Who, what, where is a Wen?

Mimi: Your boyfriend probably has a sebaceous cyst. The old name was a Wen. Each hair follicle has a sebaceous (oil) gland attached to it. The oil should be poured into the hair follicle and absorbed into the hair shaft to keep the hair shiny and lubricate the skin. If the follicle or pore becomes clogged, several things can happen. If the skin grows over the follicle and the oil just sits there, the oil can freeze and turn into small hard “seeds” called Epstein Pearls. These white dots are not infected. They just sit there and they won’t go away on their own. DO NOT touch them. They must be removed by a professional beautician or dermatologist.

The follicle can become infected with Staph and develop into a boil. You can get infected with P. acnes and turn into an acne pimple.

Or the oil can keep building up and building up and become a sebaceous cyst. These are benign. They do not hurt and can be ignored.

Doctors usually remove the cysts. They cut two lines in an ellipse around the cyst. They remove the affected hair follicle and sebaceous gland. The two incision lines are then brought together and sutured. The result is a scar that sinks below the surface of the skin. The notch is caused by the tissue that was removed. Most doctors prefer to remove the cyst rather than drain it. By removing it completely, it disappears forever. With drainage there is a chance that it will come back. Also, draining the cyst is a complicated and tedious job.

If you are willing to drain a cyst, here are your instructions. DO NOT CUT THE SKIN. The accumulated oil in the cyst will likely have gone rancid and stink. It is not an infection, so it is not necessary to wear gloves. However, since it sucks, I recommend using disposable gloves. Have a plastic bag handy to dispose of the paper. Use paper towels, toilet paper, cotton or gauze. You will need more than you think if the cyst drains. Cysts are usually on the back, so have the “victim” lie down. Massage the cyst to soften the hardened oil. The oil will have turned into a clumpy liquid. It looks like cottage cheese. With your fingers covered in paper, bend your index fingers so that the side of each finger is next to the cyst. Don’t use your fingertips because they are not strong enough and will tire.

Press towards the center of the cyst. Move your fingers to another position and press deeply and firmly. You are trying to find the clogged pore that the oil will escape through. Once a bit of white or yellow “thread” comes out, you know which pore to work on. Keep pressing and changing the position. As the old yellow or white oil tape comes off, continue pressing and wiping it off. You can also rest your thumbs on the sides of your hands and press down with your thumbs. You have to be firm. You can push with your knuckles. Feel the cyst and reach the outer edge of it. Don’t press right where the clogged pore is or you won’t succeed.

Between pressings and cleanings, massage the cyst. When nothing comes out, you probably have a lump of frozen oil. Continue pressing firmly. Beware, when the lump comes out under the pressure of your pressure, it can “explode” like Vesuvius. The stinky goop can shoot 2 feet or even more. Continue pressing and wiping until the bump feels flat. The pressure is uncomfortable for the “victim” but not painful. Wipe the area clean. Since the cyst is not an infection, no special cleaning is needed other than disposing of smelly paper towels in the trash.

After the cyst is drained, it may never come back. Or it can come back repeatedly. So drain it again, whenever it becomes troublesome. If this seems too gross, ask your skin care specialist if they drain sebaceous cysts. Some facialists are not trained in paramedical aesthetics. Some don’t like it or don’t know how to do it. Call until you find someone who’s done this job and you’re not grossed out. The rate will probably be no more than $1.25 per minute. A flat fee can be impossible to calculate because no one knows how long it will take before the job is actually done.