The definitive treatment for a symptomatic epidermoid cyst is surgical excision. This approach involves complete removal of the cyst wall to prevent recurrence and resolve symptoms. Aspiration or antibiotics may provide temporary relief in case of infection or inflammation but do not eliminate the cyst. Surgical excision ensures that the entire cyst lining is removed, reducing the risk of chronic inflammation or recurrent abscess formation. Partial removal or drainage often leads to cyst recurrence. Thus, complete excision is the only definitive cure for symptomatic epidermoid cysts.

Reference: Bailey & Love’s Short Practice of Surgery, K. George, 27th Edition.