Epidermoid Cyst in the Scalp: What to Know

The lump is often rounded and can move slightly under the skin. Some have a tiny central opening, while others are hidden by hair. Keratin may collect gradually inside the sac. If the wall leaks or becomes irritated, the area can swell and feel sore, hot, or red; thick material may drain. A cyst can resemble a pilar cyst, abscess, or another type of skin lump, so examination is useful when the diagnosis is uncertain or the pattern changes.

Do not puncture or squeeze the lump. For a quiet cyst, observation and protection from combing friction may be enough. A clinician may use an intralesional steroid injection to calm selected inflammation, while a painful collection may need abscess drainage. Cyst removal can be considered when the lump recurs, catches during grooming, or remains bothersome. Drainage can address pressure or infection, but removing the cyst wall is the part that aims to reduce recurrence.

Get prompt medical advice if pain, warmth, redness, swelling, or drainage is increasing, or if you have fever. Seek urgent help for rapidly spreading redness, severe pain, confusion, or feeling very unwell. A lump that is hard, fixed, bleeding, ulcerated, or rapidly changing should be assessed rather than treated at home.

Ask whether the lump is inflamed or infected, whether an injection, drainage, observation, or removal is most appropriate, and what each option means for the scalp skin and hair. Confirm wound care and the signs that should prompt follow-up.