Pilar cysts are one of the most common types of benign skin cysts, typically forming on the scalp. Although they are non-cancerous, they can become uncomfortable, tender, or cosmetically concerning, especially when they grow larger or multiply.
At Cyst Removal Clinic London, our doctors specialise in the safe, complete removal of pilar cysts using minor surgical techniques designed to prevent recurrence and minimise scarring. This page explains what causes pilar cysts, how they are treated, and what to expect from the removal procedure and recovery.
What is a Pilar Cyst?
A pilar cyst (also known as a trichilemmal cyst) is a smooth, firm lump that develops just beneath the surface of the skin. It forms when cells that normally help grow hair become trapped within the hair follicle and multiply, creating a small sac filled with keratin, the same protein that makes up hair and nails.
Pilar cysts are most often found on the scalp, but they can occasionally appear on the face, neck, or other areas with hair. They tend to be round, mobile under the skin, and can vary in size from a few millimetres to several centimetres.
Unlike other cyst types, pilar cysts usually run in families, suggesting a genetic tendency. They are more common in middle-aged adults and can occur singly or as multiple cysts across the scalp.
Although harmless, pilar cysts can become inflamed or infected if irritated or squeezed, which can lead to pain and swelling. For this reason, medical assessment and removal by an experienced doctor is recommended rather than attempting self-treatment.
Common Symptoms and Causes
Most pilar cysts develop gradually without obvious symptoms. You might notice a firm, dome-shaped lump under the skin that feels smooth and moves slightly when pressed. The cyst may be flesh-coloured, pale yellow, or match your skin tone.
Typical signs and features include:
- A round, smooth lump on the scalp or hair-bearing area
- Gradual growth over weeks or months
- Occasional tenderness or discomfort when combing or washing hair
- Redness or swelling if inflamed or infected
The main cause is the accumulation of keratin within a blocked hair follicle. Inherited factors can increase the likelihood, meaning some people develop several cysts throughout life. Injury to the scalp or irritation around hair follicles can also trigger new cyst formation.
It’s important to differentiate pilar cysts from other types, such as epidermoid cysts or lipomas, as treatment and appearance can vary. An accurate diagnosis is usually made by clinical examination, though in some cases, the cyst may be sent for histology after removal to confirm it’s benign.
Diagnosis and When to Seek Treatment
Pilar cysts are generally diagnosed through visual and physical examination. At Cyst Removal Clinic, your doctor will inspect the lump’s size, texture, and location to determine whether it is indeed a pilar cyst or another type of skin lesion.
Most cysts are harmless, but you should seek professional treatment if you notice:
- Rapid growth or pain
- Redness, warmth, or pus discharge
- Bleeding or signs of infection
- Multiple cysts that interfere with hair washing or styling
- Cosmetic concern or irritation from daily activities
Once inflamed, a pilar cyst cannot be treated effectively with creams or home remedies. In some cases, antibiotics may be prescribed if infection is present, but the cyst itself will not resolve permanently unless surgically removed.
Early removal is often the best option to prevent further growth and to achieve a cleaner cosmetic result.
Pilar Cyst Removal Procedure
At Cyst Removal Clinic, we perform pilar cyst removal as a quick, minimally invasive outpatient procedure under local anaesthetic. The treatment takes around 20–30 minutes and allows you to return home immediately afterwards.
Here’s what to expect:
- Preparation and anaesthetic – The area is cleaned thoroughly and numbed using a small injection of local anaesthetic, ensuring the procedure is completely comfortable.
- Precise incision – A fine incision is made over the cyst, carefully positioned to minimise visible scarring, especially on the scalp.
- Complete removal – The doctor gently separates and removes the cyst sac in its entirety, including the keratin contents and the cyst wall. This step is crucial to prevent recurrence.
- Closure and dressing – The small wound is closed using dissolvable or fine removable stitches and covered with a sterile dressing.
The procedure is performed using sterile surgical technique, and our doctors prioritise both clinical safety and cosmetic outcome. In cases of multiple cysts, several may be removed in a single session depending on their size and location.
You can resume normal activities shortly afterwards, though we advise avoiding strenuous exercise or washing the area for the first 24 hours.
Recovery and Aftercare
Recovery after pilar cyst removal is straightforward, with most patients experiencing minimal discomfort. Mild soreness or swelling around the incision site is normal for a few days and can be managed with simple pain relief such as paracetamol.
Your doctor will provide tailored aftercare instructions, which typically include:
- Keep the wound clean and dry for the first 24 hours
- Avoid touching or scratching the area
- Wash hair gently once permitted (usually after 1–2 days)
- Attend a follow-up appointment for wound review or stitch removal if required
If the cyst was infected before removal, antibiotics may be prescribed to ensure full healing. Most wounds heal within 7–14 days, leaving only a faint mark or line. Hair generally regrows normally over the treated area.
Recurrent cysts are rare when the entire capsule is removed, but new cysts may form elsewhere on the scalp if you have a hereditary tendency. Regular scalp checks and avoiding trauma to the area can help reduce recurrence risk.
Why Choose Cyst Removal Clinic London
- Experienced doctors specialising in skin cyst and minor surgical procedures
- Quick, walk-in treatments under local anaesthetic with same-day discharge
- Focus on cosmetic outcome using precision techniques and minimal scarring
- Central London location with flexible appointment times
- Transparent, fixed-fee pricing with no hidden costs