What is a Pilar cyst?

A pilar cyst (or trichilemmal cyst) is a common, harmless, flesh-colored bump under the skin, usually on the scalp, filled with keratin (a skin protein) from a blocked hair follicle, forming a smooth, round lump that's often inherited but can also appear sporadically. They are generally benign, don't usually hurt unless ruptured or irritated, and can grow slowly, but a doctor can easily remove them if bothersome.

What are pilar cysts caused by?

Pilar cysts form when old skin cells and keratin (a skin protein) get trapped and build up under the skin, creating a sac, often from a blocked hair follicle on the scalp, and can be spontaneous or hereditary (genetic), commonly appearing in middle-aged women and often running in families. They're not caused by infection, but by a disruption in skin cell turnover, leading to a hard, keratin-filled lump.
 

How do you get rid of a pilar cyst?

To get rid of a pilar cyst (trichilemmal cyst), the most effective method is surgical removal by a doctor, often under local anesthesia, where the entire cyst wall and contents are removed to prevent recurrence. While some temporary relief for inflammation can come from warm compresses or corticosteroid injections, these don't eliminate the cyst; surgical excision is key for permanent removal, though new ones can form.
 

Is it safe to pop a pilar cyst?

Even though pilar cysts have thick walls that make them less likely to rupture spontaneously, they can break open due to injury or if you try to pop them. You shouldn't try to pop them because it increases the risk of infection and scarring.

Can a pilar cyst become cancerous?

Yes, although extremely rare, a pilar cyst (trichilemmal cyst) can transform into a malignant tumor, specifically a Proliferating Pilar Tumor (PPT) or even squamous cell carcinoma, often preceded by a benign proliferating stage. Signs of potential malignancy include rapid growth, ulceration, large size, or changes in consistency, warranting a doctor's evaluation for any unusual or changing scalp growth. 

Pilar/Trichilemmal Cyst: Cyst on the Scalp

What happens if you don't remove a pilar cyst?

When left untreated or inadequately managed, cysts can become inflamed or infected, leading to pain, swelling, and more significant health issues. By opting for sebaceous cyst removal in a Westford provider with a trusted name, you prevent future complications associated with these growths.

When to worry about a cyst on the scalp?

Skin cysts do not need to be treated if they're not causing any problems. But treatment may be recommended if you have: an infected skin cyst – you may be given antibiotics. a large, painful cyst which interferes with everyday life – for example, a cyst on your head that catches when you brush your hair.

Do pilar cysts ever stop growing?

Pilar cysts do not typically go away on their own. They may remain the same size, grow slowly over time, or occasionally become infected. Treatment is usually necessary for removal.

Will insurance pay for pilar cyst removal?

Yes, insurance often covers pilar (or other skin) cyst removal if it's medically necessary (pain, infection, bleeding, obstruction), but usually won't if it's purely cosmetic, though coverage varies by plan, so checking with your provider and doctor is crucial. Expect costs to count toward your deductible, and you'll pay out-of-pocket until it's met.
 

How painful is pilar cyst removal?

Pain after pilar cyst removal is normal, usually mild to moderate discomfort, tenderness, redness, and swelling that peaks in the first few days and gradually subsides as the incision heals, managed with OTC pain meds and proper care like keeping the area clean/dry; however, severe pain, fever, excessive bleeding, or worsening redness/swelling warrants immediate medical attention as it could signal infection or complications. 

How to shrink a pilar cyst at home?

To prevent infection or possible scarring, see your doctor to remove a pilar cyst. Don't try to pop it, stick a needle in it, squeeze it, or cut it open yourself. You can try to use warm compresses to help it drain on its own.

Can I leave a pilar cyst alone?

Epidermoid and pilar cysts are harmless. Small cysts that give no trouble can safely be left alone. Your doctor may give you an antibiotic if your cyst becomes infected. If removal is necessary, both types of cysts may require surgical removal under a local anaesthetic.

Will hair grow back after pilar cyst removal?

Yes, hair usually grows back after pilar cyst removal, often starting within a few months as regrowth can be patchy initially, though it depends on whether the hair follicles were damaged or scarred during removal; proper removal of the cyst sac is key for full recovery and regrowth, but if follicles are scarred, hair might not regrow in that spot.
 

What age do people get pilar cysts?

Sebaceous cysts most commonly occur when you are young or middle-aged. Men get them more than women. Pilar cysts occur in middle age and affect women more than men.

What can be mistaken for a pilar cyst?

Schwannomas are benign peripheral nerve sheath tumors that are rarely found in the scalp and are often overlooked due to their nonspecific clinical presentation. Their resemblance to the common pilar (trichilemmal) cyst may lead to misdiagnosis and unexpected findings on pathology.

What's inside a cyst?

Inside a cyst is a sac-like pocket filled with various substances like fluid, pus, air, or semi-solid material (like skin cells, keratin, or oily sebum), depending on the cyst's type and location, with common examples being watery fluid in ovarian cysts or cheesy keratin in skin cysts. These growths form anywhere in the body and are usually benign (noncancerous), though their contents vary greatly, from joint fluid in ganglion cysts to hair and teeth in rare dermoid cysts.
 

What type of doctor removes a pilar cyst?

A dermatologist is the primary type of doctor who removes pilar cysts, as they specialize in skin conditions and perform minor surgical procedures like excision in their office, though a general surgeon or even a plastic surgeon could also perform the removal, especially for larger or complex cases. The procedure usually involves numbing the area, making an incision, removing the cyst sac, and closing the wound, often with minimal scarring.
 

Can urgent care remove a pilar cyst?

Urgent care centers can provide treatment for cysts, particularly if they become painful or infected. Cysts are fluid-filled sacs that can develop in various tissues of the body due to infections, blockages, or inflammation.

Who is prone to pilar cysts?

Pilar cysts have no known racial predilection, and they occur more commonly in women than in men. Family history may be present since the disease follows autosomal dominant inheritance in some cases.

Can stress cause scalp cysts?

Since stress can aggravate a variety of skin conditions, practising stress management activities such as yoga, meditation and mindfulness can have a positive impact on skin health, thereby reducing the likelihood of developing pilar cysts on the scalp.

What happens if you leave a cyst for years?

For most cysts, the greatest risk of damage comes from the likelihood of scarring. While some cysts may resolve themselves on their own, others resolve themselves in a way that can leave permanent scars on the skin – including post-inflammatory hyperpigmentation, atrophic scarring, and other damage.

What are the signs that a cyst is cancerous?

You can't definitively know if a cyst is cancerous just by looking; the only way to confirm is through medical evaluation, but suspicious signs on imaging (like solid parts, irregular walls, "dirty" fluid) or changes in a lump (rapid growth, pain, bleeding, color change) warrant a doctor visit, potentially leading to a biopsy, which is the gold standard for diagnosis. Most cysts are benign (non-cancerous), but a doctor uses imaging (ultrasound, CT, MRI) and possibly fluid/tissue samples (biopsy) to tell the difference.
 

Why do I keep getting small hard balls on my scalp?

A variety of health issues can cause bumps to form on the scalp, including sweating, folliculitis, acne, head lice, and eczema. Treatment will depend on the cause but may include medicated shampoos, ointments, and other topical products.

How to know if a cyst on the scalp is cancerous?

A cancerous cyst on the scalp often presents as a persistent, non-healing sore, a lump that bleeds easily, changes color/size/shape, or has irregular borders, differing from typical harmless cysts (pilar/sebaceous) which are usually smooth, slow-growing, movable, and lack deep color/bleeding issues. Watch for hard lumps, rapid growth, tenderness, redness, or recurring sores, and see a doctor for any suspicious scalp growth, especially if it doesn't heal or changes over time.