Unusual types of Cysts: Eruptive Vellus Hair Cysts, Part 1 in a Series

THIS IS PART ONE IN A SERIES, AND THE VIDEOS GET BETTER!!

This is the first time I have tried to extract these type of cysts. The reason for this is twofold: 1. This is not a common condition, and I have only personally had a few cases of people with this condition. 2. As you will see this is a time-consuming type of procedure, and would likely not be covered by health insurance. So, if a patient wants a “cosmetic” procedure such as this done which is very time consuming, it will likely be very expensive, and not a reasonable expense for most people.
Well, I chose to do this because I wanted to see if these type of cysts could truly be “popped out” successfully, and I offered to treat these for free if she consented to my videotaping the procedure for you all to learn from and enjoy.
As I write this, she has had 3 sessions, and let me tell you, I’ve gotten much better at removing these little suckers! This is the first session, about 3 months ago, and here you will see me struggling as I was learning how to remove these cysts. I decided not to do too many, because I wanted to see how the areas heal after removal. She has a darker complexion (skin type III/IV), and I know that she will get post inflammatory hyperpigmenation (meaning that areas of skin trauma will turn dark initially and take some time to lighten up). I want the area to look better over time, not worse!
Now, let’s talk about these eruptive villus hair cysts (EVHCs)! They are really interesting! EVHCs appear as multiple and can be in the 100s!, usually 1 to 4mm skin colored or blue grey firm bumps on the chest and upper arms. They usually appear between ages 17 and 24. So, these small cysts contain coiled up vellus hair, which is that fine downy hair that you see in newborns or on the cheeks and temples of adult faces. Treatment is not medically necessary, but the bumps won’t disappear or regress. If we extract them as we do here, there is a chance she won’t get new ones and we can get rid of them.
Remember, this is Part 1 in an ongoing series. You will see me getting better at removing these EVHCs, and it’s pretty amazing to see what they look like under the microscope!

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This video may contain dermatologic surgical and/or procedural content. The content seen in this video is provided only for medical education purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

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