Sebaceous cyst on top of the head: what to know

A rounded lump on the crown can arise from a cyst beneath the scalp. The label sebaceous cyst is often used for an epidermoid cyst, while pilar cysts are also common in hair-bearing skin. The lump may be smooth, firm or mobile and can be painless until pressure, scratching or combing irritates it. An abscess or another skin growth can look similar, so a hands-on assessment matters.

Track whether it changes in size, tenderness, colour or drainage. A general overview of [Skin Lumps](/symptoms/skin-lumps/) may help you describe what you notice, but it cannot identify a specific lump.

Do not pop, cut or repeatedly check the lump by pressing it. Wash the scalp gently, use a soft brush, and limit pressure from hats, helmets or headrests if those trigger soreness. A warm compress can calm mild discomfort; stop if it irritates the skin.

A comfortable cyst may be monitored after assessment. If it is recurrent, painful, catches during grooming or causes persistent concern, [Cyst Removal](/treatments/surgical-dermatology/cyst-removal/) may be discussed. For marked inflammation, a clinician may consider [Steroid Injection Into The Skin](/treatments/injectables/intralesional-steroid-injection/). A collection of pus may need [Abscess Drainage](/treatments/minor-procedures/abscess-drainage/).

Seek prompt care if the lump becomes hot, red, rapidly larger or increasingly painful, or if it leaks pus or is accompanied by fever. These changes can signal infection. Get urgent help for severe pain, rapidly spreading swelling, confusion or feeling very unwell. Arrange an examination for a lump that is fixed, bleeds, ulcerates or keeps changing, even if it is not tender.

Does this feel like an epidermoid or pilar cyst? Is there inflammation or infection? If removal is suitable, will the entire sac be treated, and what scalp care should I follow afterwards?