A cyst on the face: what it is, whether to remove it, and the scar
Most lumps on the face that people call a cyst are epidermoid (“sebaceous”) cysts: harmless sacs of keratin under the skin that grow slowly and can be left alone. If one bothers you, our plastic surgeons remove the whole sac under local anaesthetic through a small cut in the natural skin lines, which leaves a permanent scar planned to be as fine as possible. Cyst removal at Waterfront is from £695, after a £200 consultation.
What is a cyst on the face?
A skin cyst is a small sac under the skin filled with keratin, the soft cheesy material the skin makes. It forms when a hair follicle becomes blocked, and most “sebaceous” cysts are, strictly, epidermoid cysts. On the face they are common on the cheeks, forehead, jaw, behind the ear and near the nose.
A typical one is a round, firm lump that moves a little with the skin, often with a tiny dark dot on the surface. It grows slowly, is usually painless, and is benign and not infectious.
Is it a cyst, or could it be something else?
Several facial lumps look alike, and examination tells them apart.
- Milia: tiny white spots a millimetre or two across, often around the eyes.
- Acne cysts: deep, tender spots that come and go with other acne. Your GP or a dermatologist treats them with acne medicines.
- Lipoma: a soft, rubbery fatty lump that slides under the skin, seen on the forehead more than elsewhere on the face.
- A skin cancer: a basal cell carcinoma can look like a smooth, pearly lump. A “cyst” that bleeds, crusts or keeps breaking down is checked as a possible skin cancer first.
A lump in front of the ear or at the angle of the jaw can come from the salivary gland underneath, and needs a different assessment first.
Should I squeeze or pop it?
No. Squeezing or lancing a cyst at home can burst the sac under the skin, and the leaking contents set up inflammation that turns a quiet lump into a red, painful one. It can cause infection and a worse scar, and makes a later removal harder. The sac also stays behind, so the cyst usually fills up again.
Will a cyst on my face go away on its own?
Rarely for good. A cyst can shrink after it discharges or an inflammation settles, but the sac is still there and it often refills.
A harmless cyst that does not bother you can be left alone. People usually choose removal when it grows, becomes sore or infected, leaks, catches when shaving, or simply shows.
When should I see my GP rather than book a removal?
See your GP, or have the lump checked as a possible skin cancer, if it:
- has grown quickly over weeks rather than slowly over years
- bleeds, crusts, or is a sore that has not healed within a few weeks
- has changed colour, or is a new pigmented spot
- feels hard and fixed, and does not move with the skin
- sits in front of the ear or at the angle of the jaw
Get medical help the same day if the cyst is hot and painful with redness spreading across the skin or towards the eye, or you have a temperature.
If you are worried about skin cancer, your GP can refer you on the NHS, or you can book a mole and skin check with us. A lump that might be a cancer is removed as a biopsy with a margin of normal skin.
How is a cyst on the face removed?
The aim is to take out the whole sac in one piece, which gives the lowest chance of it coming back. Under local anaesthetic, your surgeon removes a small ellipse of skin over the cyst, lined up with the skin lines, lifts the sac out intact, and closes the wound with fine stitches, often with a dissolving layer underneath. Most removals take 30 to 45 minutes including preparation, and you go home the same day.
Every cyst goes for histology, with results in about three to four weeks. A cyst close to the eyelid, lip or nostril, or a large or deep one, may be planned under sedation or a general anaesthetic.
Will removing a cyst leave a scar on my face?
Yes. Every cut through the skin leaves a permanent scar, and no method is scarless. Our surgeons plan the scar so it is as fine and as well hidden as the site allows.
- Placement: the cut follows the natural skin lines, or sits in a crease or along the edge of a feature such as the jawline or nose, where the site allows.
- Length: the scar is usually a little shorter than the cyst was wide, so a larger cyst usually means a longer scar.
- Closure: a dissolving layer beneath fine skin stitches reduces the pull on the wound. On the face the stitches usually come out at about 7 days, at Waterfront.
- Timing: a calm cyst usually comes out whole; an inflamed one tears, and the wound is harder to close neatly.
Expect the scar to be pink or red for the first few months, then fade towards white and keep improving for a year or more. Use sunscreen on it for the first year.
A raised, thickened scar (hypertrophic or keloid) is uncommon. It is more likely on the earlobes, on the chest, shoulders and upper back, and in darker skin. Tell us early if a scar starts to thicken, because early treatment works well.
What if my cyst is inflamed or infected right now?
We do not remove the sac while it is acutely inflamed, because the wall is fragile and pieces left behind make the cyst more likely to return. The inflammation is settled first, with antibiotics or drainage if needed. Drainage relieves it but leaves the sac, so once the area has calmed down, usually a few weeks later, your surgeon removes the whole sac.
Will the cyst come back?
When the whole sac has been removed intact, recurrence is uncommon. It is more likely if a fragment of wall was left, most often after previous infection, and a returning cyst can be removed again. New cysts can still form elsewhere.
Who is cyst removal on the face not right for?
- You want the lump gone without any mark. On the face the scar will show.
- The cyst is red, hot and painful today, so it needs settling first.
- The lump is changing, bleeding or growing quickly, which needs a diagnosis first.
- You have acne cysts or milia, which are treated differently.
What are the risks?
Wound infection needing antibiotics is under 1 in 50 (Dixon and colleagues, 2006) and bleeding needing attention under 1 in 100, as on our cyst removal page. Rarely, a nerve under the facial skin is injured, causing lasting numbness or weakness of a nearby muscle, so your surgeon plans around the known danger zones.
How much does it cost, and can I have it done on the NHS?
Current guide prices for cyst removal at Waterfront:
Every price includes
- the plastic surgeon, hospital and theatre
- local anaesthetic and histology
- dressings and written wound care advice
- stitch removal and nurse wound checks
- one year of aftercare, including treatment of any complication caused directly by the procedure
The consultation is £200 with a consultant, paid when you book it.
The final price depends on the size and site of the cyst and how the wound is closed, and is confirmed in writing after the consultation. There is no routine review once the stitches are out, though your surgeon will see you if needed. Our guide to mole, cyst and skin tag removal costs covers our other skin lesion prices.
The NHS usually removes a cyst only when it causes a medical problem, such as repeated infection or pain. Waterfront is self-pay and does not treat patients through private medical insurance.
Facial cysts at Waterfront are removed by Mr Kazem Nassar and Mr Ben Aldridge, consultant plastic surgeons on the GMC Specialist Register for plastic surgery; Mr Aldridge is also trained in dermatology. You do not need a GP referral: book a consultation online or call 0131 376 3785.
Questions patients ask
Can a cyst near my eye, lip or nose be removed? Usually, yes, by the same method. Close to the eyelid, lip line or nostril the closure must not pull the eyelid or lip out of shape, so the planning matters more. Some are done under sedation or a general anaesthetic, priced after assessment. Your surgeon explains the likely scar for your site at the consultation.
Can the cyst be removed on the same day as the consultation? Sometimes, for a small cyst where time allows. The usual plan is a separate appointment, normally within two weeks of the consultation, so the procedure is set up properly and you have time to think. An inflamed cyst is settled first, so it is not removed on the day.
When can I go back to work after facial cyst removal? Most people are back at office work the next day, though bruising and swelling on the face can show for one to two weeks. Bring someone with you, because you may not be able to drive home after surgery on the face. Leave the gym until the wound has healed, usually two to four weeks.
What is the small black dot on my cyst? It is usually the blocked opening of the hair follicle the cyst grew from, sometimes called a punctum, and it is a typical sign of an epidermoid cyst. Squeezing it can push material out, but the sac stays behind and the cyst usually refills, and pressing hard can burst the sac and inflame it.
Is a cyst on the face dangerous? Almost never. Epidermoid cysts are benign. Have a lump checked if it grows quickly, bleeds, crusts, feels hard and fixed, or sits in front of the ear or at the angle of the jaw. Every cyst we remove goes for histology, so you know for certain what it was, with results in about three to four weeks.
How much does facial cyst removal cost? At Waterfront a small cyst (under 2cm) is from £695, a medium cyst from £895, and a large one (over 5cm) £1,195 to £2,500, with histology included. The £200 consultation is separate. Removal under sedation or general anaesthetic is priced after assessment, and your final price is confirmed in writing after the consultation.
Ready to talk it through?
Book a consultation online, call the team, or send us a question first.