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What Is the Treatment for a Pilar Cyst?

K.C. Bruning
K.C. Bruning

The two standard treatments for a pilar cyst, also known as a trichilemmal cyst, are antibiotics or physical removal. It may not be necessary to treat this kind of cyst, as they tend to be benign. Many doctors even advise against treatment unless the cyst has grown significantly or is painful, which usually means it has developed an infection.

The least invasive procedure for removing a pilar cyst can be done in a few minutes with local anesthesia. It is known as a punch biopsy. As this type of cyst develops from hair follicles, it is often necessary to secure the hair away from the growth before beginning the procedure. Then the area around the cyst is cleaned.

Antibiotics may be required to treat a pilar cyst infection.
Antibiotics may be required to treat a pilar cyst infection.

After the cyst has been prepped, anesthesia is typically injected into the area with a syringe. Then the doctor will make a small incision in the cyst. This will cause a small amount of the keratin inside to ooze out. The doctor will then press gently and firmly on the cyst to extract the rest of the keratin inside.

Once the soft matter has been removed, the doctor will insert a tool in the hole in order to remove the sac from which it came. Then topical medication is administered to slow the bleeding associated with the procedure. The doctor will then suture the wound and close it with a stitch. As it is a simple and quick process that is not invasive to the patient, one to several cysts may be treated during a single procedure.

Topical antibiotics may be used to treat pilar cysts.
Topical antibiotics may be used to treat pilar cysts.

There is another procedure for removing pilar cysts that requires cutting down farther into the skin and around the cyst. While this procedure can still be done with local anesthesia, it requires longer recovery time and results in a more pronounced scar. It also causes much heavier bleeding.

Another rare problem is the development of an infection in the pilar cyst. These are typically treated with antibiotics. In some cases, surgical treatment may also be necessary. If the cyst is still small and responds to drug treatment, it is not likely that additional treatment will be pursued.

Pilar cysts are most commonly found in the hair follicles of the scalp.
Pilar cysts are most commonly found in the hair follicles of the scalp.

The pilar cyst is a soft, fluid-filled growth that erupts from hair follicles. They are hereditary and tend to grow because of a malformation at the root sheath of the follicle. These cysts are most commonly found in the hair on the scalp. While they are usually benign, they can become cancerous on extremely rare occasions.

Discussion Comments

anon260837

I have a pimple like structure beside my left eye but it does not cause me any pain if I squeeze it. It looks odd on my face, I am wondering what it is.

I guess it is a cyst but I am not sure.

Should I cut it by myself because I can feel that it like a ball and does not having any connection. It's just present there, kind of hanging.

KLR650

I work for a dermatologist, and I help with these cysts a lot. They usually don't amount to much, but it's important to get the biopsy on the ones that don't go away, just to make sure that it isn't cancer. Most of the time it is nothing, but if there is cancer you want to get on it as quickly as possible.

It's an outpatient procedure, and it can be done with minimal interruption to your day. Once it's gone you don't have to worry about it anymore.

Nepal2016

@horsebite - I do that too! Drives my wife crazy. But worse than popping my own, I am obsessed with those videos on YouTube that show other people's cysts being popped. The stuff they get out is amazing, and disgusting. I really like the reaction of other people who are in the video. The guy having it done usually doesn't even realize how nasty it is because they can't see it while it happens.

Amazingly, I had one of these a while back and I was able to contain myself and not mess with it until it went away. I'm not sure if I'll be able to do that again if I get another one.

horsebite

Certainly, the best treatment for a cyst is to leave it alone or go to the doctor if it doesn't go away. However, that very good advice is pretty much lost on me. I have the uncontrollable habit of trying to pop every pimple and cyst I come across. This sometimes annoys my girlfriend, because I chase her around trying to pop hers too.

Of course, most of the time I try this nothing comes out and it just ends up getting all swollen and hurting much worse than it did in the first place. This minor sacrifice is more than covered by the fact that every so often, you get a really spectacular pop. I know, there's something wrong with me.

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    • Antibiotics may be required to treat a pilar cyst infection.
      By: Piotr Marcinski
      Antibiotics may be required to treat a pilar cyst infection.
    • Topical antibiotics may be used to treat pilar cysts.
      By: Coprid
      Topical antibiotics may be used to treat pilar cysts.
    • Pilar cysts are most commonly found in the hair follicles of the scalp.
      By: Paul Huxley
      Pilar cysts are most commonly found in the hair follicles of the scalp.
    • Many times pilar cysts can be removed using local anesthesia.
      By: Radu Razvan
      Many times pilar cysts can be removed using local anesthesia.