Dermatology -Scalp or Pilar Cyst Removal

Pilar cyst (also known as a trichilemmal cyst) is a benign (non-cancerous) cyst that most commonly occurs on the scalp. It arises from the outer root sheath of a hair follicle.

Commonly found on the scalp, but they can occur elsewhere.

They appear as Firm, round, and smooth lumps under the skin.

They are usually non tender unless infected.

It can vary from a few millimetres to several centimetres.

Generally slow-growing.

Filled with keratin (a protein found in skin, hair, and nails).

Believed to be genetic, with an autosomal dominant inheritance pattern. You might have noticed that one of your parent or grandparents had these cysts

More common in middle-aged adults, especially females.

Associated with hair follicles, unlike epidermoid cysts, which come from the skin surface.

Often diagnosed based on appearance and location.

A definitive diagnosis can be made through histological examination if the tissue is removed.

Treatment:

Not always necessary unless the cyst becomes painful, infected, or cosmetically bothersome.

You need to see a doctor if there is

1. Rapid growth.
2. Pain, redness, or signs of infection.
3. Changes in the cyst’s appearance.

Surgical removal is the most effective treatment and as these cysts are well-encapsulated.

The cyst removal can be done as an office procedure under local anaesthesia. It involves numbing the area of the cyst with a local anaesthetic injection. Making a small incision and removing the cyst completely, hence, recurrence is uncommon. And closing the incision site with dissolvable sutures which do require to be removed

The specimen is sent for histology

You can wash your hair after 24 hrs

Simple analgesics such as Panadol or Nurofen are sufficient for post procedure pain