Pilar cysts, also known as trichilemmal cysts, are common benign growths that typically form on the scalp. Understanding these cysts is crucial for both health and cosmetic reasons, as they can sometimes cause discomfort or concern.

What is a Pilar Cyst?

A pilar cyst is a keratin-filled bump that originates from the outer root sheath of hair follicles. These cysts are usually round, firm, and painless, and they often appear on the scalp. Unlike epidermoid cysts, which originate from the epithelium or hair follicle cavity, pilar cysts have thicker walls and are less prone to rupture. Diagnosis is typically made through a visual examination by a dermatologist, but a biopsy may be used to rule out other conditions.

What Causes a Pilar Cyst?

Pilar cysts form when keratin builds up in a blocked skin pore, preventing the removal of sebaceous gland secretions. This buildup leads to the formation of a cyst. They can develop spontaneously or be inherited in an autosomal dominant pattern, meaning if a parent has it, there is a 50% chance their child will inherit it. Other contributing factors include trauma to hair follicles and genetic predisposition.

How Are Pilar Cysts Treated?

• Self-Healing: Pilar cysts may resolve on their own without treatment. However, this process can be slow.
• Medical Treatments: Options include incision and drainage, where the cyst is cut open and drained, and surgical removal, which involves removing the entire cyst and its sac to prevent recurrence. Surgical removal is the most effective method but may leave a scar.
• Post-Treatment Care: After treatment, it is essential to keep the area clean to prevent infection. Follow-up visits may be necessary to ensure the cyst does not return.

How Can I Prevent Pilar Cysts?

While there is no guaranteed way to prevent pilar cysts, maintaining good scalp hygiene and avoiding trauma to hair follicles can help manage existing cysts. Regular check-ups with a dermatologist can also aid in early detection and treatment.

When Do I See a Dermatologist?

Potential complications of pilar cysts include inflammation, rupture, infection, and, very rarely, malignant transformation into proliferating trichilemmal tumors. Signs of infection include redness, swelling, pain, and pus drainage. If you experience these symptoms, it is crucial to seek medical advice promptly. 

Dermatologists can also provide guidance on how to prevent pilar cysts from recurring. They can also help patients manage any scarring or discomfort that may result from pilar cyst removal. Overall, dermatologists play a critical role in the diagnosis and treatment of pilar cysts and can provide patients with the information and support they need to make informed decisions about their health.

Conclusion

Pilar cysts are generally harmless but can cause discomfort and cosmetic concerns. Understanding their symptoms, causes, and treatment options can help manage and alleviate these issues. If you suspect you have a pilar cyst, consult a healthcare provider for an accurate diagnosis and appropriate treatment plan.