Epidermal cysts that have not previously ruptured can be excised easily and completely under local anesthesia. Epidermal cysts on the face may rupture and lead to scarring. Cosmetic considerations of elective surgical excision must be weighed against scar formation resulting from rupture. Such lesions are far more difficult to remove once they have ruptured. Recurrent epidermal cysts that have previously ruptured and scarred are best excised along with the surrounding scar once the inflammation has subsided. Asymptomatic epidermal cysts occurring elsewhere do not require treatment.