Pilar cysts are firm, often painless lumps that form on the scalp and can become inflamed or grow over time. At City Dermatology Clinic in Harley Street and the City of London, we offer private pilar cyst removal with minimal scarring, performed by experienced dermatologists and aesthetic surgeons. Our same-day treatments are a trusted alternative to long NHS waits, with a focus on cosmetic results and patient comfort.
Pilar cysts, also known as trichilemmal cysts, are benign growths that develop from hair follicles – most commonly on the scalp. While harmless, they can grow, become irritated, or interfere with grooming, prompting removal.
The most effective treatment is complete surgical excision under local anaesthetic. The cyst and its sac are removed in full to prevent recurrence. Scalp incisions are made carefully, often hidden between hairlines, and closed with dissolvable or fine stitches.
If the cyst is inflamed or infected, it may need to be drained first. However, this is only a temporary solution, as the sac remains and the cyst is likely to refill. Definitive removal is done once the inflammation has settled.
The cyst can be sent to the lab for analysis if advised by your doctor. While most pilar cysts are benign, histology can confirm the diagnosis and provide added reassurance.
| Stage | Details |
|---|---|
| Specialist Consultation | A dermatologist or surgeon will examine the cyst, confirm the diagnosis, and advise on the best treatment method, including the option for multiple removals if needed. |
| Local Anaesthetic | A small injection is used to numb the area completely. This makes the procedure pain-free. |
| Cyst Removal | A small incision is made over the cyst. The entire cyst and sac are gently separated and removed without bursting. On the scalp, incisions are placed discreetly to preserve hair growth. |
| Closure | The incision is closed with dissolvable stitches or fine sutures. A dressing is applied to protect the site, and patients are given aftercare advice to support healing. |
| Same-Day Discharge | You can return home immediately after the procedure. Patients are advised to avoid hair washing for 24 hours and heavy exercise for a few days. |
| Common Symptoms of Pilar Cysts | Typical Causes |
|---|---|
| Firm, round lump on the scalp beneath the skin | Blockage of hair follicle or build-up of keratin under the surface |
| Grows slowly over time, may become tender or sore | Genetic predisposition; often runs in families |
| Can become inflamed or infected with pain or swelling | Friction, trauma, or bacterial entry |
| Cosmetic concern, difficulty brushing or washing hair | Accumulation of keratin beneath the outer root sheath |
Our dermatologists and aesthetic surgeons perform hundreds of cyst removals, ensuring the entire sac is removed to prevent regrowth – all while preserving cosmetic appearance.
Located in Harley Street and the City of London, we offer a private and discreet setting for treatment, with minimal downtime and no long waits.
We understand the importance of careful incision placement on the scalp. Our surgeons prioritise preserving the hairline and minimising visible scarring, even for multiple cysts.
We offer fast diagnosis and same-day procedures for patients tired of delays or being told their case is “cosmetic only” on the NHS.
Our experienced dermatologists and minor surgery specialists are trusted for safe, effective pilar cyst removal with cosmetic care. Whether you have one or several scalp cysts, our team ensures expert-led treatment from diagnosis to recovery.
A pilar cyst, also known as a trichilemmal cyst, is a benign, firm lump that forms under the skin – most commonly on the scalp. It develops from the outer root sheath of a hair follicle and is filled with keratin (a protein found in skin and hair). These cysts are slow-growing and usually painless unless inflamed or infected.
No – the procedure is performed under local anaesthetic, which completely numbs the area. Patients may feel some pressure but no pain during the removal. Mild soreness or tightness may occur after the procedure, but this is usually short-lived and manageable with simple pain relief.
Any surgical procedure can leave a small mark, but our doctors use refined surgical techniques and discreet incision placement between hairlines to minimise scarring. In most cases, once the hair grows back, the scar is barely visible. We also use dissolvable stitches to avoid the need for removal.
Yes – if you have multiple pilar cysts, we can often remove several in one session, depending on their size, location, and your medical history. This will be confirmed during your consultation and included in your tailored treatment plan.
If the cyst is infected, we may recommend antibiotics first to settle the inflammation. In some cases, temporary drainage may be needed. Once the infection has cleared, we’ll schedule a follow-up for full excision – which is necessary to remove the cyst sac and prevent recurrence.
Pilar cysts are benign and can be left alone if they are not causing problems. However, they may grow over time, become infected, or interfere with daily activities like hair brushing or styling. Many patients choose removal for cosmetic reasons or to avoid future complications.
If the entire cyst and its sac are removed cleanly – which is our standard approach – the chance of recurrence is very low. Incomplete removal, such as drainage or poor technique, increases the risk of regrowth. Our experienced surgeons are trained to remove the full cyst to prevent this.
Histology is optional for pilar cysts, but it may be recommended in certain cases – particularly if the cyst looks unusual or has changed in size or texture. Histological testing provides a formal diagnosis and peace of mind. We’ll discuss this with you during your consultation.
The NHS may remove pilar cysts if they are infected, painful, or interfering with function. However, if they’re classed as “cosmetic,” removal is often declined. At City Dermatology Clinic, we offer fast access to expert care without waiting lists – even if your case was previously turned away by the NHS.
Most patients can resume normal activity on the same day. We recommend avoiding heavy lifting, strenuous exercise, and washing the scalp for at least 24–48 hours. You’ll receive personalised aftercare instructions to support healing and maintain results.
Our clinic is perfectly located in Central London near a number of conveniently located stations.
Warwick House,
65-66 Queen Street
London
EC4R 1EB
0208 050 5981
Nearest Stations:
4 Harley Street
London
W1G 9PB
0208 050 5981
Nearest Stations:
Experience exceptional care with our team of leading dermatologists in London at our private clinic, dedicated to providing outstanding skin health services in a state-of-the-art facility. Choose City Dermatology Clinic for private, expert dermatological care in the City of London.
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