You have a small, hard lump under your skin that hasn't bothered you in years. Or maybe that same lump has suddenly turned red, swollen, and very sore. This is the usual story of an epidermoid cyst. Even though they are completely harmless, going to a regular doctor's office to get rid of them can mean long waits and expensive trips to a specialist for a simple procedure. But there is a better way. Direct Primary Care (DPC) is a simple, cheap, and hands-on way to take care of these common skin cysts right in your doctor's office.
Epidermoid cysts are common, harmless (non-cancerous) growths that start in a hair follicle that is blocked. People often call them "sebaceous cysts," which is wrong.
What is in there? They aren't full of oil; they're full of keratin, a soft, cheese-like protein that smells bad and makes up our hair and skin.
How do they look? Usually, they are bumps that move and are shaped like domes just under the skin. In the middle, you might see a small dark spot. This is the original blocked pore, which is called a punctum.
The Issue: Inflammation and Breakage. These cysts are not dangerous, but they can burst under the skin or become inflamed, which can cause a painful, red, swollen abscess that needs medical attention to relieve the pain and pressure.
The Key to Getting Better: Taking Out the Whole Cyst Sac
To permanently get rid of an epidermoid cyst and stop it from coming back, you need to surgically remove the whole cyst wall or "sac," which is the part that makes the keratin.
Direct Primary Care (DPC) is a membership-based system that lets patients talk to their doctor directly and as often as they want. The DPC model's focus on access and in-office procedures is very helpful and valuable for a common condition like an epidermoid cyst. This is why DPC is the best option for this condition:
A "See and Treat" Model for a Common Issue:
DPC makes the whole process easier, often into one visit.
Quick Access: You don't have to go to an expensive urgent care or wait hours in the ER when your cyst gets painful and inflamed. You can see your DPC doctor on the same day or the next day.
Procedures in the Office: Most DPC doctors are very good at doing small skin surgeries. They can find out what's wrong with your cyst and treat it right in their office, which will save you time, trouble, and money.
Professional care for cysts that are both inflamed and not inflamed:
No matter what stage the situation is at, your DPC doctor can handle it.
If you have a painful, inflamed cyst, your doctor can make an incision and drain it (I&D) to relieve the pain and pressure right away. Then, after a few weeks, they will ask you to come back for a follow-up procedure to take out the cyst wall. This will make sure that it doesn't come back.
For a Cyst That Isn't Inflamed: Your doctor can easily remove the whole cyst and its sac in one simple procedure if it bothers you for cosmetic reasons or because of where it is.
A very cheap and easy solution:
This is one of the main benefits of DPC.
One trusted doctor in one familiar place handles the whole process, from diagnosis to I&D to final excision.
In most DPC practices, you either pay for these common procedures with your monthly membership fee or you can get them for a small, clear fee for supplies (usually less than USD 50). This way, you don't have to pay for separate and expensive facility fees, specialist co-pays, or surprise bills that can add up to hundreds or even thousands of dollars in the old system.
Case 1: David, 48, has a cyst on his back that gets red, swollen, and very painful over the weekend. He calls his DPC doctor first thing on Monday morning and is seen an hour later. The doctor makes an incision and drains the fluid, which gives immediate relief. David comes back four weeks later, and the doctor cuts out the cyst sac in a simple way so it won't come back. The total cost for David, in addition to his monthly membership, was USD 25 for the surgical supplies.
Case 2: Jessica, 32, has an epidermoid cyst on her arm that isn't inflamed but is ugly. She asks her DPC doctor about it during her yearly checkup. The doctor says, "If you want, we can take care of that right now." Fifteen minutes later, the cyst has been carefully cut out and the skin is sewn back together with a few small stitches.
Q: Is an epidermoid cyst cancerous or dangerous?
A: No. They are completely safe and won't turn into cancer. The only "danger" is when they get very inflamed or infected, which can be very painful and may need a procedure to drain the pressure that has built up.
Q: Why did my cyst come back after I had it drained at an urgent care clinic?
A: An incision and drainage (I&D) is a great way to get rid of the pain from an inflamed cyst right away because it gets rid of the contents. But it doesn't get rid of the cyst wall or "sac" that makes those things. A surgeon must remove the entire sac in order to permanently cure the cyst. This important second step happens because of the continuity of care in a DPC practice.
Q: Can't I just pop the cyst at home?
A: You should definitely not do that. If you squeeze a cyst, it can easily break open under the skin. This lets the keratin, which is very inflammatory, into your tissues. This can cause a much bigger and more painful inflammatory reaction and make it harder for a doctor to completely remove the cyst later.
DPC has a clear advantage for this very common skin problem because:
Giving "One-Stop" Care: DPC can often do the whole thing in one place, from diagnosis to incision and drainage of an inflamed cyst to final excision.
Big savings on costs: By including these common procedures in your membership, you can avoid paying high fees for ER or urgent care visits and expensive specialist procedures.
Making sure that treatment is complete and of high quality: DPC's ongoing support makes sure that the right two-stage approach (I&D followed by excision) for inflamed cysts is finished, which greatly lowers the chance that the cyst will come back.
A bothersome or painful skin cyst shouldn't lead to a long, expensive, and broken medical journey. Direct Primary Care is a simpler, cheaper, and more effective way to get the help you need. You can get hands-on, expert care that will fix the problem for good in your trusted doctor's office.
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