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Trichilemmal Cysts on the Scalp – Causes and Removal

What are Trichilemmal Cysts?

Trichilemmal Cyst is a benign skin growth which develops from the outer layer of the root of the hair follicle. Trichilemmal Cyst generally develops in females and around 10% of the general population is affected by this condition. In the initial phase of development, Trichilemmal Cyst looks like a firm nodule which is sometimes painful. Even though Trichilemmal Cyst can develop in any area where hair grows, the scalp is the area where majority of Trichilemmal Cysts are seen[1].

An individual with a family history of Trichilemmal Cystis is more likely to develop it than the normal population. These cysts tend to get inflamed if they rupture. In extremely rare cases, these cysts grow and take the shape of a full sized tumor. These enlarged cysts are termed as proliferating Trichilemmal Cysts. These cysts are benign but tend to grow very rapidly[2].

It is very rare for Trichilemmal Cyst to become malignant. It is quite easy to remove the cyst and is usually a same day procedure with little risk involved. However, there is a high likelihood of the cyst recurring even after removal. In many cases, these cysts go away on their own without treatment provided the affected individual does not damage the skin around the site of the cyst by pricking at it[2].

Trichilemmal Cysts on the Scalp – Causes and Removal

What Causes Trichilemmal Cysts on the Scalp?

To know the cause of Trichilemmal Cyst it is important to understand about a protein called keratin found in the cells of the skin. This protein helps to keep the hair and the skin around it flexible and strong. Under normal circumstances, the cells containing keratin move towards the surface of the skin where they either fall off or are washed away when the individual baths[3].

Sometimes instead of moving towards the surface of the skin, these cells containing keratin move much deeper into the skin. There they get trapped and start multiplying. This is how Trichilemmal Cyst forms. The cyst will have a yellow colored paste like material which is actually keratin[3].

Trichilemmal Cyst runs in families and the chances of an offspring having this condition if the parent has it are close to 50%. Trichilemmal Cyst is seen mostly in middle aged females and is quite rare in males. There are no specific risk factors for Trichilemmal Cyst aside from those individuals who have damaged hair follicles or damaged skin around it[3].

How to Treat Trichilemmal Cysts on the Scalp?

Majority of Trichilemmal Cysts heal on their own without any treatment required. Placing a warm cloth over the cyst is also an effective way to calm down the swelling and facilitate healing. The primary mode of treatment for Trichilemmal Cyst is by way of antibiotics if the cyst gets infected. As long as the Trichilemmal Cyst is not a source of any problem people generally do not go for treatment of it[3].

Some people however want to get rid of the cyst. This is because Trichilemmal Cyst on the scalp tends to get painful while brushing the hair. The procedure to remove a Trichilemmal Cyst on the scalp is quite easy and is a same day procedure. The removal of the cyst is done under local anesthetic[3].

The removal of the Trichilemmal Cyst on the scalp is normally done in two ways. The first method is to make a small nick in the cyst under local anesthesia and allow the fluid to drain out of the cyst thereby shrinking it. The second method is to remove the cyst in its entirety without making any nicks within the cyst. It is a relatively small procedure[3].

Post removal of the cyst a dressing will be applied on the scalp. The patient will be advised not get the dressing wet until the wound heals. Normally, there are no complications from the procedure; however, in some cases scars can form after removal of the Trichilemmal Cyst on the scalp. There is also a remote possibility of the cyst recurring even if it is removed in its entirety[3].

Recurrence is more common if the Trichilemmal cyst is drained rather than removed. In some rare cases, the cyst may start growing in size and tale the shape of a tumor. These tumors are normally benign and completely harmless. The overall prognosis of an individual with Trichilemmal Cyst on the scalp is extremely good with little to no complications after removal of the cyst[3].

Majority of the cysts do not require any treatment and go away on their own. Treatment for Trichilemmal Cyst on the scalp is only required if the cyst gets infected or it causes pain to the patient. The recurrence rate of a cyst that goes away on its own is quite high but in cases where the cyst has been entirely removed the recurrence rate is quite low[3].


Sheetal DeCaria, M.D.
Sheetal DeCaria, M.D.
Written, Edited or Reviewed By: Sheetal DeCaria, M.D. This article does not provide medical advice. See disclaimer
Last Modified On:July 23, 2019

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