Pilar Cyst Removal

Pilar cyst are common swellings found on the scalp.

Found more commonly in women and often run in families, they can occasionally get infected.

pilar cyst removal singapore
Scalp pilar cyst

About Pilar Cyst

Pilar cyst (aka Trichilemmal cyst) are common dermal cyst that grows over the scalp region in 90% of patients. While the pilar cyst is a mostly benign and harmless skin cyst, many seek removal as it may look and feel cosmetically unacceptable.

Pilar cyst tends to grow slowly over time. These skin coloured cyst feels firm to the touch, and you may appreciate them moving when you put your finger and thumb over the cyst, and jiggle it.

Very often multiple cyst can be found in the majority of patients with pilar cyst. Unlike the epidermal cyst, the pilar cyst does not have an opening (the punctum). However, it is still possible for the pilar cyst to rupture, and get inflammed and infected causing redness, swelling and pain.

Pilar cyst are common cysts frequently found on the scalp. They are mostly benign skin growths. However, they can get infected, rupture and cause pain and discomfort in some situations. Pilar cyst removal surgery is an office based procedure under local anaesthesia. Healing is excellent in most individuals.

How Common Are Pilar Cysts?

It is estimated to affect about 5-10% of the population. Women tend to get pilar cyst more often than men do (the reason for this is still shrouded in mystery!), and these cysts are known to run in families.

What Causes it?

The exact cause remains unknown at the moment. What we do know is that the cysts are lined by keratin and arises from the outer root sheath of the hair follicle.

How Are Pilar Cyst Diagnosed?

Most pilar cysts have a characteristic history of slow growth over the years, and may run in familities (Autosomal dominant inheritance). They feel round, smooth with regular edges and do not have a punctum opening (which is what you would find in an epidermal cyst). Most pilar cysts are diagnosed based on clinical appearance. 

In cases where diagnosis is in doubt, imaging techniques such as CT and MRI scans may prove useful.

what are the Complications

Most pilar cyst occurs over the scalp region. They can be traumatised when you comb or brush your hair. Pilar cyst can occasionally get infected and rupture. When this happens, the cyst will feel painful, swollen and may even discharge pus. If this happens, please see a doctor for medical treatment, to treat the infection and bring the symptoms under control.

Fortunately, the rate of cancer arising from a pilar cyst is very rare. However, we usually send all specimens for a biopsy to be certain. 

Pilar Cyst Removal Surgery

There is no medication that will shrink or cure the cyst. As the pilar cyst is a physical structure within the skin, pilar cyst removal with surgery is curative. An incision is placed over the skin, and the pilar cyst, together with its cyst wall is excised. The skin is then closed with sutures, and the scars are usually not obvious as it is located on the scalp. This is a simple office based procedure done under local anaesthesia.

Frequently Asked Questions About Pilar Cyst Removal Surgery

Pilar cysts are usually harmless, but they may be removed if they become inflamed, infected, painful, or cosmetically undesirable. In some cases, removal is also necessary for diagnosis to rule out other conditions.

The procedure is performed under local anaesthetic. It is a virtually painless procedure.

As with most surgical procedures, there is a risk of bleeding, infection, scarring, hair loss and recurrence. Fortunately, these are uncommon and most can be managed easily.

Most individuals heal within 1-2 weeks. Stitches are removed between 7-10 days.

After removal of the pilar cyst, it is very important to keep the wound site clean with daily anti-septics, topical antibiotics and dressings. 

Yes, there will be a small linear scar. The appearance of the scar will improve over time and most times can be hidden with your hair.

While recurrence is possible, it’s relatively uncommon. Proper removal of the cyst and its capsule typically reduces the risk of recurrence.

schedule a consultation for pilar cyst removal in singapore

Although harmless, many patients may want their pilar cyst removed due to its appearance history of recurrent infections. Contact us today to schedule a consultation, so that Dr. Ng can develop a personalized treatment approach for resolving your skin concerns and helping you to achieve long-term improvements in the appearance of your skin.

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Related Information:
  1. James WD, Berger TG, Elston DM. Andrews’ Diseases of the Skin: Clinical Dermatology. 12th ed. Philadelphia, Pa: Saunders Elsevier; 2015. 673.
  2. Satyaprakash AK, Sheehan DJ, Sangueza OP. Proliferating trichilemmal tumors: a review of the literature. Dermatol Surg. 2007 Sep. 33(9):1102-8.
  3. Mehrabi, D., Leonhardt, J.M. and Brodell, R.T. (2002), Removal of Keratinous and Pilar Cysts With the Punch Incision Technique: Analysis of Surgical Outcomes. Dermatologic Surgery, 28: 673-677.