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    A cyst is a benign (non-malignant) lesion that contains a fluid or is semi solid.

    What are Cysts?

    The two main common types of cyst that appear on the skin are; epidermoid cyst, and pilar cyst (also known as trichilemmal cyst), these are sometimes referred to as sebaceous cysts.

    Pilar cyst  Cyst

    Cyst  Cyst

    Image credit to Dermnetnz.org.

    Both types of cyst are filled with keratin, the material that makes up our hair and outer layer of skin. The difference between the linings of epidermoid and pilar cysts can be seen under a microscope.

    Cysts are common, benign, and not contagious.


    What are the symptoms of Cysts ?

    Epidermoid cysts and pilar cysts are similar in appearance. They are round, or dome shaped, and appear under the surface of the skin.

    They can appear yellow or white in colour and range in sizes, from the size of a pea, to several centimetres across.

    Cysts tend to grow slowly. They can become infected or catch on clothes, or hair brushes if they appear on the scalp. When they become infected they can discharge pus which may have an odour.

    Pilar cysts are most common on the scalp, and can be numerous, where as Epidermoid cysts are most common on the face, neck and upper trunk, and are more prone to rupture.


    What causes Cysts?

    Epidermoid cysts and pilar cysts are caused by a build up of keratin under the skin. Epidermoid cysts can appear after a hair follicle has been inflamed.


    Who is at risk of Cysts?

    Epidermoid cysts affect young and middle aged adults, and are common in patients suffering from acne. They are not hereditary, but sometimes play a part in rare conditions that are hereditary.

    Pilar cysts tend to arise in middle age, and affect more women than men. They run strongly in families, as they are inherited as an autosomal dominant trait, meaning that there is a 50% chance of a child developing the condition if the parent has it.



    How does a dermatologist diagnose Cysts ?

    A Dermatologist will examine the cyst with a Dermatascope in order to diagnose. If the Dermatologist has any doubt they may recommend that the cyst is surgically removed and sent to the laboratory for further analysis.


    How does a dermatologist treat Cysts?

    Both epidermoid and pilar cysts are harmless, and therefore if they are small, and do not impact on daily life then they may require no treatment at all.

    However, if they are causing physical or emotional discomfort, or are becoming infected, they can be removed. They are removed in an outpatient surgical procedure where the whole cyst is removed under local anaesthetic. The lining will also be removed to reduce the chance of the cyst growing back. This will leave a scar and so those considering surgery should assess the impact of a scar versus the cyst itself.


    Where can I find more information on Cysts?

    More information on Cysts can be found on DermNet NZ.

    Learn more at https://www.dermnetnz.org/topics/pilar-cyst/



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