Diagnosis and Treatment of Pilar Cysts

Pilar cysts form at the bottom of the hair follicle and are most commonly found on the scalp. 

A pilar cyst forms a smooth, mobile lump under the surface of the skin and is filled with thick, semi-fluid content. The fluid is made up largely of keratin – the protein that makes up hair, skin and nails.

Pilar cysts form when cells from the epidermis (outer skin) or follicles get into deeper parts of the skin but continue to multiply and produce keratin beneath the skin’s surface like they would on the top layer; forming a keratin-filled sac.

Pilar cysts are most commonly found on the scalp and are more frequent in middle-aged females. The size can vary from a small pea size to something much larger. They can occur alone, but patients may have several at the same time.

Other names for a pilar cyst are trichilemmal cyst, wen, pilar cyst or isthmus-catagen cyst.

Treating Pilar Cysts

Treatment of pilar cysts is a minor surgery procedure. This is generally undertaken in clinic (no hospital visit required) as it can be carried out using local anaesthetic.

The objective is to remove the cyst complete with its sac, so that the cyst does not recur, but if it does then the procedure can be repeated.

Before and After Scalp Cyst Removal

These images show the results of surgery by Dr Ross Perry.

Cyst Removal

Cyst Removal

Pilar cysts are generally not approved for removal on the NHS, as they are classed as a cosmetic issue. This is increasingly an issue as NHS cut backs mean that the threshold for treatment is raised.

Private cyst removal is available with organisations such as Skin Surgery Laser Clinic who have a selection of clinics based in London and Bristol. Skin lesions are removed using the latest surgical techniques for minimal scarring; with trained doctors and surgeons. The lack of waiting lists is a real advantage and if the doctor and patient agree, many cysts can be removed in the consultation without need for booking a separate appointment for treatment.

For more information or to book a consultation, please complete the form on this web page or call 020 7386 0464.