What should you know about a dermoid cyst over the scalp?

A cyst over the scalp can sit just below the skin and may be noticed while washing or brushing the hair. Pilar cysts are associated with hair follicles and can be firm, rounded, and mobile. Some stay quiet for a long time; friction, pressure, or rupture can make one sore and swollen. The label dermoid does not replace an examination: other cysts, inflamed lesions, and unrelated lumps can look similar from the outside.

Arrange a routine appointment for a new or persistent lump, particularly if it is enlarging or catching on a comb. Keep the area clean and avoid pressing it to test its contents. Take a clear note of changes in size, texture, tenderness, and skin colour. If a clinician recommends treatment, [Cyst Removal](/treatments/surgical-dermatology/cyst-removal/) can be discussed, including whether the capsule can be removed and how the scalp wound will be cared for. General information about [Skin Lumps](/symptoms/skin-lumps/) may help you prepare.

Seek prompt care when the lump becomes hot, increasingly red, very painful, soft in the centre, or starts draining. Fever or feeling unwell alongside these changes raises the need for timely review. Go to urgent care for new neurological symptoms, severe headache, confusion, or repeated vomiting, especially if the lump followed an injury. Do not wait for routine observation when symptoms are progressing quickly.

What features make this lump more consistent with a cyst? Is it attached to the skin or deeper tissue? Should it be monitored or removed? If it is inflamed, should treatment wait until the inflammation settles?