Pilar cysts are fluid-filled lumps that develop under the skin, most commonly on the scalp. These cysts are typically benign, meaning they are not cancerous, but they can grow over time and become bothersome. While pilar cysts are usually painless, some may cause discomfort, tenderness, or infection, leading to the need for removal.
Unlike other types of cysts, pilar cysts form from hair follicle cells, which is why they are most often found on the scalp. They are more common in adults, particularly women, and may run in families. While some cysts remain small, others can grow significantly and may require medical attention.
This article explains why pilar cysts develop, when removal is necessary, and what to expect from treatment and recovery. Whether a cyst is causing discomfort or is simply an aesthetic concern, knowing the available options can help in making an informed decision.
What Are Pilar Cysts and Why Do They Develop?
Pilar cysts are benign growths that form under the skin, originating from hair follicle cells. They are most commonly found on the scalp, where hair follicles are densely packed, but they can also develop in other areas of the body. These cysts are usually smooth, round, and firm, often moving slightly when pressed.
Causes and Risk Factors
- Blocked hair follicles – Pilar cysts develop when keratin, a protein found in hair and skin, becomes trapped under the skin instead of shedding normally.
- Genetics – There is evidence that pilar cysts may run in families, making some individuals more prone to developing them.
- Age and gender – These cysts are most commonly seen in middle-aged adults, with women experiencing them more frequently than men.
- Scalp trauma or irritation – Damage to the scalp from injuries, hair treatments, or chronic irritation may contribute to cyst formation.
How to Identify a Pilar Cyst
| Feature | Description |
|---|---|
| Size | Typically 1-5 cm, but can grow larger over time. |
| Location | Most commonly found on the scalp, but may occur elsewhere. |
| Texture | Smooth, firm, and round. Moves slightly under the skin when pressed. |
| Pain Level | Usually painless, but may become tender if inflamed or infected. |
| Growth Rate | Slow-growing over months or years. |
| Appearance | Skin-coloured or slightly yellow. May have a small central opening. |
While pilar cysts are generally harmless, they can become irritating, inflamed, or infected, prompting some individuals to seek medical removal. Dermatologists and surgeons can confirm whether a lump is a pilar cyst and recommend the most appropriate treatment options.
When Is Removal Necessary?
Pilar cysts are benign and often do not require immediate treatment. However, in some cases, removal may be recommended, especially if the cyst is causing discomfort, growing larger, or becoming infected. Treatment options range from watchful waiting to surgical excision, depending on the size and symptoms of the cyst.
Medical vs. At-Home Management
- Monitoring – If the cyst is small and not bothersome, some patients choose to leave it untreated. However, pilar cysts do not disappear on their own and may continue to grow.
- At-home methods are not recommended – Attempting to drain or remove a pilar cyst at home can lead to infection, scarring, or recurrence, as the cyst sac needs to be fully removed to prevent regrowth.
- Antibiotics – If a cyst becomes infected, a doctor may prescribe oral antibiotics to reduce swelling and inflammation. However, antibiotics do not remove the cyst itself.
Surgical Removal and What to Expect
For cysts that are large, painful, or infected, surgical removal is the most effective treatment. A dermatologist or surgeon can perform this quick outpatient procedure using local anaesthetic.
| Surgical Method | How It Works | When It’s Used |
|---|---|---|
| Excision Surgery | The entire cyst and its sac are removed through a small incision. | The most effective method for permanent removal. |
| Incision and Drainage | A small cut is made, and the cyst is drained, but the sac remains. | Used for infected cysts but carries a risk of recurrence. |
| Minimal-Incision Technique | A small cut is made to remove the cyst with minimal scarring. | Suitable for cosmetic concerns. |
Is Pilar Cyst Removal Painful?
- The procedure is done under local anaesthetic, meaning the area is fully numbed, and the patient feels no pain.
- Most removals take less than 30 minutes, depending on the size of the cyst.
- Patients can return home the same day with minimal discomfort.
Aftercare Following Pilar Cyst Removal
Pilar cyst removal is a straightforward procedure, and most patients experience minimal discomfort during recovery. Proper aftercare is essential to ensure smooth healing, reduce the risk of infection, and minimise scarring.
| Timeframe | Healing Stage |
|---|---|
| First 24 Hours | Mild swelling and redness around the incision. Keep the area clean and dry. |
| Days 2-5 | A small scab may form. Some tenderness or bruising may be present. |
| Week 1-2 | Stitches (if used) may be removed. Any redness or swelling continues to fade. |
| Weeks 3-4 | The wound fully closes, and the scar begins to flatten. Scar creams can be used. |
| Months 1-3 | Skin texture and colour even out. Any scarring becomes less noticeable. |
How to Care for the Treated Area
- Keep the area clean and dry for the first 24-48 hoursafter the procedure.
- Avoid touching or scratching the incision site to prevent irritation.
- If stitches were used, follow your doctor’s instructions on when they should be removed or if they will dissolve naturally.
- Apply any prescribed antibiotic ointments to aid healing and prevent infection.
- Avoid strenuous activities that may put pressure on the treated area, especially for cysts removed from the scalp.
Minimising Scarring
While pilar cyst removal is designed to leave minimal scarring, following these steps can improve cosmetic results:
- Use silicone-based scar gels or creams after the wound has fully closed.
- Apply sunscreen if the treated area is exposed to sunlight, as UV rays can darken scars.
- Avoid picking at any scabs that form, as this can cause unnecessary scarring.
Long-Term Outlook and Recurrence Risk
- Once a pilar cyst is fully excised, the likelihood of recurrence is very low.
- If only the fluid is drained but the cyst sac remains, the cyst may return over time.
- Some individuals are prone to developing multiple pilar cysts, especially if there is a family history.
- Routine scalp and skin checks can help detect any new cysts early before they grow larger.
Most patients recover quickly from pilar cyst removal with little to no complications. By following proper aftercare, the treated area heals smoothly, allowing for a quick return to normal activities.
Why Choose City Dermatology Clinic for Pilar Cyst Removal?
At City Dermatology Clinic, our team of experienced dermatologists and surgeons provides expert care for pilar cyst removal, ensuring safe and effective treatment with minimal scarring. Whether the cyst is causing discomfort or is a cosmetic concern, we offer advanced removal techniques tailored to each patient’s needs.
Expert-Led Treatment for the Best Results
- Specialist care from a team including Mr Parviz Sadigh, Dr Jana Torres-Grau, Mr Georgios Pafitanis, and Dr Nicki Bystrzonowski, ensuring precise and professional removal.
- Complete cyst excision to prevent recurrence, using refined surgical techniques for a smooth cosmetic outcome.
- Same-day consultations and procedures available for patients seeking quick and efficient treatment.
- Minimally invasive approach designed to reduce discomfort and promote a fast recovery.
Ensuring a Comfortable Experience
- Local anaesthetic is used to keep the procedure pain-free, with most removals taking less than 30 minutes.
- Post-procedure care includes tailored aftercare guidance to ensure optimal healing and minimal scarring.
- Quick recovery allows most patients to return to daily activities within a few days, with full healing expected in a few weeks.
Pilar cysts are harmless in most cases, but if they become bothersome, infected, or continue to grow, professional removal is the most effective option. At City Dermatology Clinic, our team is dedicated to providing high-quality care, ensuring patients feel confident and informed throughout their treatment journey.
