Dermatology/eruptive vellus hair cysts
Plain and simple, what is the best way to get rid of EVHC other than surgery?
Twenty-five percent of eruptive vellus hair cyst (EVHC) cases resolve spontaneously through transepidermal elimination.
Keratolytic treatment is as follows:
Clinical benefit was reported after gentle mechanical dermabrasion with an exfoliating sponge (eg, Buf Puf, 3M; St. Paul, Minn) followed by an application of 10% urea cream.
Significant clinical improvement resulted in one case with 12% lactic acid applied to the affected areas.
Retinoid treatment is as follows:
Topical tretinoin applied nightly to the affected area is a reasonably safe treatment option. This method reportedly cleared a case of congenital EVHC after only 5 applications, leaving only a slight residual erythema that gradually faded.
Topical tazarotene cream 0.1% applied to the affected area was shown to be more effective than some surgical options for the treatment of EVHC.
Oral isotretinoin at 1 mg/kg/d produced no improvement in one patient after 20 weeks of therapy.
Systemic vitamin A therapy (100,000 IU/d) has also been tried; however, this also produced no clinical improvement and resulted in severe headaches requiring discontinuation of therapy.
Calcipotriene treatment has been reported. A single case report showed a partial response of EVHCs after a 2 months treatment course with topical calcipotriene.
Lazer therapy has been also shown to be effective.