To minimize recurrence after sebaceous cyst removal, what is the recommended surgical approach?

• A. Remove the cyst sac and fill the dead space to prevent recurrence
• B. Just drain the cyst
• C. Apply topical antibiotics only
• D. Leave it alone until it resolves

Answer: (A)

The main idea is that prevention of sebaceous cyst recurrence hinges on removing the entire cyst wall and closing the wound in a way that eliminates dead space. The cyst is lined by epithelium that continues to produce material; if any part of that lining remains, the cyst can refill and recur. By removing the cyst sac completely and closing the wound to obliterate the dead space, you eliminate both the source of future buildup and the pocket where fluid or keratin could accumulate, creating a more definitive cure.

Draining the cyst does not remove the lining, so recurrence is common. Relying on topical antibiotics addresses infection risk but not the cyst itself. Leaving the cyst to resolve on its own is inappropriate for an identifiable cyst that will likely enlarge or become inflamed.