Concerns About an Epidermoid or Dermoid Cyst
I currently have what medical professionals believe to be an epidermoid or dermoid cyst located in my submandibular region, near the neck. Following a difficult experience with a fine needle aspiration (FNA), the cyst became infected, necessitating two drainage procedures and a five-day hospital stay for intravenous antibiotics. Since then, I have been shuffled between various specialists without a clear plan of action. The cyst does not react like a standard cyst typically would, leading them to refrain from immediate surgical intervention. Initially, I was examined by an Ear, Nose, and Throat (ENT) specialist, then referred to a plastic surgeon. Following this, I underwent an MRI, which revealed some dubious findings that might involve my salivary gland and there were signs of scarring. This has now led to yet another referral to a maxillofacial surgeon. A significant issue I face is the long wait times for each appointment due to the inefficiencies within the healthcare system. In the meantime, I am dealing with an opening in the cyst that remains unhealed. This has led to the formation of a fistula, which continually produces keratin, a situation that genuinely worries me, particularly because I also suffer from intermittent severe, pulsating pain. The opening measures approximately 2 mm, large enough for debris to enter, which means that water from showering easily gets into the cyst. After showering, I gently expel some of the accumulated water along with the softened keratin. Additionally, I apply rubbing alcohol to keep the area sterile. While the cyst appears mostly deflated at this point, I'm uncertain about the best course of action. On one side, physicians have advised against squeezing the cyst as it could drive bacteria deeper and promote further infection. On the flip side, it feels alarming to allow tap water, known to harbor bacteria, or keratin, which could nourish bacteria, to remain inside. For months, I’ve managed this routine without triggering a secondary infection, but I’m unsure if I’m truly safeguarding my health or merely risking it. I feel directionless—no one has provided a definitive diagnosis or coherent guidance, and surgery seems to be a distant prospect.
Answers (1)
9/14/2025, 4:40:50 PM
OpenHealth AI
It sounds like you're experiencing a challenging situation with your epidermoid or dermoid cyst, especially given the complications you've faced. Managing an open cyst that is producing keratin and has formed a fistula can be frustrating and concerning, particularly with the added pain and uncertainty about the next steps.
Key Points:
- Infection Risk: The open cyst could be at risk for further infection, particularly with exposure to water and debris.
- Self-Care Routine: You have developed a consistent routine to manage the situation, but it may need adjustments to ensure better hygiene and healing.
- Need for Clear Guidance: You deserve a clear treatment plan, especially as you navigate through different specialists.
Explanation:
An epidermoid or dermoid cyst may behave differently than typical cysts, particularly if there is scarring or involvement of the salivary gland. The presence of a fistula can complicate healing, and while some degree of keratin production is normal in these types of cysts, it can lead to an increased risk of infection, especially with water exposure.
Prioritized Next Steps:
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Maintain Cleanliness:
- Continue gently cleaning the area daily with mild soap and water to prevent infection. Avoid using alcohol as it may cause irritation.
- After showering, gently pat the area dry without squeezing the cyst to minimize irritation or driving bacteria deeper.
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Avoid Water Exposure:
- To reduce the risk of bacteria entering the cyst, consider using a waterproof cover while showering to keep the area dry.
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Monitor for Signs of Infection:
- Watch for redness, increased swelling, warmth, or discharge that has a foul odor, which could indicate infection. If these symptoms arise, seek prompt medical attention.
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Pain Management:
- Over-the-counter pain relief, such as acetaminophen or ibuprofen, may help manage your pain. Ensure to follow dosing instructions based on your personal health condition.
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Stay in Touch with Specialists:
- Document your symptoms, including pain intensity and any changes in the cyst, and share these notes with your next specialist appointment.
- If delays continue, consider reaching out to your primary care provider to express your concerns or to discuss potential alternative or expedited referrals.
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Explore Support Options:
- If you feel lost in your treatment plan, consider speaking with a patient advocate who can help navigate appointments and communication with your healthcare team.
Remember, it’s essential to feel supported throughout this process. You’re not alone in this, and maintaining an open line of communication with your healthcare providers will be key in finding a resolution.
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