
09/23/2025
MINOR SURGERY 9-22-25- Dr. Hal London
β οΈ Vewer discretion alert: Surgical images included
The procedure presented today is removal of a scalp cyst( pilar cyst). These are rewarding little procedures that are actually fun for me and yield great cosmetic results for my patients.
A pilar cyst, also known as a trichilemmal cyst, is a harmless, non-cancerous lump that develops on the scalp from the outer sheath of a hair follicle and is filled with keratin, the same protein that makes up hair and nails. These smooth, firm, mobile, and round cysts can be solitary or multiple, may run in families.
Inside of these cysts is a cheesy, foul smelling substance( think foot odor mixed with Parmesan cheese). They may become irritated and infected but usually are just unsightly with patients wanting them removed for cosmetic reasons.
Scalp surgeries usually present no problems because the blood supply is rich making them less prone to infection and in hair bearing areas the scar will be hidden. Even if there is no hair to hide the scar proper technique creates the smallest scar.
After numbing the area a single, small, superficial skin incision is made over the cyst deep to the top of the cyst but not into the cyst. This way the cyst can be dissected out intact to include the capsule that surrounds it(see photo). If the cyst ruptures during the procedure the foul smelling contents( consistency of cottage cheese) can be expressed then the capsule dissected and removed. If the capsule is not removed the cyst will reoccur.
Skin cysts, similar to the pilar cysts, can be found on the skin anywhere on the body and are removed in a similar fashion.
Do you have something you want removed from your skin?
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