By Gary M. White, MD

Eruptive vellus hair cysts

Eruptive vellus hair cysts represent multiple small cysts containing vellus hairs usually in the anterior chest of a young person. Familial EVHCs occurs with AD transmission. Rare cases have been associated with ectodermal dysplasia, pachyonychia congenita, and Lowe syndrome.


Multiple, tiny, 1-3 mm., blue-black papules occurring on the anterior chest in a child or young adult is characteristic of eruptive vellus hair cysts. There may be overlap with steatocystoma multiplex as vellus hair containing cysts with sebaceous glands have been reported. Rarely, EVHC may present as multiple papules about the eyes [PD 2002;19;26].


No treatment is needed and spontaneous resolution may occur. Various topical medications have been used including tretinoin 0.05-0.1% cream, 10% urea, 12% lactic acid, and 0.1% tazarotene. Other treatment modalities include excision, curettage, needle evacuation, incision and drainage, dermabrasion, and laser therapy, but there are chances of scarring and recurrences. The CO2 laser has been recommended as being fast and bloodless [Derm 1991;183;294]. The Erbium:YAG laser has been used.

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