What should you know about a dermoid cyst on an infant's scalp?

Some scalp cysts are present from birth or become noticeable during early growth. A lump may be smooth, firm, and covered by normal skin, but its position and depth matter in an infant. A pilar cyst is one possible diagnosis; a true dermoid cyst is another, and not every bump is a cyst. A paediatric clinician may examine the skin, feel the margins, and decide whether imaging or specialist input is needed.

Arrange an appointment with the child’s paediatrician or a clinician experienced in infant skin lumps. Record whether the lump was present at birth, whether it is changing, and whether the skin over it has a pit, hair tuft, redness, or discharge. Photographing it beside a familiar object can help show change over time. Do not squeeze, puncture, or repeatedly press the area. If removal is advised, ask about [Cyst Removal](/treatments/surgical-dermatology/cyst-removal/) and the reason for the proposed timing. [Skin Lumps](/symptoms/skin-lumps/) provides broader background.

Seek prompt assessment if the lump grows quickly, becomes red, warm, swollen, painful, or starts to drain. Urgent care is appropriate if the infant is unusually sleepy, repeatedly vomits, has a seizure, develops weakness, or seems acutely unwell, particularly after an injury. A fever with a hot or draining lump also needs timely medical review.

Was this lump present from birth, and does its location suggest a particular type? Does it need imaging or referral? What changes should we monitor at home? If removal is considered, what anaesthetic, timing, scar care, and follow-up would be involved?