evaluate.

Treatment for dermoid cysts

Specific treatment of a dermoid cyst will be determined by your child's physician based on:

  • Your child’s age, overall health and medical history
  • Location and extent of the cyst
  • Your child’s tolerance for specific medications, procedures or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

Dermoid cysts tend to enlarge slowly over time and therefore treatment often includes surgery to remove the cyst. In most cases, the surgeon will recommend waiting until the child is at least 6 months old to undergo surgery. The cyst is removed through a simple incision in the skin. Draining the cyst with a needle is not recommended because if the cyst lining is not removed, the cyst will grow back.

If the cyst has any connection with the skull or tissues deeper within the body, the procedure is performed with a plastic surgeon and a neurosurgeon.

What to expect during your child’s surgery

Surgery to remove a dermoid cyst takes about an hour and is typically scheduled as an outpatient procedure. This means you may go home once the child has recovered from anesthesia and is able to drink liquids.

In most cases, the incision is closed with dissolvable sutures and covered with a small paper bandaid called a steri strip. The incision can get wet in the bathtub or shower one day after surgery. The steri strip will fall off within one to two weeks, and the stitches will dissolve on their own. At the time of surgery, your surgeon will discuss some interventions that you can do at home to optimize the appearance of the scar.

Follow-up care

Your surgeon may request a follow-up visit to check the scar, but typically there is no need for additional monitoring or treatment.

Reviewed by Peter Mattei, MD, FACS, FAAP, Anita Romero, MSN, CRNP, CORLN

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