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Pilar Cyst

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What is Pilar Cyst?

This medical condition is a growth that usually just below the skin commonly on your scalp but can appear anywhere on your skin. The reason that they are most commonly found on your scalp is because they develop from follicle roots which are in abundance on your scalp. Most of these cysts are benign, which means non-cancerous but at the site of the cyst they can have aggressive growth. It is very rare that they become cancerous. Another name for a pilar cyst is a Trichilemmal cyst or a sebaceous cyst. It has also been referred to as wens. A pilar cyst contains a fibrous protein called keratin, which is a component of your hair and skin.


This type of cyst appears in five to ten percent of the population with the individual having one or more of them and although they can appear at any age, in both males and females, and any race they are most commonly found in women of middle age. They can also be visible in young people who are going through hormonal changes or have just attained puberty. It is rare to see these cysts in children.

A pilar cyst is derived from your hair follicles and is an outgrowth of your hair follicle which is called a trichilemma. This is the outer sheath of the root of your hair.

Pilar Cyst Symptoms

Most of the people who have a pilar cyst do not have any negative effectives from the cyst nor do they usually have any pain or tenderness, unless they rupture. Pilar cysts are usually asymptomatic, which means a person does not have any symptoms but these types of cysts do have certain characteristics such as they:

  • Are usually moveable bumps under your skin that are smooth but they can also be firm-feeling.
  • Can become quite large
  • May be tender to the touch
  • Are filled with soggy keratin
  • Are flesh-colored or white in color
  • Are dome shaped
  • Can range in size from one to five centimeters.
  • Can appear red if there is an infection due to a rupture
  • Can have a foul smell if it has ruptured and there is pus oozing out.
  • It can also be itchy and make a person want to continually scratch their head.

There can also be more than one in the area. A person may also show hair loss that can range from mild to moderate but it is rare that a person will have a bald spot on their scalp due to a pilar cyst.

Pilar Cyst Causes

One of the causes of having a pilar cyst is hereditary because they can run in families and are inherited from the parents. It is transmitted through the genes. Because a pilar cyst is an outgrowth of the trichilemma, it can turn into one of this cyst if there are big deposits of keratin made in the area in a short amount of time. Other causes may include:

  • Having a sebaceous gland becomes obstructed or blocked in some way. This is the gland that produces sebum that is used to waterproof and lubricated your hair and scalp and is a waxy/oily matter.
  • Having an inflamed hair follicles.
  • Having an injury to the skin, especially on the scalp, that can lead to keratin accumulating in the area.
  • Improper hair care.
  • Excessive production of testosterone can be a major cause which is why pilar cyst is often found in males who have just achieved puberty.

Pilar Cyst Treatment

Most of the time a pilar cyst will not require any treatment because they are usually small and will go away on their own within a couple of weeks but if it becomes infected or ruptures you need to see your physician or dermatologist as these can lead to tenderness and pain in the area of the pilar cyst. If you have an infected pilar cyst, which is rare, you will usually be given oral antibiotics to get rid of the infection or in some cases you may be prescribed topical antibiotics. If the pilar cyst is chronically infected or ruptures the treatment that is required may be more permanent which would be to surgically removing them.

If you want to treat a pilar cyst at home that is not infected or has not ruptured you can try either of these two methods.

  • You can shampoo your hair or use gels that are designed specifically for the removal of cyst. The shampoo or gels should contain herbal ingredients as these ingredients are quite effective in treating this type of scalp problem.
  • You can also use heat therapy such as warm compresses.

One thing that you need to make sure that you do not do is squeeze a pilar cyst and get it to pop open because this can lead to infection. You should also not try to drain the cyst yourself. If the pilar cyst needs to be drained let a professional do this procedure because they know how to properly drain the keratin out of the cyst.

Removal

Having a pilar cyst removed is a minor surgical procedure and will only require a local anesthetic. The dermatologist or physician will make a small incision that is just big enough to remove the pilar cyst intact which also includes the wall or capsule of the cyst and then they will close the wound using one or two sutures. This surgical procedure can take from ten to fifteen minutes to perform. A person may have a small scar after having the pilar cyst removed. There also may be times that even after removing the cyst it will re-grow gradually in the same area under the scar.

Pilar Cyst Pictures

Pictures collection of Pilar Cyst…

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  1. I have had a cyst on my head for over 2 years now and its got to the size of a peach stone. I can feel it move with fluid. However, now I’m getting a much larger one and I’m afraid that there both going to get too large and people will begin to notice so can I ask to have them surgically removed? Anyone with any answers please let me know. Thank you in advance

  2. Hi Jill, sorry to hear but both my sister and I have Pilar cysts. We both have had some of them removed. It is a simple procedure if you go to a dermatologist to remove it. Surgeons can remove it but they gave me general anesthetic. The dermatologist uses local. The one removed by the surgeon was more painful and the opening was larger with more stitches. It also cost more for the removal. The dermatologist removed it in her office and I only paid a copay. She used 2 stitches to close it. It could grow back but if they remove the sack/walls, It probably wont. I hope this helps you. Good luck.

  3. I have many of these and have had one removed. You can have these removed, let the doctor know that it is painful and it drains at times. This will help you get it approved for removal.

  4. Yes, have them surgically removed by a dermatologist. I have had a number of them removed and it is a very easy procedure…a little strange knowing they are working on your head & pull this gooey thing out, but they numb the area, so no pain, just the gentle tugging to loosen the cyst. I have a few more, but just haven’t made an appointment yet, but am concerned they may show soon. So will have to do this after the holidays. Good luck & know that I don’t like any kind of surgery, but my dermatologist was very gentle. Hope yours is too.

  5. I just had three removed from my scalp and the third was done today. Two of them were starting to poke through my hair so I figured it was time to have the dermatologist remove them. One was removed every two weeks to lower the risk of infect. The nurse would numb the area and the doctor would surgically remove in office. Typically took approximately 45 for each one of mine. I also had external and internal stitches. Not to much afterwards. Good Luck

  6. I just had mine removed. It took about 10 minutes for the numbing medicine to work and about 5 for the doctor to remove it. It had been in my head about 10 years but had begun to grow. On a side note about two days after removing it my lymph nodes in my scalp and neck were so swollen and painful that I had to go back. The nurse removed the stitches but no sign of infection in the wound. Two days on antibiotics and I woke up to wet hair. The cyst removal site had begun draining nasty gunk. Just be aware that there is a risk. The nurse said it’s really unusual, but it can happen.

  7. Hi Jill, if it bothers you, have a nicely rated dermatologist remove it for you. Check out youtube videos to get an idea what the procedure will be like for you. As a bonus, some of the tissue will be sent to a lab to determine the nature of the cyst with a resulting pathology report. Good luck!

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