Mr. Onur Gilleard
Qualifications & Experience
Mr Onur Gilleard is a distinguished consultant plastic surgeon on the GMC specialist register. He previously held an NHS consultant post at St Bartholomew’s Hospital in London, specialising in skin cancer and microsurgical reconstruction. In 2021, Mr Gilleard transitioned from the NHS to dedicate himself fully to private practice, allowing him to focus exclusively on providing personalised, high-quality care to his patients. He is recognised as an expert in laser treatments, having conducted research and developed advanced treatment protocols using cutting-edge laser technology to optimise both clinical outcomes and cosmetic results.
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The capsule is the sac wall of a cyst — and it’s the reason cysts come back. This thin lining produces
the keratin that fills the cyst, so if it’s left behind after draining or an incomplete removal, the cyst simply refills.
The only way to clear a cyst permanently is to remove the entire capsule in one piece, which is exactly what surgical
excision does.
What the Capsule Is and Why It Forms
A sebaceous (epidermoid or pilar) cyst is a closed sac under the skin. Its wall — the capsule — is made of living skin
cells that continuously shed keratin into the centre, which is what makes the lump grow over time. The capsule forms when
skin cells become trapped beneath the surface, often after minor trauma, a blocked follicle or a previous skin condition.
Because the capsule is self-sustaining, the cyst won’t truly resolve while it remains.
What Happens If the Capsule Is Left Behind
This is the crux of cyst treatment. Draining a cyst empties the contents but leaves the capsule, so it
refills — often within weeks to months. Squeezing at home does the same and adds infection risk. Even an incomplete
surgical removal that leaves a fragment of capsule can lead to regrowth. That’s why we don’t excise a cyst while it’s
acutely inflamed: swollen tissue makes it harder to remove the capsule whole. The contrast is set out in
drainage vs surgical removal.
Removing the Capsule Completely
Complete excision removes the capsule intact under local anaesthetic — you can see what that looks like in our
photo guide, which includes an image of a
fully removed capsule. It’s a same-day procedure; the consultation is £100 and straightforward removal
£400. Removing the whole capsule is the single factor that makes the result permanent. See the
cyst removal page for the full procedure.
Questions we are often asked
- What is a sebaceous cyst capsule?
- It’s the sac wall of the cyst — a thin lining of skin cells that produces the keratin filling the cyst. Because it actively generates the cyst’s contents, the lump persists and regrows as long as the capsule remains under the skin.
- Why does a cyst come back after draining?
- Because draining removes the contents but not the capsule. The remaining wall continues producing keratin and the cyst refills, often within weeks to months. Only complete removal of the capsule prevents recurrence.
- Can the capsule be removed without surgery?
- No. The capsule is a physical structure that has to be excised; no cream, compress or injection dissolves it. Surgical excision under local anaesthetic removes it in one piece, which is quick and well tolerated.
- What if a fragment of capsule is left?
- Any retained fragment can regrow into a new cyst, which is why complete, careful excision matters and why operating on inflamed tissue is avoided. A consultant removes the capsule intact to give the lowest chance of recurrence.
More on cyst removal: complete sebaceous cyst removal guide · drainage vs surgical removal
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