# Epidermoid or pilar cyst

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Epidermoid Cyst - StatPearls (NCBI Bookshelf NBK499974) - https://www.ncbi.nlm.nih.gov/books/NBK499974/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class SD74.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
EPIDERMOID OR PILAR CYST
Sources: Epidermoid Cyst - StatPearls (NCBI Bookshelf NBK499974) -
         https://www.ncbi.nlm.nih.gov/books/NBK499974/ · ICPC-3 (WONCA International Classification
         of Primary Care, 3rd edition) class SD74.00 - condition scope only, no dose · No dose -
         referral pathway, no medicine given in primary care
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (2)
    - Pilar (trichilemmal) cysts are usually painless unless they calcify or rupture, causing
      inflammation and pain  [cyst]
    - Pressure from an enlarging cyst or an underlying bony prominence can also cause pain  [cyst]
  SIGNS - what you find (3)
    - These cysts occur mainly on hair-bearing skin, most often the scalp, and also the face and
      neck  [cyst]
    - They typically present as flesh-colored, smooth, mobile, firm, well-circumscribed nodules,
      often multiple
    - Rapid growth of a previously slow-growing cyst raises concern for infection or malignant
      transformation  [cyst]
  TESTS (3)
    - Diagnosis is mainly clinical, and further investigation is rarely needed
    - Imaging may be needed for midline head and neck lesions to check for central nervous system
      involvement
    - CT best shows the extent of bone invasion, while MRI is preferred for deeper soft-tissue
      extension
  IF NOT THIS - what else fits (7)
    - Acne keloidalis nuchae
    - Cutaneous lipoma
    - Dermoid cyst
    - Epidermal inclusion cyst
    - Favre-Racouchot syndrome, which combines nodular elastosis with cysts and comedones
    - Pilomatrixoma
    - Steatocystoma multiplex
  Source  StatPearls "Pilar Cyst" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Common benign skin/scalp cysts; primary care recognises them, treats secondary infection
            if present, and refers for elective surgical excision. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Common benign skin/scalp cysts; primary care recognises them, treats secondary infection
            if present, and refers for elective surgical excision.
   Caution  A rapidly enlarging, painful, or discharging cyst suggests infection or abscess needing
            incision and drainage or antibiotics.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Rapid increase in size (as opposed to the usual slow growth) suggests
            infection or malignant transformation and warrants more than routine elective referral.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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