A cyst is a harmless lump under the skin that is usually filled with fluid, pus, or a keratin build up with the appearance of soft cheese. Cysts form when the normal process of shedding dead skin cells goes wrong and the cells stay under the skin forming a small sac into which they continue to secrete keratin, forming a pus-filled lump. Unlike boils or abscesses that are caused by an infection, cysts are not painful, but can be tender if pressed.

Cysts can vary in size and type, and usually grow slowly. They are common as a presentation with acne (cystic acne), as pilar cysts that form around hair follicles, usually on the scalp, and as epidermoid or sebaceous cysts found on the face and neck, the chest and shoulders, and the skin around the genitals.

It is important to identify the type of skin cyst and treat appropriately; do not be tempted to burst a cyst yourself as this can cause infection. Cysts that have been burst will come back again as the whole sac must be professionally removed to stop it from refilling again.

Skin tags are small growths of excess skin that hang off the skin as small ‘dangly’ protrusions, usually a few millimetres in size. They are commonly found in areas of friction upon the skin from underwear or jewellery, or where skin rubs together and chafes, so are often located around the neck, in the groin, under the armpits, or under the breasts in women. They can occur more if you are overweight and have folds of skin and become more common with age. Skin tags can also appear on eyelids.

In all cases, skin tags are harmless, and do not cause pain, but are often regarded as annoying if they catch on clothing or jewellery or affect your self-confidence if they are cosmetically unsightly; thankfully they are quick and simple to remove.

Skin tags have their own blood supply, thus, minor surgical removal is designed to interrupt and cut off the blood supply safely so they can be removed or allowed to wither and fall off naturally as a part of the healing process. You should not attempt to remove skin tags yourself as they can bleed heavily.

A lipoma is a collection of fatty tissue under the skin, that is usually soft and spongy to the touch, moving a little under the skin if pressed. Lipomas are harmless, although they may be cosmetically unsightly if they are visible, such as on the face, and could impact on day-to-day life depending on their location and size.

Lipomas vary in size from the equivalent of a pea to much larger lumps that can grow as big as a tennis ball if left untreated. They grow slowly and most people will seek medical attention before they get too large. Lipomas are not usually painful and occur in all areas of the body including the face, chest, arms, back, shoulders, thighs, and buttocks.

As most moles are harmless, they are regarded as a cosmetic concern, therefore, mole removal is not something you will find via a referral from your GP or via the National Health Service (NHS), and you will be advised to seek private treatment, which we can offer at Blemish Clinic. We can also help if you suspect that your mole may be pre-cancerous or a melanoma as we have in-house consultant dermatologists available for referral.

Cysts are not contagious, are harmless, and can occur at any time, although they are more common with acne sufferers. If a cyst becomes infected you may be prescribed antibiotics by your GP, but they will not be able to offer cyst removal through the NHS. You may find that you have multiple cysts that need removing, something we commonly do at the Blemish Clinic by draining the cyst and then removing the sac to prevent reoccurrence.

Skin tags are seen as a cosmetic concern because they have no medical impact, although they may affect you psychologically. Cosmetic procedures are not routinely available through the NHS; thus, your GP will advise you to seek private treatment for the removal of skin tags. This can be quickly performed at Blemish Clinic using cryotherapy or cautery.

Lipomas are regarded as harmless lumps, so again you will usually not be able to get treatment via primary care services on the NHS and will need to seek private treatment as offered at Blemish Clinic.

Minor surgical procedures refer to a number of dermatology procedures that are used to address the surgical removal of various diagnosed moles, cysts, skin tags, and lipomas and other ‘lumps and bumps’. These are performed using local anaesthetic to numb the area but do involve the action of cutting or excising a piece of tissue. Examples of minor surgical procedures that we perform at Blemish Clinic include:

• using a scalpel – for cutting to excise a lesion and then sealing the wound with internal and external surgical sutures or stitches,
• using a curette for curettage – a looped or hooked instrument for scooping, scraping, or excising a mole or cyst,
• using cautery – heat used to seal off minor blood vessels as a skin tag is removed.

Minor surgical procedures are performed in one simple appointment that follows a previous appointment for a consultation with either Jan Birch or Dr Andrew Winter.

Jan Birch, our dermatology specialist nurse has many years of experience in treating moles, cysts, skin tags, and lipomas. Jan uses her own protocols which vary depending on the individual case and can include cryotherapy, curettage, cautery, or minor surgical excision and suturing, alongside a bespoke aftercare protocol to follow at home. Similarly, Dr Andrew Winter is available as a consultant dermatologist for referral in more complex cases.

During a consultation with either our dermatology specialist nurse, Jan Birch or consultant dermatologist, Dr Andrew Winter, your mole, cyst, skin tags, or lipoma will be accessed to decide on the most appropriate treatment option. A full medical history will be taken to determine if there are any underlying health issues or medications which could be impacting on the formation of your skin concern, such as acne in the case of cysts, or that could conflict with the proposed treatment. Any known allergies will also be discussed.

The removal of moles, cysts, skin tags, and lipomas via minor surgical procedures is suitable for men and women of all ethnicities and skin types, although scarring is a possibility and will vary by skin type. We aim to carry out all minor surgical procedures using techniques that minimise scarring. If you have a problem with healing, such as keloid scar formation, you may not be suitable for some of the minor surgical options.

If you have an active viral infection, such as a cold, or an active skin infection (bacterial, viral, or fungal) in the area where the lump is to be removed, then these will need to be treated with prescribed medication before minor surgery can be performed.

Similarly, if you are currently pregnant or breast feeding, we will ask you to wait before removing any moles, cysts, skin tags, or lipomas as these can be affected by hormonal changes. Such lumps are usually harmless so waiting will not be a concern, but we will ensure that the lesion has been properly assessed, particularly in the case of moles.

Minor surgical procedures are all performed using a local anaesthetic called lidocaine that will be injected into and around the targeted lump to numb the area and avoid any pain or discomfort during removal.

You may experience some pain, soreness, and tenderness to the treated area afterwards, and advice will be given on aftercare options including over-the-counter pain medications and caring for the wound whilst it heals.

As treatment involves minor surgery, your skin will need time to heal and for any initial scarring to fade. We aim to use techniques that minimise scarring, but it will depend on the type of lump removed, its size and location, and your predisposition to scarring. You should expect skin to be fully healed and the impact of the surgical procedure to be barely noticeable after 6-8 weeks.

Any discomfort, irritation, or cosmetic dissatisfaction caused by the original mole, cyst, skin tags, or lipoma will be gone, and skin will return to normal (with minimal to no visible scar).