How to Get an Epidermoid Cyst (Atheroma) Removed in Tokyo: Steps, Costs and Insurance

Introduction

You may have a lump under your skin and been told — or suspect after researching — that it could be an epidermoid cyst (粉瘤 / atheroma). You are living in or visiting Japan and would like to have it removed at a Japanese clinic. This article is written for people in that situation. Using IC Clinic Tokyo, located near Tokyo Station, as an example, it explains what to expect at your appointment, the conditions under which same-day surgery may be possible, an overview of costs, and how Japan’s public health insurance works.

Here is a summary of the key points:

• Epidermoid cyst removal is covered by Japan’s public health insurance (National Health Insurance, employee health insurance, etc.) if you are enrolled. Eligibility will be confirmed by the doctor at your appointment.
• Your out-of-pocket share depends on your age and income. For most working-age adults it is 30%. At the 30% co-payment rate, a typical total — including consultation, examination, surgery, and pathological tissue testing — is generally around ¥10,000–¥15,000 (tax included; varies by site and size).
• Same-day, outpatient surgery may be possible if the doctor finds no issues at your consultation (subject to appointment availability and your condition).
• You do not need to speak Japanese. Appointments can be made through our English-language booking form.

What Is an Epidermoid Cyst? (What You Should Know Before Your Visit)

An epidermoid cyst is a benign lump that forms when a sac develops beneath the skin and fills with keratin and sebum. It rarely disappears on its own. Left untreated, it may grow larger or become an inflamed cyst — red, swollen, and painful — if bacteria enter. Inflammation can be managed with antibiotics, but as long as the sac remains, the cyst is likely to recur. Surgical removal of the sac itself is therefore necessary to eliminate the lump. Please do not try to squeeze or pierce it yourself, as this can cause infection or adhesion.

Whether a lump is an epidermoid cyst is determined by the doctor at your consultation, and the removed tissue is as a rule sent for pathological examination.

How Your Visit Works (IC Clinic Tokyo)

1. Booking: Use the English booking form (https://ic-clinic.com/en/reservation/tokyo/) to choose a date, time, and symptom category. Appointments are prioritized; walk-ins may face longer wait times. If the lump is red, swollen, painful, or has ruptured, please note this in the form.
2. Reception: Your insurance eligibility will be confirmed using your My Number health insurance card or eligibility confirmation document (if enrolled). Please bring your residence card or passport for identification. An English-language medical questionnaire will be provided.
3. Consultation: The doctor will examine the lump and perform any necessary tests such as ultrasound imaging. You will receive an explanation of whether it is an epidermoid cyst, the proposed surgical method, whether same-day surgery is possible, and an estimated cost. Communication with staff and the doctor will be conducted in English using a translation application.
4. Surgery: If same-day surgery is deemed appropriate, it will proceed under local anesthesia. If a separate date is preferred, a surgery appointment will be scheduled.
5. Payment: Payment for insurance-covered treatment is by cash (Japanese yen) only. Electronic money and QR code payment are not accepted.
6. Post-operative instructions: You will receive guidance on wound care and, where suture removal or a follow-up visit is required, information on scheduling.

When Same-Day Surgery May Be Possible

The doctor will assess your individual situation and, if there are no particular concerns, surgery on the same day as your consultation may be possible. Small cysts of a few millimetres can often be removed in around five minutes; larger ones are generally completed within around twenty minutes. For cysts of a certain size, surgery may be scheduled for a separate day after the initial consultation.

If the cyst is severely inflamed — red, swollen, and very painful — it may be better to drain the abscess and reduce the inflammation on the day of your visit, with the removal surgery performed at a later appointment. Inflamed cysts may require prompt attention, so please contact us as soon as possible. If the cyst has ruptured before your visit, gently clean the area with water, apply gauze, and do not attempt to squeeze out the contents.

Surgical Methods: Punch Excision and Elliptical (Fusiform) Excision

There are two main surgical approaches for epidermoid cysts.

• Punch excision (minimal excision technique): A small punch hole is made over the cyst, the contents are expressed, and the deflated sac is then pulled out. This method typically results in a smaller scar.
• Elliptical (fusiform) excision: The skin is cut in an elliptical shape, the cyst is removed together with its sac, and the wound is sutured. For larger cysts or those that have been inflamed, this approach tends to result in a better post-operative course.

The doctor will recommend the appropriate method based on the location, size, and presence or absence of inflammation.

Costs and Japan’s Public Health Insurance

Conditions for insurance coverage: If you are enrolled in Japan’s public health insurance, epidermoid cyst removal is covered as an insured treatment. Eligibility does not depend solely on your residency status; you must have completed the enrollment process through your local municipality or employer. Insurance eligibility is confirmed at reception using your My Number health insurance card or eligibility confirmation document.

Your co-payment rate: This varies by age and income. For most working-age adults, the standard rate is 30% of the medical fee.

Estimated costs (at 30% co-payment): A typical total including consultation, examination, surgery, and pathological tissue testing is generally around ¥10,000–¥15,000. The amount varies depending on whether the site is exposed or non-exposed, the size, and the location. Consultation fees, prescription fees, and examination costs are charged separately. Estimated surgery fees by size and site are listed on the IC Clinic Tokyo epidermoid cyst page.

If you do not have Japanese health insurance: Patients who are not enrolled in Japan’s public health insurance — such as those on a short-term visit — are also welcome. In this case, the full amount (100%) is payable based on the same medical fee schedule. A cost estimate will be provided before treatment begins. If you intend to claim reimbursement from overseas travel insurance, we can issue a receipt and, upon request, an English-language medical certificate (¥5,500 tax included per document; available by post).

Payment method: Insurance-covered treatment must be paid in cash (Japanese yen).

Post-operative Care

• On the day of surgery, please avoid bathing, alcohol, and strenuous exercise, as there is a risk of bleeding. From the following day, you may shower and wash the wound gently with soap. Avoid soaking in a bathtub or swimming pool for approximately one week; showers only during this period.
• Bandages or wound dressing films may generally be removed after one to two weeks once the wound has closed and there is no bleeding. As this varies by individual, please check with the doctor at your follow-up visit.
• Where sutures are placed, removal is typically around two weeks after surgery. The treating doctor will advise you on timing at the time of your procedure.
• Please contact us promptly if you experience persistent pain at the wound site, fever, ongoing swelling or warmth, or any discharge from the wound.

FAQ

Q1. I am not enrolled in Japanese health insurance. Can I still receive treatment?

A. Yes. You will be charged the full amount (100%) based on the same medical fee schedule as insured treatment. An estimated cost will be provided after your consultation and before surgery.

Q2. I do not speak any Japanese. Is it all right to come on my own?

A. Yes. Reception, consultation, and post-operative explanations are conducted in English using a translation application, and English-language medical questionnaires and consent forms are available. Please note that telephone inquiries are handled in Japanese only, so please use the English booking form to make your appointment.

Q3. I take blood-thinning medication. Can I still have surgery?

A. Depending on the medication, surgery may not be possible without stopping it for a certain period beforehand. Whether you are able to pause the medication must be confirmed with the medical institution that prescribed it. Please be sure to inform us of any medications you are taking, either on the booking form or at reception.

Supervising physician: Kota Takakuwa, M.D., IC Clinic Tokyo