We frequently encounter patients concerned about lumps or bumps on their scalp or body, which can often be perplexing. Two of the most common types of cysts that people come across are pilar cysts and sebaceous cysts. These benign (non-cancerous) lumps, while often harmless, can sometimes cause discomfort, infection, or cosmetic concern. We will explain the distinctions between pilar and sebaceous cysts, what causes them, and what options are available for their removal.

What are Pilar Cysts?

Pilar cysts, also known as trichilemmal cysts, typically form on the scalp. They originate from the outer root sheath of hair follicles and contain keratin—a protein that makes up skin, hair, and nails. Pilar cysts are usually round, firm, and smooth under the skin and tend to be painless unless they become inflamed or infected. They grow slowly, often remaining unnoticed until they reach a size that’s visible or palpable.

What are Sebaceous Cysts?

Sebaceous cysts are commonly mistaken as a type of cyst due to their misnomer; however, they are actually known as epidermoid or keratinous cysts. Sebaceous cysts can form almost anywhere on the body but are commonly found on the face, neck, and torso. Unlike pilar cysts, they develop from sebaceous glands (oil glands) and contain a yellowish, greasy material that results from trapped keratin. Sebaceous cysts can also grow slowly, but they may become irritated if they rupture, leading to swelling and possible infection. They often have a punctum which is an opening which may discharge.

What is the Bump on My Scalp?

A bump on the scalp may be caused by a variety of factors, from cysts to lipomas (benign fatty lumps) and other skin conditions. However, when the bump feels round, firm, and movable, it is likely a cyst—specifically, a pilar cyst if located on the scalp. Pilar cysts are more common in women and may even run in families, suggesting a genetic predisposition. Sebaceous cysts are less common on the scalp but can still develop there due to clogged hair follicles or sebaceous glands.

What Causes Lumps in the Scalp?

Lumps on the scalp can be caused by pilar cysts, sebaceous cysts, lipomas, and other growths. For cysts, the cause often relates to a blockage in a hair follicle or oil gland. Trauma, inflammation, and infections can also lead to lumps, and in some cases, genetics plays a role. Pilar cysts, for instance, may be more common in families with a history of similar cysts. Sebaceous cysts, on the other hand, are often the result of trauma to the skin or blocked oil glands.

What Causes Pilar Cysts?

The exact cause of pilar cysts is not fully understood, but they are thought to develop from cells within hair follicles. These cells produce keratin, a thick protein that can build up and form a cyst. Pilar cysts are more common in people with a family history of them, particularly on the scalp, where they tend to multiply. Although they may sometimes appear after trauma, most pilar cysts develop slowly and painlessly over time.

Why Do I Get Sebaceous Cysts?

Sebaceous cysts occur when sebaceous glands become blocked or damaged, causing a build-up of keratin and oil within a cystic cavity. The reasons for this blockage vary; they may be due to trauma, infection, or even hereditary conditions. People who have a tendency to develop cysts might notice recurring sebaceous cysts in areas with high oil production, such as the face, neck, and torso.

How Can I Remove a Lump from My Scalp?

For those with persistent or bothersome lumps on the scalp, cyst removal is typically recommended. This is especially true if the cyst is large, causing discomfort, or prone to infection. Here are the steps for removing a cyst:

1. Consultation: A professional evaluation is essential for accurate diagnosis.

2. Anaesthesia: Local anaesthetic is applied to numb the area before the procedure.

3. Incision and Removal: The surgeon will make a small incision and carefully remove the cyst sac to prevent recurrence.

4. Closure: The incision is then closed with stitches to promote healing.

5. Follow-up: Post-surgical care instructions will help reduce any risk of infection or complications.

It’s important to have this procedure done by an experienced doctor or surgeon to ensure minimal scarring and a lower risk of recurrence. Our team of skin doctors and plastic surgeons at CLNQ can offer you cyst removal in our clinics in Manchester and Knutsford, Cheshire.

What Does Pilar Cyst Removal Involve?

Pilar cyst removal is typically a straightforward procedure. It is usually done in an outpatient setting with local anaesthetic. Here’s what to expect:

• Incision: A small incision is made over the cyst, and the cyst wall is carefully separated from the surrounding tissue.

• Extraction: The entire cyst, including the sac, is removed to prevent regrowth. Sometimes the cyst may not come out in one piece but we will try to ensure most of it is removed to reduce recurrence risk.

• Stitching: The wound is closed with sutures, which will either dissolve on their own or need removal after about 10-14 days.

• Healing and Recovery: Most people recover quickly, with only minor discomfort. Following care instructions helps minimise scarring.

What are the Risks of Cyst Removal from the Scalp?

While cyst removal is a low-risk procedure, there are some potential risks:

• Infection: Any surgical procedure carries a risk of infection, though it is low with proper care.

• Scarring: Though minimal, a small scar just slightly larger than the cyst may remain, which often fades over time.

• Recurrence: If the cyst sac isn’t fully removed, there’s a chance the cyst may recur. You may also develop further new cysts in the future.

• Bleeding or Bruising: Some minor bleeding or bruising can occur but typically resolves within a few days.

• Hair Loss: Where the incision is made and scar is there will be no hair growing from within the scar. There is rarely some minor hair loss from around the scar.

Can a Cyst Grow Back After Removal?

Yes, a cyst can potentially grow back if the entire sac isn’t removed. In cases where only part of the cyst sac is removed, cells may remain, leading to recurrence. However, with thorough surgical removal by an experienced doctor or surgeon, the likelihood of recurrence is low. In some rare cases, people with a predisposition to cyst formation may develop new cysts in the same or nearby areas.

How Much is Cyst Removal in Manchester?

The cost of cyst removal in Manchester varies widely based on the provider, location, and complexity of the procedure. At CLNQ, prices generally start around £450 depending on the size of the cyst and increase to £650 and £950 accordingly. A small cyst is considered smaller than 1cm, a medium one is between 1-2cm and a large one over 2cm. During your consultation, our specialist will assess you and provide a more accurate estimate on the price for cyst removal.

Conclusion

Pilar cysts and sebaceous cysts are common, benign growths that often cause cosmetic concerns or discomfort but are generally harmless. Understanding the differences between these types of cysts, their causes, and the options for safe removal is key to managing them effectively. At CLNQ in Manchester and Cheshire, we offer safe and professional cyst removal options tailored to individual needs. If you have a lump or bump on your scalp or elsewhere that is causing concern, consider a consultation to discuss the best course of action.Whether for aesthetic reasons or peace of mind, knowing more about your options and the procedure can be empowering. Remember, professional evaluation and treatment can help ensure the best possible outcome.