Sebaceous cyst on the scalp: treatment options

A lump called a sebaceous cyst is often an epidermoid cyst, a sac under the skin filled with keratin. On the scalp, it may catch on a comb, become tender after pressure or make hair washing uncomfortable. A pilar cyst can look similar, and an inflamed follicle or abscess is another possibility. A clinician feels the lump and examines the overlying skin before choosing treatment.

A stable, comfortable cyst may be monitored. Treatment is more often discussed when it is painful, repeatedly inflamed, enlarging, snagging on hair tools or causing ongoing concern. General information about [Skin Lumps](/symptoms/skin-lumps/) can help you prepare for an assessment.

Do not puncture or squeeze a scalp lump. Use gentle shampoo, avoid scratching it, and protect it from repeated combing or helmet pressure. A warm compress can be soothing for mild tenderness, but it should not replace an examination if the lump is changing.

When a cyst is not acutely inflamed, [Cyst Removal](/treatments/surgical-dermatology/cyst-removal/) may remove the sac and reduce the chance of it filling again. If inflammation is prominent, a clinician may first consider [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/) or another approach. Cutting into an actively infected lump may require [Abscess Drainage](/treatments/minor-procedures/abscess-drainage/).

Book prompt medical review if the scalp becomes hot, red, increasingly swollen or painful, or if pus, fever or spreading redness appears. These signs can indicate an abscess and may need drainage. Seek urgent help for severe pain, rapidly expanding swelling, confusion or feeling very unwell. A lump that is hard, fixed, bleeding, ulcerated or steadily changing needs an in-person assessment even without pain.

Could this be an epidermoid or pilar cyst? Is it inflamed today? Would removal be easier after inflammation settles, and how should I wash and protect the scalp afterwards?