Medical therapy with topical retinoids may be of some benefit. The eruptive vellus hair cysts present as flesh-colored papules found usually on the face, chest, neck, thighs, groin, buttocks, and axillae. They represent an anomaly of the vellus hair follicles and may be hereditary. Histopathology reveals a mid dermal epithelial cyst containing vellus hairs and keratinous material. These cysts may undergo spontaneous regression, form a connection to the epidermis, or undergo degradation with a resultant foreign-body granulomatous formation.
Treatment is often difficult.
Incision and drainage of individual lesions carries the risk of subsequent scarring, and modalities such as CO2 laser ablation are difficult to use over large surface areas. Characteristically, it appears after the administration of topical or systemic corticosteroids, including intravenous and inhaled therapy. The eruption usually resolves after discontinuation of the steroid and, in addition, may respond to the usual treatments of acne vulgaris. Other associated skin findings may include xerosis and pigmentary changes. Internal changes involving the ophthalmic, nervous, and hepatic systems also may occur, and some chloracnegens can be oncogenic.