Pilar Cyst

Last reviewed by Dr.Mary on August 8th, 2018.

What are Pilar Cysts?

Pilar cyst is a type of cyst that is full of semi-fluid content that looks like toothpaste. Growths of pilar cyst usually form from hair follicles which are most often developed on the scalp. These cysts are mobile as well as smooth, filled with soggy keratin that is a protein material found in nails, hair, and skin and they may or may not be tender.


These types of cysts can run in families. Very rarely, these cysts can grow more extensively as well as form rapidly multiplying pilar tumors – proliferating trichilemmal cysts. These are benign or non-cancerous but have very aggressive growth at the site of the cyst. There are very rare cases where the pilar cysts do become cancerous.

Pilar cysts are firm nodules that are flesh-colored developing on the scalp and are easily palpable. The surface is dome-shaped and smooth, and these cysts are often hard to differentiate from epidermal cysts. Pilar cysts can affect anyone but are more common in women who are middle-aged. They can appear anywhere on the skin but more commonly develop on the scalp. It is also common to get multiple cysts to grow at the same time.

Cysts that are large can be cosmetically offensive. Many large cysts are so tender; they can obstruct with wearing helmets or hats. Acute inflammation of these cysts because of a rupture is often mistaken as an infection. Antibiotics have very little value in these cases. Incision with drainage under local anesthesia will help with comfort as well as limit scarring. Excision that is elective before rupture can prevent any complications.

How to prevent Pilar cysts?

It is not possible to prevent these cysts from forming. However, young adults may try regular exercise so as to keep this condition from developing. Exercise helps in managing a hormone balance inside the body and can prevent pilar cyst formation due to an overproduction of testosterone. Also proper and daily hair care can as well avoid any damage to hair follicles.

If there is a family history of these types of cysts, then there is almost nothing that can be done to prevent them from developing.

Treatment

In the majority of cases, these cysts have no significant symptoms, and they don’t need any treatment. With some individuals nevertheless, these cysts become infected or can rupture, causing pain as well as soreness in the area. In these cases, treatment is necessary.

When one or more pilar cysts become infected the typical treatment is with antibiotics that are oral. In other cases, a topical antibiotic can be required. Chronically infected or ruptured cysts need more permanent treatment – that being some form of surgical removal.

Pilar Cyst Removal

The removal of pilar cysts is a surgical process which is minor and requires only a local anesthetic to numb the area that is being worked on. An incision that is just small enough to enable the removal of the intact cyst is made with a scalpel. The keratin material inside the cyst is then removed along with the capsule or wall of the cyst. The wound is cleaned and then closed with 1 or 2 sutures as needed. A small scar may develop. At times a sample of this cyst can be taken to the lab for testing to confirm that it is benign. Pilar cysts that are malignant are such a rarity that in the majority of cases a biopsy is not needed.

There are times after the original removal of a cyst where it can gradually regrow in the same area under the scar. Although unusual, if it does happen, it can again be removed.

Pilar Cyst Pictures

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