Don't Let It Get Under Your Skin

by Shelley White
^{(creative writers at http://www.morewriting.co.uk)}

Michael gave Karen a big cuddle. ‘I’m so glad we’ve finally set a date for the wedding, darling,’ he said, covering her face with kisses. ‘I only want to be with you all the time.’

‘Yes. I can’t wait either. July seems a long way off but it’s only six months. We’ve got so much to do before we get married that it’s bound to fly by. You make me feel like a lovesick teenager all over again.’

It was second time round for both of them, but they knew they were made for each other. This time it would be for keeps.

‘Michael, please,’ said Karen, pulling herself free, ‘I can hardly breathe.’

‘That’s your fault for being so gorgeous,’ he said, brushing aside her blonde hair, now streaked with silver and nuzzling her neck. ‘Oh, what’s this on your neck?’

There was a spot on her neck – small, hard and rounded and about the size of a pea.

‘That?’ she said, looking in the mirror and giving it a squeeze. ‘That’s been annoying me for a while. You’d think that now I’m in my fifties, I’d be free of blooming spots.’

It didn’t pop like a normal spot but stubbornly stayed put.

‘Don’t squeeze it. You’ll make it sore.’ Michael rubbed a finger over its smooth surface. ‘You’ve made your skin red, now. Leave it alone and it’ll clear up by itself.’

Over the following weeks, the ‘‘spot’’ refused to budge. In fact, she was convinced it was growing – only very slowly – but it was bigger than when she first discovered it. It didn’t hurt but it was in an awkward place. She felt embarrassed when she imagined people were staring at it but above all, she was determined to be rid of it before the wedding. A pesky spot wasn’t going to spoil her wedding photographs.

‘Michael, I’m worried about this thing on my neck. It won’t go away.’

‘I wish you wouldn’t upset yourself. I think you’re worrying needlessly,’ he said giving her a hug. ‘But if you feel like that, you’d better let the doctor check it out. Go on, make an appointment.’

‘It’s nothing sinister,’ said Dr Steiner after examining her neck. ‘It’s an epidermoid or pilar cyst, sometimes called a sebaceous cyst. They’re very common and can appear anywhere on the skin but develop mostly on the face, neck, chest or upper back. They’re benign and usually don’t cause any harm or problems.’

‘That’s a relief. But will it get any bigger?’ asked Karen, chewing her bottom lip.

‘It might slowly increase in size to reach a few centimetres in diameter but that would happen over many months.’

‘I see.’

Karen mulled this over. She didn’t fancy the prospect of a lump growing in such an awkward place. Worse still, was she still going to have the darn thing when they got married?

‘It may just stay as it is, or even disappear of its own accord.’

Karen felt reassured then, but was curious to know what had caused the cyst to develop.

‘It’s interesting,’ said Dr Steiner. ‘It appears that some cells are usually near to the surface of the skin – cells of the epidermis or cells in hair follicles – find their way into deeper parts of the skin but keep multiplying.’

‘Why do they do that?’

‘Well, you might have had an injury to the skin, or something along those lines. These cells form into a sac and produce the keratin that they’d normally make on the top layer of the skin. The keratin gets soggy and forms into a kind of toothpaste-like material.’

‘Ugh! That sounds disgusting,’ said Karen going pale. ‘I can’t recall having injured my neck, though.’

‘Actually, most epidermoid cysts form for no apparent reason in healthy people.’

‘What about having it removed?’ Karen was eager to be rid of it in time for the wedding.

‘If it’s not bothering you, it’s best to leave it alone. I should warn you, though, that sometimes these cysts can become infected.’

‘I don’t like the sound of that. Then what?’

‘Don’t panic if that does happen. Come back and see me and I’ll decide what the next step is.’

Karen was too busy with planning the wedding over the next few weeks to give the cyst much thought, then one day it started niggling again. It was tender when she felt around it gently with her fingers.

‘Karen, stop messing with your cyst,’ said Michael. ‘It’s all swollen and red.’

‘Hell,’ said Karen, as she examined it in the mirror. ‘Do you think it’s infected just as Dr Steiner warned could happen?’

‘It could be. Maybe see if the infection clears itself over the next day or two.’

No such luck. The cyst and the area around it grew more swollen and painful, even when she wasn’t touching it. At one point, she thought it might burst. She returned to Dr Steiner’s.

‘That looks infected, Karen. You’ll need antibiotics to clear it.’

‘Will that be the end of the cyst, then?’

‘It depends. The infection should clear – the swelling might even start oozing but there’s no telling whether the cyst will disappear. We’ll just have to wait and see.’

The corners of Karen’s mouth turned down.

‘I’m fed up with it. Can’t I have it removed? I’m getting married in a few months. I don’t want this to spoil my wedding.’

‘Married? Congratulations. If necessary, you can have the cyst removed,’ said Dr Steiner, ‘but you’ll have to wait till the infection’s gone and the area’s settled down. I’ll assess the situation then.’

By the time the infection had cleared a couple of weeks later, Karen still had the cyst and a reddish discolouration around it. She felt self conscious and imagined people were looking at it. What if it became infected once more? She didn’t want to go through that pain again and have to try to disguise the swelling. She was determined she wasn’t going to cover up with a scarf at the wedding! There was nothing else for it but to ask for it to be removed.

Dr Steiner was sympathetic. He referred her to the local hospital where a specialist assured her that it was a simple operation to remove the cyst under local anaesthetic. He warned her that she’d have a little scar, but Karen didn’t mind a tiny scar so long as she wouldn’t have the cyst to get infected again. A few weeks later, Michael accompanied her to the hospital and it was removed quite easily. The surrounding skin was ‘numbed’ by injecting some local anaesthetic and a small cut was made over the cyst. The cyst was pulled out and the wound was stitched. Karen felt a little uncomfortable while it was being removed but it didn’t hurt. She was advised to take the rest of the day off work but was fine to go back to work the next day. A week after the operation, the stitches were removed by the practice nurse at Dr Steiner’s surgery. The wound had healed well and Karen felt relieved.

By July, there was hardly a scar at all to be seen on her neck. Everyone said how beautiful she looked in the wedding photographs.