A Dr Pimple Popper Pilar Cyst Pop

This patient has three pretty large pilar cysts on her scalp. We both agreed to take them out one at a time.. Here’s the first.

Many of you ask why is it that I see pilar cysts in three’s? Is this how they present?
Well, my answer is no, a person can have just one pilar cyst but it is not uncommon to have multiple and for the development of pilar cysts to run in families. I think I commonly see pilar cysts in three’s because when a person gets their third pilar cyst this is when many of them finally say: “Ok, it’s about time I get these bumps removed!”
I also have noticed I see larger pilar cysts on the top of the head and I believe this is because people will tend to leave them alone and let them grow if they are on the top of their head and they can hide them in their hair. Imagine if you have a bump like this on the side of your head or on the back or your head, you will be more aware of it because when you sleep or lean up against something, you would put pressure on a cyst in these areas. On top of your head, you will be less reminded of a cyst growing.

A Pilar Cyst, aka a trichilemmal cyst, an isthmus-catagen cyst, or a “wen”, looks identical on examination to the more common epidermoid cyst, except that 90% of them occur on the scalp. They tend to be more mobile and firmer than epidermoid cysts, and are derived from a different part of the hair follicle/skin. The internal content tend to be more “homogenous”/ smooth (looks different under the microscope), but it is also a benign growth. It is not uncommon to have multiple pilar cysts on the scalp and to have other family members to have these cysts (tend to run in families). Treatment is for cosmetic reasons usually (people don’t like the appearance of them), and excision with removal of the cyst and it’s contents is curative.

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This video may contain dermatologic surgical and/or procedural content. The content seen in this video is provided only for medical education purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

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