The two standard treatments for a pilar cyst, also known as a trichilemmal cyst, are antibiotics or physical removal. It may not be necessary to treat this kind of cyst, as they tend to be benign. Many doctors even advise against treatment unless the cyst has grown significantly or is painful, which usually means it has developed an infection.
The least invasive procedure for removing a pilar cyst can be done in a few minutes with local anesthesia. It is known as a punch biopsy. As this type of cyst develops from hair follicles, it is often necessary to secure the hair away from the growth before beginning the procedure. Then the area around the cyst is cleaned.
After the cyst has been prepped, anesthesia is typically injected into the area with a syringe. Then the doctor will make a small incision in the cyst. This will cause a small amount of the keratin inside to ooze out. The doctor will then press gently and firmly on the cyst to extract the rest of the keratin inside.
Once the soft matter has been removed, the doctor will insert a tool in the hole in order to remove the sac from which it came. Then topical medication is administered to slow the bleeding associated with the procedure. The doctor will then suture the wound and close it with a stitch. As it is a simple and quick process that is not invasive to the patient, one to several cysts may be treated during a single procedure.
There is another procedure for removing pilar cysts that requires cutting down farther into the skin and around the cyst. While this procedure can still be done with local anesthesia, it requires longer recovery time and results in a more pronounced scar. It also causes much heavier bleeding.
Another rare problem is the development of an infection in the pilar cyst. These are typically treated with antibiotics. In some cases, surgical treatment may also be necessary. If the cyst is still small and responds to drug treatment, it is not likely that additional treatment will be pursued.
The pilar cyst is a soft, fluid-filled growth that erupts from hair follicles. They are hereditary and tend to grow because of a malformation at the root sheath of the follicle. These cysts are most commonly found in the hair on the scalp. While they are usually benign, they can become cancerous on extremely rare occasions.