For a swollen, painful cyst, a dermatologist can tell whether the lump is a cyst, an abscess or something else, drain or inject it if that's needed, and see you again to follow up. Urgent care can be a reasonable option for a simple, painful abscess when your dermatologist's office is closed. Go to the emergency room if a lump comes with fever or chills, redness that spreads quickly, red streaks, or you feel very unwell. If you think it's an emergency, call 911.
The setting also changes how the visit is billed, explained below without prices, since those depend on your plan.
Dermatologist: identifying the lump, then treating it
Not every lump under the skin is a cyst. Some common possibilities:
- Epidermoid cyst (also called an epidermal inclusion cyst): a slow-growing sac under the skin that can become swollen and tender when it's inflamed
- Abscess: a pocket of pus that MedlinePlus describes as red, raised and painful
- Boil: an infected hair follicle
- Lipoma: a soft, fatty lump that usually moves a little when pressed
- Painful lumps that keep returning in the armpits or groin, which can point to a long-term condition called hidradenitis suppurativa that needs ongoing care
Once the lump is identified, Cleveland Clinic describes several options for an epidermoid cyst:
- Watching it, if it isn't causing symptoms
- An injection into the cyst to bring down swelling for a while
- Antibiotics, if it's infected
- Incision and drainage, a small opening that lets the contents out and eases the pressure
- Surgical removal of the whole cyst, including its wall (Bay Ridge doesn't perform this; see below)
A dermatologist can also plan follow-up, including what to do if the cyst fills up again.
Urgent care: a reasonable after-hours option
Urgent care centers are open evenings and weekends, when many offices are closed, and many can drain a simple abscess. Services differ from center to center, so it's worth calling ahead.
What urgent care may not offer:
- a dermatologist to identify a lump that looks unusual
- planned follow-up for a cyst that keeps coming back
If urgent care drains a lump, ask what they think it was and whether you should see a dermatologist afterward.
Emergency room: signs that need emergency care
MedlinePlus lists signs of a spreading skin infection (cellulitis) that need prompt care, and situations where hospital care may be needed. Go to the ER, or call 911, if a painful lump comes with:
- fever with chills or sweats
- redness or swelling that spreads fast, or red streaks moving out from the area
- blistering over the area, or feeling unusually drowsy or sluggish
- vomiting that won't stop, or feeling very sick
- swelling around an eye
A weakened immune system is another reason MedlinePlus gives for hospital care, so don't wait if that applies to you.
Comparing the three settings
- Dermatologist's office. Suited for: identifying the lump, draining or injecting an inflamed cyst, and planning for a cyst that returns. Follow-up: usually with the same practice. How billing generally works: an office visit plus any procedure, often under your plan's specialist cost-sharing.
- Urgent care. Suited for: a simple, painful abscess when offices are closed. Follow-up: often a referral back to your own doctor or a specialist. How billing generally works: under your plan's urgent care cost-sharing, though a center run by a hospital may bill differently.
- Emergency room. Suited for: fever, fast-spreading redness or feeling very unwell. Follow-up: the ER treats the emergency and usually sends you to your own doctor afterward. How billing generally works: as hospital outpatient care, which usually adds a hospital charge (see the next section).
Why the same drainage can be billed differently by setting
Whether you're in Bay Ridge or anywhere else in Brooklyn, the setting can change what you owe for the same procedure:
- Hospital charges. For people with Medicare, Medicare.gov explains that outpatient care in a hospital setting (its list of hospital outpatient services includes emergency services) usually means paying the hospital a copayment for each service on top of what you pay the doctor, and that you may pay more there than for the same care in a doctor's office. That separate hospital charge is what people mean by a facility fee. With other coverage, how it's handled depends on your plan.
- Different cost-sharing by setting. Many plans set different amounts for a specialist visit, urgent care and the emergency room. Your plan's Summary of Benefits and Coverage, which HealthCare.gov says insurers and job-based plans must provide, is the place to compare them.
- Hospital-run urgent care. Some urgent care centers belong to hospitals. If yours does, ask whether it bills as a hospital outpatient department.
- Paying yourself. If you are uninsured or not using insurance, the federal No Surprises Act gives you the right to a Good Faith Estimate of expected charges, according to CMS. The estimate is tied to care scheduled at least 3 business days ahead, or to a request you make, so with a walk-in or same-day visit there may not be time to get one before you're seen.
This is why we don't list a price here. The total depends on your plan, the setting and what's done at the visit. For a visit at Bay Ridge, check your plan or call the office.
After drainage: why a cyst can come back
Draining a cyst lets out what's inside and eases the pain, but it leaves the cyst's wall (its capsule) in place. Cleveland Clinic notes that because the wall stays behind after incision and drainage, the cyst can come back. Removing the wall is a separate surgical procedure, which Cleveland Clinic describes as taking out the entire cyst under local anesthetic. Individual results vary.
Cyst care at Bay Ridge Dermatology
- Cyst drainage and cyst injections are done in the office. See our in-office procedures.
- The practice treats skin infections.
- Cyst excision (removing the whole cyst and its wall) is not performed here. If it's recommended for you, ask the office about next steps.
- The practice offers same-day appointments. Call to ask about availability for a cyst visit.
- The office is open 9 a.m. to 5 p.m. Monday through Thursday and 9 a.m. to 4 p.m. on Fridays, and closed on weekends. On a weekend, urgent care or the ER are the options, depending on your symptoms.
- Bay Ridge accepts most insurances, including Aetna, BCBS, Cigna, United, Medicare, Oxford, Empire and Humana. Whether a particular procedure is covered is up to your plan; see our insurance page.
You'll find the practice at 515 84th Street in Bay Ridge, with directions on our contact page.
Don't squeeze or lance it at home
Cleveland Clinic advises against popping or draining a cyst yourself, because it can lead to infection and make the cyst more likely to come back. What you can do instead: hold a warm, damp cloth over it for comfort if it's swollen or sore, keep the area clean, and cover it if it's leaking.
When to see a dermatologist
Book a visit for:
- any new lump, so it can be identified
- a cyst that is painful, red, swollen or draining
- a lump that grows quickly or gets bigger than about 5 centimeters (2 inches), a size Cleveland Clinic flags
- a cyst that keeps coming back
- any change in a lump you've had for a while
If a cyst is bothering you, book online or call (347) 497-4984.
This article is general information, not medical advice. For advice about your own skin, see a dermatologist.