Pilar cysts, also known as trichilemmal cysts, are benign (noncancerous) growths that typically develop on the scalp in the root sheath of hair follicles. About 10% of the population develops pilar cysts, which occur most often in women. If you’re bothered by a pilar cyst, minor surgery can remove it.
What Are Pilar Cysts?
Pilar cysts are fluid-filled sacs that occur when the outer layer of the hair root sheath produces keratin, a protein found in hair, skin, and nails. The keratin builds up within the hair follicle, creating a smooth, round bump under the skin.
Although these cysts are relatively rare, affecting less than 10% of the population, they are the most common type of skin cyst. They can appear anywhere on the body, but pilar cysts most often develop on the scalp.
Pilar Cysts vs. Sebaceous Cysts
People commonly confuse sebaceous and pilar cysts, but the 2 types of growths have several differences.
- Origin: Pilar cysts develop from hair follicles, while sebaceous cysts form when sebum, an oily substance produced by the sebaceous glands, builds up and blocks the glands.
- Location: Because pilar cysts develop in hair follicles, they occur most frequently on the scalp. Sebaceous cysts can appear anywhere on the body.
- Appearance: Pilar cysts are round, smooth, and firm and can become quite large. Sebaceous cysts are tiny domes with a small opening that oozes sebum if squeezed.
You can read more about different skin cysts in our previous blog post.
Who Is Prone To Getting Pilar Cysts?
The exact cause of pilar cysts is not fully understood, but risk factors make some people more likely to develop them. For example, they’re more common in middle-aged women. They also tend to run in families, so genetics plays a role in who develops them. Injuries to hair follicles may also increase the risk of cysts forming.
What Happens If a Pilar Cyst Pops?
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. If the cyst pops on its own, you may notice a thick, white, or yellow pasty substance. The area can also become painful and swollen.
If a pilar cyst pops and you experience infection symptoms, such as a fever or pain at the cyst’s site, you should see a doctor.
Pilar Cyst Treatment Options
A physician can diagnose the growth during a physical examination. You have several treatment options if the pilar cyst bothers you or is unsightly.
These options include:
- Surgical excision: Removing a pilar cyst is a minor surgical procedure. The doctor numbs the area with a local anesthetic, makes an incision directly over the cyst, removes it, and closes the incision with sutures. Our Royal College-certified plastic surgeons minimize incisions to leave the smallest possible scars. Surgical removal is the most effective treatment for pilar cysts.
- Punch excision: Our surgeons can use a punch biopsy tool to remove smaller pilar cysts. This method leaves a smaller scar but may not be suitable for large cysts.
- Laser treatment: Some dermatologists use laser therapy to destroy the cyst wall. It can be an effective option for smaller cysts.
Can Pilar Cysts Be Removed Without Surgery?
While surgical excision is the most effective treatment for pilar cysts, some nonsurgical options may help manage symptoms or reduce the size of the cyst. Applying a warm compress promotes drainage and lessens inflammation. Corticosteroid injections can also help reduce inflammation and shrink the cyst, but they won’t completely remove it. Some over-the-counter creams containing salicylic acid or tea tree oil may help with inflammation, but their effectiveness is limited.
We can remove smaller cysts that aren’t infected using a less invasive method. This technique involves making a smaller incision and draining the cyst’s contents. It is usually a temporary solution, as the cyst will likely refill unless you remove the wall.
How To Minimize the Risk of Pilar Cysts
Although you cannot prevent a pilar cyst, you can reduce your chances of developing one by keeping your scalp clean and avoiding harsh hair treatments. Regularly checking your scalp helps you detect developing cysts early. It’s also helpful to reduce stress, which often triggers skin conditions, including the development of cysts.
If you’re bothered by a pilar or sebaceous cyst and want to learn more about your treatment options, request a consultation using the online form to meet with one of our plastic surgeons. Or call us at (416) 663-9649 to schedule an appointment.
Leave a Reply