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What is a Pilar Cyst?

By Emma Lloyd
Updated Mar 03, 2024
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A pilar cyst is a type of benign growth which usually forms on the scalp, just below the surface of the skin. These cysts are more common in women than in men, and are more likely to develop in people of middle age or older. Most people with these cysts do not experience any pain, tenderness, or other negative effects, and find there is no need to have the cysts removed.

Pilar cysts are small outgrowths which contain keratin, a fibrous protein which is a primary component of skin and hair. These cysts are derived from hair follicles, and form as an outgrowth of a part of the hair follicle called the trichilemma. This part of the follicle is the outer sheath of the root of the hair. The trichilemma may turn into a cyst if large amounts of keratin are deposited in the area within a short space of time. Because pilar cysts develop from hair follicle roots they are more likely to occur in locations where follicle numbers are high; this is why the cysts are typically found on the scalp.

Up to 10% of the population has one or more of these cysts. Of these 10%, around 70% have more than one cyst. It is not uncommon for someone to have several cysts, but regardless of how many are present, it is very rare for these cysts to cause any negative effects. There have been a small number of cases where a pilar cyst has become malignant, but this is an extremely rare occurrence.

In most cases, these cysts are asymptomatic and do not require any treatment. For some people, however, the cyst may rupture or become infected, leading to pain and tenderness in the area. In such cases, some form of pilar cyst treatment is necessary.

If one or more pilar cysts becomes infected the most common treatment is with oral antibiotics. In some cases, topical antibiotics may be required. Ruptured or chronically infected cysts may require more permanent treatment, which is carried out in the form of surgical removal.

Removal of pilar cysts is a minor surgical procedure which requires only a local anesthetic. A small incision is generally enough to remove the intact cyst, after which the wound can be closed. Sometimes a sample of the cyst may be taken and tested in a laboratory to ensure it is benign. The rarity of malignant cysts means this is a rare occurrence, so in most cases, a biopsy is not necessary.

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Discussion Comments
By anon948557 — On Apr 30, 2014

For those putting off getting your cyst removed because you are afraid of shaving your hair, the dermatologist removed mine without shaving. I have very long hair too. The pain afterwards isn't too bad either. Go get them removed if they're large enough to bother/embarrass you. I wish I had gone sooner.

By needananswer — On Nov 07, 2012

I had a small one on my head about the size of a small green pea. I've been messing with it for a while and it finally popped out today! It was hard and white. Now I have a small hole in my scalp. Do I need to do anything besides put alcohol on it?

By anon233895 — On Dec 09, 2011

Do I have to have the area around the cyst shaved before removing it? This is really the only thing stopping me from doing it (I'm a woman). I have a few but one is definitely bigger than a pea and hurts when I hit it with a hairbrush from time to time.

By anon169484 — On Apr 21, 2011

A pilar cyst is a type of sebaceous cyst. I just had one removed from my scalp yesterday. They numbed the area and I barely felt a thing. They did send my cyst in to be checked for cancer, although cancer in this type of cyst is very rare.

By pharmchick78 — On Nov 12, 2010

@earlyforest -- It's really not recommended that you try to take a pilar cyst off by yourself, even by using reputable sebaceous cyst home treatments.

Since it is so rare for pilar cysts to have any ill effects, most doctors recommend that you leave them alone. However, since you said that yours is bothering you, then you may want to get a doctor to check it out.

What he or she will most likely do, if they do decide that you should have it removed, it to make a small incision in the cyst to drain it. Since the cyst will likely be filled with keratin as well as other material (if it's infected), this may not be the most pleasant experience, but it won't be too painful. More "gross" than painful.

If the cyst is merely infected, then it's more common for the doctor to prescribe oral antibiotics -- that usually takes any infection down, and can shrink the size of the cyst as well.

If the cyst is really very problematic, then the physician may excise it altogether. This is a simple, usually outpatient procedure in which the doctor makes an incision in the skin, removes the cyst, and closes the incision with sutures.

Complications are unlikely, and most people recover without any problem at all.

So to answer your question, no, don't try to do it at home. If it's really bothering you, then go ask your doctor to do something about it.

By EarlyForest — On Nov 12, 2010

If I have a pilar cyst, can I use a sebaceous cyst home treatment to remove it? I've had a huge pilar cyst on the back of my head for years, and I don't think it's infected or anything, but it's really uncomfortable, and I would really like to get rid of it ASAP. I mean, it even makes it difficult for me to sleep sometimes, if the pillow is too hard.

So can I use any kind of home sebaceous cyst removal to get rid of this thing, or do I have to go to the doctor? What do you think?

By rallenwriter — On Nov 12, 2010

I'm so glad I read this article -- I've had a few pilar cysts on my head for years, but I never knew what they were. I though that it was some kind of odd lump, but I was always kind of afraid that it would turn out to be cancer.

I'm really glad that I know now -- this article totally eased my mind. Just to double-check, pilar cysts are a kind of sebaceous cyst, right? That's what it sounds like after reading the article.

Thanks for cluing me in!

By mj000017 — On Jan 11, 2010

I'm 17 years old and i have an inborn couple cyst on my head. Is it dangerous? there were times that it hurts but i can tolerate the pain and also it moves from different place around my head.

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