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  #1  
Old 09-03-2009, 03:16 PM
HeyHomie HeyHomie is offline
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At-Home Cyst Removal: Isn't This a Bad Idea?

http:/ /www.youtube.com/watch?v=Q8fsco3C_Zc (Link broken. It's gross. SFW, probably, but totally GROSS .)

Mrs. Homie saw this on a friend's FB page. The anesthesia consisted of ice applied locally, and the patient consuming quite a bit of beer. Sterilization consisted of boiling a razor blade. The video doesn't show the wound being cleaned or closed, so I'm guessing the cleanup involved tap water and a band-aid.

Is this sort of at-home medical care ill-advised, or are these people saving the resources of the health care industry? I mean, I for one wouldn't go to the ER for a minor laceration, but I think a sebaceous cyst deserves a little more respect and care than a home first aid kit?

What say you, medical Dopers?
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  #2  
Old 09-03-2009, 03:37 PM
CookingWithGas CookingWithGas is offline
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I didn't look at the video, thanks for the warning.... But I had a cyst removed from my back once and I cannot imagine that as a DIY procedure. Boiling a razor blade? Please. There's a reason that doctors go to medical school.
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  #3  
Old 09-03-2009, 03:37 PM
Mangetout Mangetout is offline
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I am not a medical doper, and if your link is one of the many 'huge zit pop' videos on the net, then I think you're right - it's probably a bad idea.

When doctors remove cysts, I believe they also remove the sac lining the thing by turning it inside out and cutting it off - reducing the chances that it will just fill up again.

And squeezing big zits or cysts can cause some of their contents to leak or spread under the skin, which, combined with the generally reckless and unsanitary methodology employed by these funsters, could lead to serious, even life-threatening infections. I've certainly heard of/seen photos of really nasty follow-up infections in the aftermath of internet zit-popping escapades.
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  #4  
Old 09-03-2009, 03:37 PM
Shodan Shodan is online now
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Not a medical Doper, but I quit watching the video when one of the observers wanted to smell the pus.

I rather suspect a lot would depend on the aftercare of the wound. It looked like something that needed to be packed with gauze so it would heal from the inside out.

The patient looked young and healthy enough to survive a lot of things that I couldn't, but that doesn't make it a good idea.

Thanks to the magic of the Internet, we can all enjoy the sight of that ribbon of pus after the cyst was lanced. I am suitably grateful.

Regards,
Shodan
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  #5  
Old 09-03-2009, 03:42 PM
J Cubed J Cubed is offline
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I would just use a safety pin and try to lance it right through the problematic pore. If I was going to get drunk and film it, I'd use a syringe to suck the gunk out. I'd have to be pretty good friends with the guy, though.
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  #6  
Old 09-03-2009, 06:05 PM
DSYoungEsq DSYoungEsq is offline
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Paging Qadgop!!!
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  #7  
Old 09-03-2009, 07:11 PM
Mangetout Mangetout is offline
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Originally Posted by J Cubed View Post
I would just use a safety pin and try to lance it right through the problematic pore. If I was going to get drunk and film it, I'd use a syringe to suck the gunk out. I'd have to be pretty good friends with the guy, though.
Sounds like a terrible idea. Make sure you put fresh batteries in the camera.
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  #8  
Old 09-03-2009, 07:27 PM
Qadgop the Mercotan Qadgop the Mercotan is offline
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Originally Posted by DSYoungEsq View Post
Paging Qadgop!!!
Yes, at-home cyst removal is a bad idea. Infection risk, incomplete removal of the cyst, removal or severing of the wrong structure (arterioles, nerves, gonads) are all possible concerns.

Last edited by Qadgop the Mercotan; 09-03-2009 at 07:29 PM..
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  #9  
Old 09-04-2009, 07:30 AM
Serenata67 Serenata67 is offline
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I have a pilonidal cyst and I had it drained at home a few times... however, it was by my mother, who is a rather successful doctor and very educated woman. Ever since we moved apart, I have trained medical professionals drain it in their office. Wouldn't do it at home at all.
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  #10  
Old 09-04-2009, 09:42 AM
brossa brossa is offline
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What was seen in the video was not a cyst removal, it was an "I&D" (incision and drainage) of an abscess that had formed because of an infected cyst. A cyst has a lining that gradually secretes material into a closed space, and if the lining is not stripped away OR widely connected to the outside world, the cyst will probably recur. If the cyst can't be completely removed, the process of sewing the skin edges to the edges of the cyst lining is called marsupialization - and yes, it does create a pouch which (ideally) shrinks over time. Google it at your own risk.

I&D of such a large abscess at home is not a good idea, although, let's be honest, all of us reading here have popped our own zits and dug out splinters with a needle and have lived to tell the tale -so far. From a technical standpoint, the 'sterilization' of the razor blade by boiling was defeated by plopping it onto a (nonsterile) paper towel, handling it with bare hands, not prepping the skin with antiseptic, etc. Local anesthesia for this type of I&D can be tricky given the chemical changes in the inflamed areas; an ice cube was not a bad idea, actually, given that some MDs use ethyl chloride freeze spray to get the same effect.

Ideally one would incise the abscess, strip the contents and the cyst wall away from the surrounding tissue, and pack the wound to heal by secondary intention, perhaps with multiple packing changes if the cavity is large. In circumstances where future wound care may be sketchy, it can help to make the incision in such a way that the edges of the wound can't immediately close up and trap infected material below the surface - this can be done by making an elliptical incision rather than a linear one, or (as these tools did) by making a cruciate incision (although both incision lines should enter the cyst cavity, not just one as in this case). The edges of a X-shaped incision tend to pull apart, so the wound will stay open and draining for longer. The area should be monitored for signs that the local inflammation is getting better rather than worse, etc. etc.
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  #11  
Old 09-04-2009, 12:27 PM
gigi gigi is offline
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Are there guidelines are how large/painful/icky-looking a cyst would need to be to go to the doctor? I'm afraid to look at the video because it will stick with me (ick) but don't mind seeing a "before" picture somewhere. I don't want to overreact but would like to know when I should see a professional, should I get something like this.
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  #12  
Old 09-04-2009, 01:05 PM
Shodan Shodan is online now
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Quote:
Originally Posted by gigi View Post
Are there guidelines are how large/painful/icky-looking a cyst would need to be to go to the doctor? I'm afraid to look at the video because it will stick with me (ick) but don't mind seeing a "before" picture somewhere. I don't want to overreact but would like to know when I should see a professional, should I get something like this.
Maybe it's obvious, but if you have a fever from an infection like this you need to get to the doctor pretty quick.

Regards,
Shodan
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  #13  
Old 09-04-2009, 01:40 PM
HeyHomie HeyHomie is offline
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Originally Posted by gigi View Post
Are there guidelines are how large/painful/icky-looking a cyst would need to be to go to the doctor? I'm afraid to look at the video because it will stick with me (ick) but don't mind seeing a "before" picture somewhere. I don't want to overreact but would like to know when I should see a professional, should I get something like this.
http://www.healthinplainenglish.com/...ebaceous_cyst/

^This looks like as good a guideline as any. NOTE: Pictures are not gross.
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  #14  
Old 09-04-2009, 01:51 PM
Broomstick Broomstick is offline
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Can I start by saying that whenever I've had a need for an I&D I went to a trained professional (excellent end results - can't hardly find the scar anymore) and, absolutely, my first, second, third, fourth, and fifth recommendations to anyone suffering from an abscess or cyst of this sort would be to go to a real doctor? Because that's the truth.

Moving on, though....

Boiling the razor blade wasn't a bad idea. Granted, there are better things than a paper towel and bare hands to manipulate it with, but at least the bacteria count was reduced and it sure as hell beats medieval ideas on sanitation. The comment by a female onlooker post "procedure" to "wash your hands real good" is also a good infection control measure. Not perfect, of course, but certainly better than nothing. I'm assuming "Dr. Joel" also washed his hands prior to slicing and dicing although that is not mentioned. Use of disposable gloves and some attempt to kill bacteria with, say, alcohol on said gloves or boiling a dish to place the razor blade on would be even better. Of course, real doctoring is even better yet.

Ice and alcohol as anesthetics is better than nothing, but I'll still take actual modern local anesthetics over them any day. I had a doc sawing at my face for the better part of an hour when I had surgery, I was wide awake, but felt no pain (after the initial needle jab, which did hurt like hell). No pain is good. Also, no hangover next day, until massive beer consumption. Also, by going to a doc you can get pain meds for the healing process. Although draining those suckers does provide some immediate relief you're still going to hurt for some time afterward as it heals.

Some of the swelling is from inflammation of surrounding tissues, not from puss build up. This did not seem to be well understood by some participants. Squeezing it will not get rid of inflammation swelling, and may make things worse if you cause further tissue damage.

If I was in the middle of the wilderness, trapped ina coal mine, stranded in Antarctica without a real doctor, or otherwise without access to real medical care yeah, I'd do something like that for a fellow human being. I'd like to think I'd be even more careful about sterilization and stuff. I'd slather something like Neosporin on the wound and stack gauze on it and let it drain and drain as it heals. But really, if you can get to a doctor that is the best way to go about it.

Anyone else notice comments about "no insurance" on this video? Gee, think maybe that had something to do with the home surgery option? I have no doubt that this sort of thing occurs with people who have excellent medical coverage, but lack of coverage surely is a factor here.

Oh, and my well-known abscess was bigger and more eruptive than his. Neener neener. Bigger incision, too. Neener.
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  #15  
Old 09-04-2009, 02:03 PM
bink bink is offline
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A word to the wise: tea tree oil does not, in fact, help to make cysts go away...and can in fact result in an itchy red rash all around the area that doesn't seem to want to go away.

(I'd see a doctor if I had insurance. I've sure thought about lancing it myself.)
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  #16  
Old 09-04-2009, 02:43 PM
tr0psn4j tr0psn4j is offline
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What about Hydrogen Peroxide in the cyst after getting rid of most of the gunk?
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  #17  
Old 09-04-2009, 04:33 PM
Broomstick Broomstick is offline
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What about it?

It isn't just gunk sitting in the cyst - there's stuff constantly seeping from the tissues around it into the Great Gaping Void. H2O2 might temporarily kill the bugs in the hole, but it's strictly temporary as more gunk will seep into the space from the area around it that your poured disinfectant can't reach.

That's why these things need to drain, heal "from the inside out", and so forth. If the gunk doesn't have somewhere to go the pus pocket just reforms in the same place.
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  #18  
Old 09-04-2009, 05:10 PM
Malacandra Malacandra is offline
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Originally Posted by Qadgop the Mercotan View Post
Yes, at-home cyst removal is a bad idea. Infection risk, incomplete removal of the cyst, removal or severing of the wrong structure (arterioles, nerves, gonads) are all possible concerns.


No concerns there, Doctor. Mine have just receded into the pelvis and will not be coming back out for a few days...
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  #19  
Old 09-04-2009, 05:15 PM
Green Cymbeline Green Cymbeline is offline
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Originally Posted by Broomstick View Post
Anyone else notice comments about "no insurance" on this video? Gee, think maybe that had something to do with the home surgery option? I have no doubt that this sort of thing occurs with people who have excellent medical coverage, but lack of coverage surely is a factor here.
Let's take this example of "DO NOT DO THIS AT HOME" home doctoring, and talk about how this type of "do-it-yourself" medical care might be increasing as more people are uninsured. If you had the choice between trying to drain a troublesome cyst yourself for $0 and being able to pay your rent and buy food this month, OR going to an ER and being charged $2,000 (probably a conservative estimate) and therefore not being able to afford your rent, people will likely take this gamble. But in the case it does get infected, then they'll go to the ER and it will perhaps end up costing the "system" even more. But this is the risk people will take.

But let's face it, how many times have one of us taken care of a relatively minor medical issue at home, that probably would have been better to see a doctor, but that turned out OK in the end, and save us thousands of dollars that we didn't have?

Let's be honest, how much would something like this cost someone if they had no insurance and were paying out of pocket? I'm willing to bet at least $1,000 or more. For someone who is low-wage or unemployed, that might as well be $10 million. It's just not affordable. So you're going to see people who have no access to health care doing it themselves - just like when women had no access to legal abortion, there were plenty of do-it-yourself abortions, some which turned out badly (even resulting in death) but many that turned out fine. People were willing to take that gamble.

My point is that NO ONE in America should ever have to consider making that gamble!! That is a good illustration of why health care should be accessible to everyone. This is a prime example.

Last edited by Green Cymbeline; 09-04-2009 at 05:17 PM..
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  #20  
Old 09-04-2009, 05:43 PM
SeaDragonTattoo SeaDragonTattoo is offline
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Originally Posted by Broomstick View Post
Oh, and my well-known abscess was bigger and more eruptive than his. Neener neener. Bigger incision, too. Neener.
Broomstick, you still totally win, hands down. Some of the best writing on the Dope. (I'd add the barfy smilie here, too, if only there was one......)
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  #21  
Old 09-04-2009, 10:04 PM
smiling bandit smiling bandit is offline
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I've actually had some trouble finding doctors capable of doing the job right themselves! They can handle the actual mechanical portion, but for some reason the people who handle genitalia, cuts, wounds, nasty diseases, etc have a problem with dealing with cysts. And one office has a policy of never excising anything like that without a full biopsy workup. Which is... rather wasteful.
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  #22  
Old 09-04-2009, 10:14 PM
Beware of Doug Beware of Doug is offline
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Originally Posted by Serenata67 View Post
I have a pilonidal cyst and I had it drained at home a few times... however, it was by my mother, who is a rather successful doctor and very educated woman. Ever since we moved apart, I have trained medical professionals drain it in their office. Wouldn't do it at home at all.
Sheee-yit no. Ouchy-bleedy slow-cooked dermal detritus all over the damn place? I had one myself at age 20; it was a helluva job just keeping myself in clean shorts until I had that puppy excised.
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  #23  
Old 09-05-2009, 01:06 AM
Colibri Colibri is offline
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Originally Posted by nyctea scandiaca View Post
Let's take this example of "DO NOT DO THIS AT HOME" home doctoring, and talk about how this type of "do-it-yourself" medical care might be increasing as more people are uninsured. If you had the choice between trying to drain a troublesome cyst yourself for $0 and being able to pay your rent and buy food this month, OR going to an ER and being charged $2,000 (probably a conservative estimate) and therefore not being able to afford your rent, people will likely take this gamble. But in the case it does get infected, then they'll go to the ER and it will perhaps end up costing the "system" even more. But this is the risk people will take.

But let's face it, how many times have one of us taken care of a relatively minor medical issue at home, that probably would have been better to see a doctor, but that turned out OK in the end, and save us thousands of dollars that we didn't have?

Let's be honest, how much would something like this cost someone if they had no insurance and were paying out of pocket? I'm willing to bet at least $1,000 or more. For someone who is low-wage or unemployed, that might as well be $10 million. It's just not affordable. So you're going to see people who have no access to health care doing it themselves - just like when women had no access to legal abortion, there were plenty of do-it-yourself abortions, some which turned out badly (even resulting in death) but many that turned out fine. People were willing to take that gamble.

My point is that NO ONE in America should ever have to consider making that gamble!! That is a good illustration of why health care should be accessible to everyone. This is a prime example.
[Moderator Note]

My point is that this is GQ, and political commentary of this kind is inappropriate here. If you want to comment on health insurance issues, do so in GD or IMHO. No warning issued, but don't do this again.

Colibri
General Questions Moderator
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  #24  
Old 09-07-2009, 09:03 PM
Serenata67 Serenata67 is offline
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Originally Posted by Beware of Doug View Post
Sheee-yit no. Ouchy-bleedy slow-cooked dermal detritus all over the damn place? I had one myself at age 20; it was a helluva job just keeping myself in clean shorts until I had that puppy excised.
I was a college student without insurance when that happened (I know where the no-insurance people are coming from), so she did it. It hasn't been severe enough or recurred often enough for me to have it removed. I take care of it and keep it clean.
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  #25  
Old 09-07-2009, 09:53 PM
Jackmannii Jackmannii is offline
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Messing with an abscess is a recipe for disaster, or at least a worsened problem that will require more complicated and expensive medical care in the end.

In the case of "sebaceous cysts" (more properly termed epidermal inclusion cysts), incompletely removing one, or traumatizing it through repeated scratching and popping it, can cause the contents to leak into surrounding tissues, resulting in an inflammatory reaction, scarring and a hard lump that will look even more unattractive.

Jackmannii, M.D. (Medical Doper)

Last edited by Jackmannii; 09-07-2009 at 09:54 PM..
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  #26  
Old 09-08-2009, 08:55 AM
CandidGamera CandidGamera is offline
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When it comes to things like this I am.. well, irrational. I too-commonly self-treat for minor skin problems (including skin tags and cysts) and in my experience, the doctor always does a better job.

.. but the embarrassment, expense, and inconvenience still sometimes causes me to grab a sterilized implement, ready to cut into my own flesh for relief.

And that's about as close to TMI as I'm going to go.
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  #27  
Old 09-08-2009, 09:30 PM
Chief Pedant Chief Pedant is offline
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The video shows an amateurish incision and drainage of a small infected sebaceous cyst over the right shoulder. This is a relatively safe procedure. Infection is not much of a concern--it's already infected. Opening the infected closed tissue space to the outside is beneficial. The thing that keeps the infection growing is the fact that it's a closed space.

Even though it's obviously being done by incompetent hands, this is a pretty ordinary infection and is probably better off drained than left closed.

Proper medical care of this would be better skin preparation to avoid introducing new contaminants, better incision--the x-shape is not necessary--and removal of the cyst wall, if there is one (and there is) to prevent reaccumulation. If there is evidence of direct invasion into the surrounding soft tissues, antibiotics might be prescribed. They are not necessary for the localized infection.

Such wounds are left open, sometimes with a small drain in place to make sure they heal from the inside out. Allowing the skin to close will create a new cavity and possibly a new closed space infection all over again.

Despite the amateurish care here, overall it is preferable for this to be opened and drained--even in amateur hands--than left closed until the pus finds a way out on its own.

Note that many sebaceous cysts are not infected. Opening of those by amateurs is worse than leaving them alone. But in general, any subcutaneous abscess is better off drained that not. As QtM mentions, sharp opening in amateur hands can damage associated structures.

Last edited by Chief Pedant; 09-08-2009 at 09:33 PM..
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  #28  
Old 09-09-2009, 01:58 AM
Markxxx Markxxx is offline
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I don't have insurance and I have a ganglion cyst on my index finger. It's really small and they wanted $600 just for the anesthetic, not even to mention what they'd charge for removal of the cyst.

I'll just keep cutting it off with a nail clipper till the time, if ever, I get insurance.

I'm sure if I could nail clipper the whole cyst it'd stop growing back.
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  #29  
Old 09-09-2009, 12:51 PM
Claire Beauchamp Claire Beauchamp is offline
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I don't have insurance and I have a ganglion cyst on my index finger. ... I'll just keep cutting it off with a nail clipper till the time, if ever, I get insurance.
Ganglion cysts do not appear on the outside of the hand, they are inside, on the joint or tendon covering. You can't slice them off, they are under the skin.

http://www.webmd.com/a-to-z-guides/ganglion_cyst
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  #30  
Old 12-20-2012, 05:15 PM
jaketheweight jaketheweight is offline
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I was actually told to do something like this to a cyst I had by a urologist. Here's the back story I live in an area of about 35 - 45 thousand people, there is 1 urologist and he has only 1surgery day a week at the hospital. He told me this is not a serious matter and I cannont waste my one surgery day on it I have to deal with cancers and other serious matters. I said I don't want this big ass sebaceous cyst on my leg. He said you can try to pop it and drain it at home if you life then he got up and left.
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  #31  
Old 12-21-2012, 09:41 AM
CandidGamera CandidGamera is offline
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I was actually told to do something like this to a cyst I had by a urologist. Here's the back story I live in an area of about 35 - 45 thousand people, there is 1 urologist and he has only 1surgery day a week at the hospital. He told me this is not a serious matter and I cannont waste my one surgery day on it I have to deal with cancers and other serious matters. I said I don't want this big ass sebaceous cyst on my leg. He said you can try to pop it and drain it at home if you life then he got up and left.
Find a dermatologist.
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