What should you know about a small pilar cyst on the scalp?

Pilar cysts often feel smooth and firm beneath the scalp and may move slightly over the tissue. They can be difficult to see through hair. Pressure from a comb, helmet, or lying on the area may cause tenderness. If the cyst wall becomes inflamed or ruptures, the skin can turn red, swollen, and sore, sometimes with drainage. A scalp lump has several possible explanations, so a clinician should confirm the diagnosis rather than relying on its feel alone.

Avoid squeezing, puncturing, or trying to empty the cyst; this can trigger inflammation and leave material behind. Use gentle hair care and protect the area from repeated impact. Note its location and any change in size, pain, redness, or drainage so you can describe the pattern accurately. If it catches on a comb, recurs, or is bothersome, ask about cyst removal. Removing the whole cyst wall can reduce the chance of the lump returning, while timing and technique depend on inflammation and scalp condition.

Arrange a medical review if the lump grows, becomes painful, reddens, drains, or returns after settling. Seek prompt care for fever, spreading redness, severe tenderness, or swelling near the eye or ear. A rapidly changing, bleeding, ulcerated, or fixed scalp lesion needs assessment even if it is not painful.

Ask: Is this consistent with a pilar cyst? Is it inflamed or infected? Would removal be useful now or later? How should the area be cared for after removal, and what recurrence signs should I watch for?