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Pilar cysts, also called trichilemmal cysts, or wens, are benign cysts which occur predominately on the scalp. These cysts present as flesh colored bumps on the surface of the skin, and can vary in size from the size of a nickel to the size of a golf ball.  As they grow in size they can create a dome-like bump on the skin, with a smooth texture, and are firm to the touch. The larger the Pilar cysts grow, the more pressure they cause, and the more discomfort they create. These cysts can rupture as a result of trauma, which can cause pain and infection. Pilar cysts are hereditary and are more common in middle-aged women than in men.

While pilar cysts are benign, due to the size and pressure caused by these cysts, many patients choose to have them removed. It is important to remove both the cyst and the epithelial lining to prevent the cyst from re-occurring. Although these pilar cysts are benign, many patients want these pilar cysts removed for cosmetic reasons as well.

What are the symptoms of sebaceous cysts?

The presence of a lump or growth under the skin is usually a sign that you may be developing a sebaceous cyst. Sebaceous cyst may initially appear soft, but later grow firmer as the amount of keratin builds up in the wall of the cyst.  Most cysts are benign and completely harmless. At the start, the the cyst is painless, but depending on the location of the cyst, it can become irritated, erythematous, and inflamed. This inflammation can be a sign of an underlying skin infection.  If the cyst becomes tender to the touch and the surrounding skin appears red and warm, the sebaceous cyst may be infected, and will need further treatment. The cyst may need to be opened and drained, allowing the infection to escape, and oral antibiotics will need to be prescribed. When the cyst becomes painful, or the surrounding skin becomes warm with a foul smelling discharge, this is a strong indication of infection. In an infection is left untreated, it can become serious. Fever, or any other systemic symptoms means that prompt medical attention is necessary.

What is a Cyst?
A cyst is a benign, encapsulated lesion that consists of a fluid sac which contains liquid, or semi-fluid material. It can vary in shape, size and location. The most common types of cysts are reviewed here.

Acne, acne cysts, and sebaceous cysts are benign skin lesions and are one of the most common reasons which patients consult with dermatologists like Dr. Michele Green in Manhattan. Sebaceous cysts are the most common type of cyst, and are slow-growing noncancerous bumps on the skin. However, if sebaceous cysts are left untreated, they tend to enlarge, get infected, and cause cosmetic scarring. Dr. Michele Green treats these sebaceous cysts in her Upper East Side NYC office each day. Through her minimally invasive techniques, she treats these cysts in a cosmetically elegant way, and avoids any unnecessary scarring.
What causes a sebaceous cyst?
Sebaceous cysts are formed within the sebaceous gland, which is the gland which produces sebum. These cysts develop when the hair follicles become clogged due to a build up of sebum or keratin. These cysts can also be formed from pimples or as a result of trauma to the sebaceous glands. Individuals with a genetic predisposition such as steatocystoma multiplex, Gardner’s syndrome or Basal Cell Nevus Syndrome are also prone to developing sebaceous cysts.

How do you diagnose a sebaceous cyst?
A diagnosis of a sebaceous cyst can be determined by a physical examination of the nodule by a dermatologist, family physician or other healthcare provider. There are occasions when additional testing is required to make a definitive diagnosis of a cyst, since it can sometimes be mistaken for a different type of skin tumor.

Common tests used to diagnosis a sebaceous cyst include:

Cat scan – This test is performed to rule out other abnormalities or cancer.
Ultrasound – This test is performed to establish the contents of the cyst and depth of inflammation.
Punch biopsy – This test is performed to identify the histology of the cyst.
Culture and Sensitivity – This exam is performed to determine the type of bacteria responsible for the infection and the best antibiotic to treat the infection.