Epidermoid Cyst vs Pilar Cyst: Causes, Differences, and Treatment Options
Finding a lump under your skin can be alarming. Two of the most common benign (non-cancerous) skin lumps dermatologists diagnose are epidermoid cysts and pilar cysts. Although they may look similar, they are different in origin, location, and treatment approach. Epidermoid Cyst vs Pilar Cyst.
In this article, Dr. David Bryant, board-certified dermatologist and founder of World’s Famous Dermatologist, explains how to tell the difference between epidermoid cysts and pilar cysts — and when treatment is necessary.
What Is an Epidermoid Cyst?
An epidermoid cyst is a slow-growing, benign lump that forms beneath the skin. It develops when surface skin cells move deeper into the skin and multiply instead of shedding normally.
Common Characteristics:
Round, firm bump under the skin
Often skin-colored or slightly yellow
May have a visible central opening (punctum)
Can become red, swollen, or painful if inflamed
Most commonly found on the face, neck, chest, or back
Epidermoid Cyst vs Pilar Cyst-Epidermoid cysts contain keratin, a protein found in skin cells. If ruptured, they may release a thick, cheese-like material.
What Is a Pilar Cyst?
A pilar cyst, also known as a trichilemmal cyst, develops from the outer root sheath of a hair follicle.
Common Characteristics:
Firm, smooth lump
Typically found on the scalp
Often runs in families
Usually lacks a visible central opening
Less likely to rupture than epidermoid cysts
Pilar cysts are especially common on the scalp and may be mistaken for other scalp growths.
Epidermoid Cyst vs Pilar Cyst: Key Differences
| Feature | Epidermoid Cyst | Pilar Cyst |
|---|---|---|
| Common Location | Face, neck, trunk | Scalp |
| Central Opening | Often present | Usually absent |
| Origin | Surface skin cells | Hair follicle root sheath |
| Texture | Soft to firm | Typically firmer |
| Rupture Risk | More likely | Less common |
Proper diagnosis ensures the correct treatment approach. Epidermoid Cyst vs Pilar Cyst.
Can Cysts Become Infected? Epidermoid Cyst vs Pilar Cyst.
Yes. Both types of cysts can become inflamed or infected.
Signs of infection include:
Rapid growth
Redness and warmth
Pain or tenderness
Drainage of pus
Swelling
Inflamed cysts may also lead to post-inflammatory hyperpigmentation, particularly in darker skin tones.
How Are Epidermoid and Pilar Cysts Treated?
Treatment depends on symptoms and patient preference.
Observation
If the cyst is small and painless, monitoring may be appropriate.
In-Office Treatments May Include:
Steroid injection to reduce inflammation
Antibiotics if infection is present
Surgical excision to remove the cyst completely
Complete surgical removal is often the only way to prevent recurrence.
Attempting to squeeze or pop a cyst at home can worsen inflammation, increase infection risk, and lead to scarring. Epidermoid Cyst vs Pilar Cyst.
Special Considerations for Skin of Color
In Black and darker skin tones:
Inflammation can lead to long-lasting hyperpigmentation
Improper removal techniques may increase scarring risk
Keloid formation may occur in predisposed individuals
This is why treatment should be performed by a dermatologist experienced in skin of color. Epidermoid Cyst vs Pilar Cyst.
When Should You See a Dermatologist?
You should seek evaluation if:
The lump is growing
It becomes painful
It drains or bleeds
You are unsure of the diagnosis
It causes cosmetic concerns
A proper examination ensures that the lesion is benign and not another type of growth.
Expert Dermatologic Care in Georgia
Dr. David Bryant is a board-certified dermatologist and founder of World’s Famous Dermatologist, serving patients in Decatur and Stockbridge, Georgia. His practice specializes in:
Skin of color dermatology
Scalp disorders
Cyst diagnosis and removal
Inflammatory skin conditions
Cosmetic dermatology
Learn more or schedule an appointment:
https://www.worldsfamousdermatologist.com
