Claire Alajooz is a senior physician associate and skin surgeon at Aventus Clinic. A member Faculty of Physician Associates at the Royal College of Physicians, she graduated from Kings College London in 2007 and went on to do her clinical training at St George’s University London. She is fully certified in minor surgery and, in 2016, started her dermatology training at St Mary’s hospital under the supervision of consultant Dr Sarwant Shah. More recently, Claire has been working in Bedford Hospital Dermatology outpatient department and doing her minor surgery lists in general practice.
After new research found a 600% increase in interest for the term ‘home cyst removal’ over the past 12 months, Claire Alajooz, senior physician associate and skin surgeon at Aventus Clinic in Hertfordshire, stresses that cyst removal is still an essential treatment that clinics should offer.
Despite an increased interest in athome removal, Alajooz says that for her, business is still booming.
“Despite reports of increased interest in at-home cyst removals by the public, we have actually seen more people requesting a procedure with us. This is hugely reassuring given the risks and gives me faith that people are choosing to do the right and safe thing by seeking help.”
This isn’t to say that Alajooz hasn’t seen the repercussions of the increased interest in at-home removals, frequently having patients come to her after attempting to remove their cyst at home but failing to do so.
“Unfortunately, we have seen the results of at-home cyst removal attempts and the most common feedback that we get from patients is ‘it didn’t work, and now it’s much bigger’.
Quite often, these patients will need a course of antibiotics to calm the cyst down again and get it back to a state where it can safely be removed surgically,” she says.
Whilst cysts are extremely common and are often not harmful, Alajooz says they should be removed to prevent issues further down the line.
“Some cysts won’t bother people for many years, so they leave them, but it’s always recommended to have them removed before they get too big (over 2cm) as bigger lumps mean bigger risks of bleeding when removing, and, as a result, skin surgery becomes a bigger op,” she says.
However, with more people considering attempting at-home removal, Alajooz emphasises that for patients who prioritise their safety, going to a clinic is the best option. “I can understand why some people may want to try and attack their cysts at home rather than come to a clinic first.
Programmes such as Dr Pimple Popper show how satisfying removal can be (and I can confirm this to be true as a skin surgeon!), but it is one hundred per cent not worth the risks it entails and, sadly, more often than not, can make the problem worse.”
Not only is there a risk of failing to remove the cyst correctly at home, which can lead to pain and infection, but there’s also the risk that it could be something more dangerous. Dr Suhail Alam, the medical director at Aventus Clinic, says, “Private cyst removal is an essential treatment for clinics to offer.
Cysts are extremely common, and whilst the majority are benign, this may not always be the case and should be treated accordingly. This is not possible to do at home.”
“Attempting these things at home risks infecting the cyst, which in the worst-case scenario can lead to an abscess and leave the patient very unwell”
“Cysts can resemble other benign lumps such as lipomas, sebaceous hyperplasia, or fibromas, but on the flip side, they can also look similar to cutaneous squamous cell carcinomas or other nodular skin cancers.
A clinician will always be happy to help and organise a scan or biopsy if there is any doubt to the diagnosis. It’s always better to be safe than sorry,” says Alajooz.
Alajooz believes that it is essential for cyst removal to be carried out in a clinic, as at-home removal lacks the necessities for getting rid of a cyst safely and with the least amount of discomfort to the patient.
“Attempting these things at home risks infecting the cyst, which in the worst-case scenario can lead to an abscess and leave the patient very unwell. Other risks include irritating the cyst so it grows bigger and also scarring the overlying skin, which in turn can make eventual removal more complicated,” she says.
“Having the removal in a clinic means the op will be done in a sterile environment and with the luxury of a local aesthetic. It also means that any possible bleeding can be controlled by an experienced clinician.
In addition, any reputable clinic will be attached to a lab so that if the cyst needs histological analysis post removal, this can be easily arranged.”
A home removal also increases the chances of scarring in patients – something that can be more controlled in a clinic.
“It is impossible to make a cut without creating a scar, but we can control the aesthetic outcome of the scar as far as possible, taking into account the anatomical location and cosmetically sensitive factors when deciding how to close the wound and whether any adjunct therapies may be required, such as steroid injections or cryotherapy”, says Alajooz.
“People should come in to consider their surgical options for cyst removal when their cyst becomes a problem for them. This problem could be traumaticmeaning that the cyst is situated in an area where it is irritated a lot, such as on the scalp for people that wear helmets.
Or the problem could be cosmetic- where the cyst has become obvious for the patient or other people to notice.”
In terms of the in-clinic cyst removal process, Dr Alam says, “We use local anaesthetic to numb the area when removing a cyst, reducing as much discomfort as possible before surgical excision.
Before stitching the wound, this method requires making a small incision around the cyst and removing it completely. We arrange a check-up for 10-14 days after the procedure to have the stitches removed. Whilst a linear scar will remain, it will fade with time.”
Dr Alam points out these five dangers that people might encounter when it comes to at-home cyst removal:
THE CYST WILL GROW BACK
The cyst is unlikely to be removed fully at home, meaning fluid will be leftover, allowing it to grow back. Not only will the cyst grow back, but it will grow back with a thicker cell wall making it even harder to remove.
INFECTION WILL SPREAD
When a cyst is removed, the entire sack of fluid must be taken. At home, there is a high chance of fluid being left over, which results in the cyst returning and potentially becoming infected. When a cyst gets infected, it can become inflamed and red or white with pus, resulting in lots of discomfort.
Attempting removal at home by popping, squeezing or bursting a cyst can result in permanent scarring that can also lead to a nasty infection.
IT MIGHT NOT BE A CYST
Many cysts can often be easily confused with boils or skin abscesses. Attempting to remove something at home that turns out not to be a cyst can worsen the situation.
THE CYST MIGHT NEED TO BE TESTED
Removing a cyst at home takes away the potential for a biopsy to check that it is not cancerous. Warning signs of a cyst being cancerous include bleeding or oozing, colour change, fast growth, itching and looking red or swollen.
When considering how medical professionals can help ensure that people seek the help that they need for a cyst, Alajooz believes that education and information are key: “As medical professionals, we need to ensure that our patients have access to good information and that we are approachable in our care so that more people are encouraged to come to us first, rather than risk their health”, she says. “We are always here to help.”