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Is surgery the only treatment for an epidermal cyst in an infant?

Q: My daughter is 14 months old and she has a 7 mm epidermal cyst on her right cheek since 3 months. From above, it just seems to be a dark coloured dot but I can feel it when I palpate the area. She had dry skin in that area before. The paediatric plastic surgeon has advised excision. My question is does it need to be excised? Is there anything, which I can do to avoid surgery? I am really worried about the scar since it will be visible on the cheek. How big will the scar be and considering she is just 14 months, will it be less visible once she grows? Is there anything I can do after the surgery for getting a less visible scar? Can laser resurfacing be done in such young kids? My concern is about how much the scar will fade over a period of time with the use of any kind of oil?

A:As your daughter has already been diagnosed to have a epidermal cyst, it has to be removed. Since the epidermal cyst arises from skin appendages, it has to be removed through a cut from the outside. Yes, there is going to be a scar no doubt. Please consult a plastic surgeon for its removal so the car can be made as inconspicuous as possible and kept within skin creases if possible. As it is in the cheek area as you say, it is very difficult to camouflage the scar. Secondly as time goes by the scar will fade. But as she is still a child as she grows older there are chances that the scar will stretch as she grows. But, that is a risk you have to take because now the cyst is small the scar is going to be smaller, if the cyst grows larger then the scar is going to be equally longer. Though I fully understand you concern as a mother, I would suggest that you please go ahead with its removal and after the removal please consult your plastic surgeon for scar care treatment. LASER resurfacing is not advisable for the child according to me. Also for the fact that, as she grows the scar is going to change, so please do not do anything right now apart from the removal and local scar care as advised by your surgeon. All the best to your daughter for the excision.

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