Epidermal Cyst on the Head: What to Know

A pilar cyst, also called a trichilemmal cyst, is another common name for a cyst arising from a hair follicle. It may feel smooth, firm, and mobile beneath the skin, and the hair can make its outline harder to see. A clinician can examine the lump and check whether it behaves like a cyst or needs a different explanation. A cyst is not the same thing as a boil: inflammation may cause warmth, redness, pain, or drainage, while a quiet cyst may cause no symptoms.

Do not squeeze, pierce, or repeatedly press the lump, because this can irritate the surrounding skin and push material into nearby tissue. Keep the scalp clean and note its size, tenderness, redness, and any discharge. If it catches on a comb, helmet, or pillow, arrange a dermatology assessment. When removal is appropriate, a clinician can discuss taking out the cyst and its surrounding sac; simple opening alone may leave tissue behind and allow it to return.

Arrange prompt medical review if the lump becomes rapidly more painful, hot, red, swollen, or starts draining, or if you develop fever or feel unwell. Seek urgent help for spreading redness, severe pain, or swelling near the eye. A new lump that is hard, fixed, bleeding, ulcerated, or changing should also be examined rather than assumed to be a cyst.

Ask whether the examination supports a pilar or epidermal cyst, whether inflammation is present, and whether observation or removal fits its location. You can also ask how the procedure would affect hair, what wound care involves, and what changes should trigger a return visit.