What Is a Dermoid Cyst?
A dermoid cyst is a benign, congenital lump that forms beneath the skin during early development, most often along the lines where the face and skull fuse in the womb. They are present from birth, though they may not become noticeable until later in infancy or childhood. The most common site is the outer edge of the eyebrow, but they can also occur on the scalp, nose, and in the midline of the face or neck.
Dermoid cysts are slow-growing and almost always benign. They are not a form of skin cancer. However, they can occasionally become infected, and midline lesions — particularly on the nose or scalp — very occasionally have a deeper connection that needs to be excluded before surgery.
Why Removal Is Usually Recommended
- Dermoid cysts do not resolve on their own and tend to grow slowly over time
- They carry a small but persistent risk of infection or rupture, which can make later surgery more complicated
- Removal while a child is young and the lesion is small usually gives the best cosmetic outcome and the least noticeable scar
- Confirming the diagnosis by removing and examining the lesion provides reassurance for the family
Assessment & Imaging
Most dermoid cysts at the eyebrow can be diagnosed clinically and removed without further investigation. For lesions in the midline of the nose, scalp or forehead, an ultrasound scan is typically arranged first, with MRI reserved for cases where there is any suggestion of a deeper connection to underlying structures. This is a routine precaution taken to plan surgery safely, not an indication that anything more serious is suspected.
The Procedure
Dermoid cysts are removed surgically, usually under general anaesthetic in children, through a small, carefully placed incision designed to leave the least visible scar — often hidden within the eyebrow or a natural skin crease. The cyst is removed intact along with its lining to minimise the chance of recurrence. Surgery is typically a day case, with the child going home the same day.
Recovery
Most children recover quickly, with mild swelling and bruising settling over one to two weeks. Dissolvable sutures are commonly used. Normal activities can usually resume within a few days, with any strenuous play or sport avoided for a short period as advised at the post-operative review.
Risks
Uncommon if the full cyst and lining are removed.
Incisions are placed to minimise visibility; scars usually fade well in children.
Uncommon; more likely if surgery is delayed and the cyst becomes infected first.
Temporary numbness near the incision can occur and usually resolves.