What should you know about a fatty cyst on the scalp?

Pilar cysts, also called trichilemmal cysts, develop from a hair follicle and commonly appear as smooth, rounded lumps beneath the scalp skin. They can feel firm or mobile and may be painless. A lump’s feel or appearance cannot confirm its identity, because other cysts and skin growths can look similar. A clinician may inspect it, feel its depth and mobility, and decide whether further assessment is needed.

A cyst can become irritated or infected, causing tenderness, warmth, redness, swelling, or drainage. Do not squeeze, pierce, or cut it at home; this can injure the scalp and make inflammation worse.

Arrange a routine appointment for a persistent scalp lump, especially if it catches on a comb, affects sleep, or is difficult to monitor. If it is quiet and confirmed as a benign cyst, observation may be reasonable. Removal may be discussed when it is recurrently inflamed, enlarging, uncomfortable, or bothersome. Cyst Removal usually aims to remove the cyst wall as well as its contents, because leaving the wall can allow it to return. Follow wound-care instructions carefully after any procedure.

Seek prompt medical advice for rapid enlargement, marked pain, spreading redness, pus, fever, bleeding, ulceration, or a lump that becomes fixed. Seek urgent help if swelling is severe or you feel seriously unwell. A painful flare may need treatment before removal is considered.

Does this lump have features of a pilar cyst? Should it be monitored or removed? What signs would suggest infection? Will the cyst wall be removed? How should I care for the scalp afterward, and when should the area be reviewed?