Keratin Cyst on the Head: What to Know

A pilar cyst is a rounded lump beneath the scalp skin that contains keratin and develops from a hair-follicle structure. It may feel smooth, firm, and mobile, and it can be painless while remaining noticeable during brushing or washing. A scalp lump is not automatically a cyst: inflamed follicles, other skin growths, or a swollen area after injury can feel different. The diagnosis depends on the lump's examination and history.

Do not squeeze, puncture, or attempt to drain the lump at home; this can introduce bacteria and increase inflammation. Protect it from repeated combing, tight headwear, and friction, and note whether it changes in size, tenderness, colour, or consistency. A quiet cyst can sometimes be monitored. If it repeatedly catches, becomes bothersome, or returns after inflammation, a dermatologist can discuss cyst removal and explain the expected wound care.

Arrange an appointment for a new, persistent, enlarging, firm, or unexplained scalp lump. Seek prompt care if it becomes hot, red, very tender, drains, opens, or is accompanied by fever. Sudden change after a head injury also warrants advice. Examination is especially useful when the lump is fixed, bleeding, or unlike any previous cyst, because not every scalp lump has the same cause.

Does this lump have the features of a pilar cyst, and do I need any testing? Is monitoring reasonable, or would cyst removal reduce repeated irritation? If it is inflamed, what wound care should I use and which changes require urgent review?