What should you know about an occipital scalp cyst?

A pilar, or trichilemmal, cyst develops from structures associated with a hair follicle. It may feel smooth, firm, and rounded, and the overlying skin may look normal. Hair-bearing areas such as the scalp are common places for these cysts. A lump can also have other causes, so its location alone cannot identify it. Growth, tenderness, redness, drainage, or repeated catching on a comb can make it more troublesome.

Book a clinical examination if the lump is new, changing, painful, or difficult to identify. Avoid squeezing, puncturing, or repeatedly pressing it, because this can irritate the cyst and introduce infection. If it is stable and causes no problems, observation may be reasonable after assessment. When removal is chosen, a clinician can discuss Cyst Removal, wound care, possible scarring, and whether the whole cyst wall needs to be removed to reduce recurrence.

Seek prompt care for rapid enlargement, marked pain, warmth, spreading redness, pus, bleeding, fever, or swelling that interferes with vision or movement. Emergency help is appropriate for severe illness, confusion, or breathing difficulty. A suddenly inflamed lump may need treatment before any planned procedure, so do not attempt home drainage.

Ask whether the lump appears to be a pilar cyst, whether examination alone is enough, what happens if it is left alone, and how removal would affect hair and the scalp wound.