What is pilar or trichilemmal cyst?
Pilar or trichilemmal cyst is a benign (noncancerous) encapsulated growth that originates from the outer sheath of the hair root [1,3]. It is filled with keratin, which is a protein that normally appears in the hair and skin.
The terms pilar and trichilemmal originate from the Latin pilus and Greek trichos, which both mean hair [1,2]. Other names for pilar cyst include wen and isthmus-catagen cyst [2]. Pilar and epidermoid cysts are commonly, but technically incorrectly, called sebaceous cysts.
Pilar cysts can be acquired or hereditary and tend to run in families [1,3]. They most commonly appear in middle-aged women and less likely in children [1,2,3].
Symptoms
Pilar cysts most commonly develop on the scalp [1,3]. Less common locations include scrotum, face, neck and trunk [3]. They can be single or multiple and appear as painless, firm, smooth and mobile lumps from 5 mm to 5 cm in size, covered by a normal, pink or yellow skin without an opening and with little or no hair [1,2]. When inflamed, they can be painful and covered with red skin. Big cysts tend to burst.
Proliferating trichilemmal cysts grow rapidly and can become as big as 25 centimeters [3,4]. They can ulcerate and damage the nearby tissues. They most commonly appear on the scalp and rarely on the back, chest, armpit, groin, buttocks, thigh, vulva, face and eyelid (Picture 4) [5].
Pilar (Trichilemmal) Cysts |
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 Picture 1. A pilar cyst on the scalp |
 Picture 2. Two pilar cysts on the scalp |
 Picture 3. A small pilar cyst |
 Picture 4. Proliferating trichilemmal cyst |
Differential Diagnosis
Other skin cysts that can be similar to pilar cysts:
- Epidermoid cyst
- Dermoid cyst
- Cystic acne
- Steatocystoma
Treatment
Pilar cysts can be removed by surgical excision. There are no known methods of prevention or treatment at home [4].
Video 1. A surgical excision of a pilar cyst on the scalp.
Pilar cysts only rarely develop into cancer [3].
- References
- Kapadia A, 2014, Pilar cyst DermNetNZ
- Abreu Valez AM et al, 2011, An inflamed trichilemmal (pilar) cyst: Not so simple? PubMed Central
- Laumann AE, Trichilemmal Cyst (Pilar Cyst), Overview Emedicine
- Laumann AE, Trichilemmal Cyst (Pilar Cyst), Medication Emedicine
- Vatanchi M, Proliferating Pilar Tumor, Overview Emedicine
- Vatanchi M, Proliferating Pilar Tumor, Presentation Emedicine
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Actually, I have a question which I would greatly appreciate an answer….I just had a Pilar Cyst removed from my head recently. My question is does a Pilar Cyst cause or create….have any proven barring on general health?….The contents of a cyst are a collection of impurities so, I am wondering if during the years that thing was on my head if it could have had any negative affects on my health?…Is it even possible???