Pilar Cyst

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What is a Pilar Cyst?

A pilar cyst, also known as a trichilemmal cyst, is most often located on the scalp and occurs in 5-10% of the population. Women tend to be affected slightly more than men, and there is a strong genetic correlation. It originates from the outer hair root sheath and is filled with keratin, the protein that makes up hair and nails. Unlike Epidermal Inclusion Cysts (EIC) that are filled with sebaceous material and are commonly located on the face or body, these cysts do not have a central opening and are less likely to become inflamed. Although they are benign, they can become quite large and bothersome and rarely resolve without treatment. Therefore, many patients prefer to have them removed.

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What Do Pilar Cysts Look Like?

A pilar cyst may be small at first, appearing rounded or dome-shaped. Most of these cysts grow at a slow pace and may not be noticed until a certain size is reached. A new pilar cyst may measure as little as .5 centimeters and may eventually grow to the size of a quarter or small ball. The cyst may develop a white or yellow hue at some point.Hair usually does not grow on the pilar cyst, so a larger cyst may cause the appearance of thinning hair or a bald spot.

Cysts are fluid-filled, so a pilar cyst may move slightly when touched but usually feels somewhat firm. It is important not to press hard on the cyst, as this will cause unnecessary pain. The pilar cyst should not be squeezed or popped. Because the skin that lies over the cyst tends to thicken, there is minimal chance that tissue would break open. However, catching the cyst with a brush or styling tool could lead to oozing and discomfort. A nick to the cyst could also lead to infection, so the cyst needs to be monitored for signs of inflammation such as redness and tenderness.

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Where On The Body Are Pilar Cysts Found?

Most pilar cysts develop on the scalp. However, any hair follicle could encounter a buildup of keratin. Areas on which pilar cysts may be found include the neck and face. It is also possible for multiple cysts to occur simultaneously.

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Are Pilar Cysts Common?

It has been estimated that only 5 to 10 percent of the population is affected by this dermatologic condition. Pilar cysts are relatively uncommon on the broader scale, but research suggests that the condition may be common within families. If a parent has pilar cysts, their offspring are twice as likely to also develop this type of condition than a person without a family history of these cysts.

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What Causes A Pilar Cyst?

Pilar cysts are related to the keratin that exists in the epithelial lining of hair follicles. Keratin is a protein that is necessary for skin, hair, and nail health. In some people, keratin production coincides with the buildup of this protein within a hair follicle. A pilar cyst is the result of this buildup.

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Diagnosing Pilar Cysts

It may be possible to observe a pilar cyst based on appearance alone. However, it is beneficial to have any growth or cyst examined by a dermatologist for the most accurate diagnosis. A dermatologic exam visualizes the skin overlying the cyst and palpates the cyst for texture and firmness. A biopsy may be taken to obtain a small sample of tissue for microscopic examination. In some cases, a CT scan may be ordered. This non-invasive imaging test can capture the internal aspects of the cyst and potentially observe if more cysts are forming in the immediate area of the first.

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What Our Patients Say

“I have always appreciated the support and assistance that I have received with any of my concerns…..the best place ever!” – Nina E.

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Are Pilar Cysts Dangerous?

Pilar cysts are generally observed as benign. Research has not indicated that these cysts could become cancerous if not treated. The most significant concern related to pilar cysts is that they may rupture spontaneously or if disturbed by a bump or other type of contact. Even in this instance, a ruptured pilar cyst poses little risk other than discomfort, skin irritation, or infection. Each of these can be easily treated.

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Pilar Cyst Removal

Like any lesions on the scalp, removal with a regular scalpel can result in significant bleeding and therefore incomplete removal of the cyst. By using the Ultrapulse Co2 Laser, we can cut and cauterize simultaneously, minimizing bleeding. The laser creates an incision that exposes the cyst, and then the lining and contents can often be removed completely intact. Rarely is there any recurrence. However, because of their genetic predisposition, more may develop over time that may need to be removed.

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Schedule A Consultation

To learn more about our treatment for Pilar Cyst, contact Remington Laser Dermatology Centre today. To contact Dr. Kent Remington, call 403-252-7784. To contact Dr. Todd Remington, call 403-255-1633. Our practice serves Calgary and surrounding areas.