Epidermoid cysts · sebaceous cysts · atheromas
Epidermoid Cyst Removal in Osaka
At Kamogawa Clinic Tenroku, a board-certified plastic surgeon removes epidermoid cysts as outpatient day surgery under local anesthesia. Treatment is covered by Japanese public health insurance, and surgery on the day of your first visit is sometimes possible.
From within Japan, dial 06-6809-6088.
Could this lump be a cyst?
- A round lump under the skin that is slowly getting bigger
- A small dark dot (pore) in the center of the lump
- White, cheese-like material with an odor has come out when pressed
- A “pimple” that has stayed in the same spot for months
- Redness, swelling, warmth or pain
- Swelling that flares up and settles down in the same spot
If any of these sound familiar, the lump may be an epidermoid cyst. Acne, lipomas and other growths can look similar, and appearance alone is often not enough to tell them apart.
On examination, a cyst usually feels as though it moves together with the skin, while a lipoma tends to move separately from it. Small or deep lumps can be hard to judge by touch, so we may use ultrasound before deciding.
If the lump is red, swollen and painful, see inflamed cysts below.
How we approach cyst surgery
Removing the whole sac
If any part of the sac is left behind, the cyst can come back. We choose the technique with complete removal as the priority.
Plastic-surgery technique
Incisions and stitches are planned to keep the scar as inconspicuous as possible, including on visible areas such as the face and neck.
Same-day surgery when possible
Depending on the cyst and our appointment schedule, surgery may be possible at your first visit. Let us know if you need to keep the number of visits low.
Swollen, painful cysts are treated too
We decide the order of treatment based on how inflamed the cyst is, from removal at the same visit to drainage first and removal later.
One minute from the station
Tenjimbashisuji 6-chome Station on the Osaka Metro Sakaisuji and Tanimachi lines, two subway stops from Umeda.
“The most important part of cyst surgery is removing the sac completely. If only the contents are squeezed out, the cyst almost always comes back. As a plastic surgeon, I have spent many years operating on visible areas such as the face and neck. That experience is why we choose techniques that aim for both complete removal and the least noticeable scar possible. If you notice a lump, please see us before it grows. Removing it while it is still small usually gives the neatest result.”
Costs and insurance
Cyst removal is covered by Japan’s public health insurance. Surgical fees are set nationally and depend on the cyst’s longest diameter and where it is on the body. The amounts below are the patient’s 30% share, the standard copay for most adults enrolled in Japanese health insurance.
| Longest diameter | Your 30% share |
|---|---|
| under 2 cmunder 0.8 in | about ¥4,980 |
| 2 to under 4 cm0.8–1.6 in | about ¥11,010 |
| 4 cm or more1.6 in or more | about ¥15,030 |
| Longest diameter | Your 30% share |
|---|---|
| under 3 cmunder 1.2 in | about ¥3,840 |
| 3 to under 6 cm1.2–2.4 in | about ¥9,690 |
| 6 to under 12 cm2.4–4.7 in | about ¥12,480 |
| 12 cm or more4.7 in or more | about ¥24,960 |
Surgical fee only, calculated at ¥10 per insurance point. The amount differs if your copay rate is not 30%.
Other costs
Depending on your condition and the care you need, the following are added to the surgical fee:
- Consultation fee (first or follow-up visit)
- Pre-operative blood test
- Pathology (microscopic examination of the removed tissue)
- Wound care after surgery
- Local anesthetic and medications, such as antibiotics or pain relievers
- Ultrasound, if needed
With these included, the total out-of-pocket cost is usually somewhere between a few thousand yen and the ¥20,000s, depending on size, location and tests. We explain the estimated cost at your consultation.
Enrolled in Japanese health insurance
If you are enrolled in National Health Insurance or an employer health plan in Japan, the fees above apply. Bring your health insurance card, or your My Number Card if it is registered for health insurance use.
Cyst removal may also qualify for a surgical benefit under Japanese private medical insurance. Check with your insurer. We can prepare a medical certificate if your insurer requires one.
Not enrolled in Japanese health insurance
A different fee schedule applies if you are not enrolled in Japanese health insurance. We will explain the approximate cost at your visit.
If you have travel or overseas health insurance, you usually pay at the clinic and then file a claim with your insurer. Check what your plan covers before your visit, and tell us in advance if you need documents for a claim.
Your visit, step by step
Consultation
The doctor checks the lump’s size, location and any inflammation.
Tests, if needed
Ultrasound may be used to look inside the lump.
Treatment plan and cost
We explain the technique, the expected number of visits and the estimated cost.
Local anesthesia
The area is numbed with an injection of local anesthetic.
Removal
The cyst is removed together with its sac, using the punch or elliptical technique.
Aftercare instructions
We explain wound care, showering, exercise and when to come back, and prescribe any medication you need.
Follow-up
If stitches were used, they are removed at a later visit. We may also ask you to come back so we can check how the wound is healing.
- Japanese health insurance card, or My Number Card registered for insurance use
- Your medication record (okusuri techo) or a list of medications you take
- A referral letter, if you have one
- Clothing that makes the area easy to reach
What is an epidermoid cyst?
An epidermoid cyst is a benign (non-cancerous) growth. A sac-like structure forms under the skin and gradually fills with keratin and sebum. Cysts can appear almost anywhere, including the face, behind the ears, the neck, back and buttocks, and some have a small dark opening in the center. The exact cause is not fully understood, but they are thought to form when cells from the surface layer of the skin end up beneath it.
Cysts are usually painless at first, so they are easy to leave alone. They are unlikely to disappear on their own and tend to grow over time. A cyst that becomes inflamed turns red, swollen and painful, and treatment can then take longer. A cyst is generally easier to remove neatly, with a smaller scar, while it is small and not inflamed.
The approach also depends on where the cyst is. We see cysts on the earlobe, back, buttocks, groin and genital area, among other places. Please feel free to consult us about lumps in areas that may feel awkward to talk about.
Swollen and painful? Inflamed cysts
A cyst that becomes red, warm and painful is called an inflamed cyst. This is usually caused by the cyst’s contents leaking into the surrounding skin and triggering an inflammatory reaction (a foreign-body reaction), rather than by a bacterial infection.
Even when a cyst is inflamed, we examine it and aim to remove it completely at that visit whenever possible. If the inflammation is too strong for complete removal, we first open and drain the cyst to calm it down, then remove the sac at a later visit. When a cyst can be removed in one procedure, healing tends to be quicker and a second operation is needed less often.
Surgical techniques
With either technique, the sac has to come out completely. Leaving part of it behind can cause the cyst to return. Both are done under local anesthesia as insurance-covered day surgery.
Punch technique
A small cylindrical blade is placed over the cyst’s opening to make a hole a few millimeters wide. The contents and the sac are removed through it. In some cases the wound is left to heal without stitches.
Elliptical excision
The skin over the cyst is cut in a narrow leaf shape, and the sac is removed whole while the surgeon can see it. The wound is then closed with stitches. This is the traditional technique.
| Item | Punch technique | Elliptical excision |
|---|---|---|
| Wound size | A few millimeters | About the diameter of the cyst |
| Stitches | Not always needed | Needed |
| Procedure time | Shorter | Somewhat longer |
| Recurrence risk | Somewhat higher if part of the sac remains | Lower |
| Best suited to | Small cysts with little inflammation | Large, adherent, previously inflamed or recurrent cysts |
Neither technique is scar-free. The final result depends on the location and your skin. We choose the technique after examining the cyst’s size, location, inflammation and any history of recurrence.
After surgery
You may feel a dull ache once the anesthetic wears off. In most cases the prescribed pain reliever is enough to manage it. Mild swelling or bruising can appear for a few days and usually fades over time. Keep the wound covered as instructed, and avoid picking at scabs or rubbing the area.
These timings vary with the location, size and whether stitches were used.
Pathology
When needed, the removed tissue is sent for pathology to confirm the diagnosis and rule out conditions that look similar. Results are explained at a follow-up visit. Pathology is billed separately under insurance.
Possible side effects and risks
Pain after the anesthetic wears off, swelling and bruising, bleeding, wound infection, a visible scar, and recurrence, particularly in cysts that were inflamed or stuck to surrounding tissue.
Frequently asked questions
Medically reviewed by
Yoshihisa Suzuki, MD, PhD
Director, Kamogawa Clinic · Board-certified plastic surgeon
Dr. Suzuki graduated from the Kyoto University Faculty of Medicine and holds a PhD in medicine. He has served as Chief of Plastic and Reconstructive Surgery at the Kyoto University Graduate School of Medicine and as the first Specially Appointed Professor in the Department of Plastic Surgery at Shiga University of Medical Science. He specializes in epidermoid cysts and underarm odor (axillary osmidrosis), performing insurance-covered day surgery, and practices community medicine in Tenroku, Osaka, with the aim of helping patients get back to their everyday lives.
Hours and access
| Time | Mon | Tue | Wed | Thu | Fri | Sat | Sun/Hol |
|---|---|---|---|---|---|---|---|
| 10:00 AM – 1:00 PM | ●Open | ●Open | ●Open | ●Open | ●Open | ●Open | –Closed |
| 2:30 PM – 4:30 PM | –Closed | –Closed | ●Open | ●Open | –Closed | ●Open | –Closed |
| 4:30 PM – 7:00 PM | ●Open | ●Open | ●Open | ●Open | ●Open | ●Open | –Closed |
〒530-0041 大阪府大阪市北区天神橋6丁目3-16 朝日生命天六ビル2階
06-6809-6088 within Japan
By train
Leave the station by Exit 3, inside the Osaka Municipal Housing Information Center, and turn right. Walk about 50 m (55 yards) along the sidewalk to the Asahi Seimei Tenroku Building, which has a France Bed store on the first floor. The clinic is on the second floor.
By car
Paid parking is available nearby, including in the amusement facility across the street.
Have a lump checked while it’s small
Call us or message us on LINE. We can also tell you whether same-day surgery may be possible.