Pilar Cyst vs Scalp Folliculitis

A keratin-filled cyst arising from the hair root sheath, usually on the scalp. Inflammation of scalp hair follicles producing itchy or tender spots.

Research updated 2026-10-23

Key differences What is it?What it looks like Diagrams When it starts Triggers Daily Care Treatment Outlook Complications When to get help Questions

Key differences

The same eight facts on every condition comparison.

Usual age

Adults

Where

Scalp

Scalp and hairline

Main sign

Smooth firm lump

Small spots at hair roots

Itch or pain

Painless unless inflamed

Itchy or tender

Contagious

Rarely

Long term

Stays until removed

Often comes back

Scars

Sometimes

Who gets it

Adults; often runs in families

Adults; oily scalp

What is it?

Pilar Cyst

Scalp Folliculitis

What is it?

What it is
A keratin-filled cyst arising from the hair root sheath, usually on the scalp.

What it is
Inflammation of scalp hair follicles producing itchy or tender spots.

What it looks like

Pilar Cyst

Gloved hands parting hair around a rounded skin-colored scalp lump.

Pilar Cyst Parted hair reveals a smooth raised bump beneath the skin.

Scalp Folliculitis

Parted hair revealing clusters of red bumps on the scalp.

Scalp Folliculitis Small inflamed bumps are visible on the exposed scalp.

Skin tones

A smooth rounded pilar cyst beneath intact scalp skin.

In the skin

Cells from the hair root sheath form a cyst lining beneath the skin. Keratin produced by this lining accumulates inside the cyst.

Inflammation develops around follicles in the scalp. Bacteria, yeast, physical irritation or other contributors can be involved.

When it usually starts

010203040506070+

Pilar Cyst. Most often recognised in adults.

Scalp Folliculitis. Can occur at different ages after a relevant exposure or follicular inflammation.

Causes and triggers

Causes

Keratin accumulates within a cyst lined by cells from the hair root sheath.

Follicular inflammation can involve bacteria, yeast or other contributors.

Risk factors

Family tendency

Oily or occlusive products, Microbial overgrowth

Trigger

● Pilar Cyst

● Scalp Folliculitis

Local trauma can inflame an existing cyst

Can contribute

Not listed

Occlusion

Not listed

Can contribute

Scratching

Not listed

Can contribute

Daily Care

Pilar Cyst

Scalp Folliculitis

Daily care

Habits that help

Leave a stable, clinician-confirmed benign lesion alone
It may not need treatment if it is comfortable and not changing.
Reduce rubbing from clothing, shaving or hair tools
Repeated injury can make a harmless lesion sore or cause bleeding.
Notice meaningful changes without repeatedly squeezing it
Arrange examination for rapid growth, persistent bleeding or a change in appearance.
Comb and wash around the lump gently
Do not puncture a scalp cyst; inflammation or drainage needs assessment.

Avoid

Avoid: Cutting, burning, freezing or acid removal at home
Home removal can cause infection, scarring and delay the correct diagnosis.

Habits that help

Wash the scalp with a mild shampoo
Rinse thoroughly and adjust frequency to sweat, oil and comfort.
Clean combs, clippers and headwear regularly
Avoid sharing tools that contact affected skin.
Reduce heavy oils and close-fitting headwear if they worsen bumps
Friction and occlusion can aggravate an irritated scalp.
Leave pustules and crusts alone
Keep nails short to reduce damage from unconscious scratching.
Seek review for pain, scarring or persistent hair loss
Recurrent scalp bumps may need a specific diagnosis and prescription treatment.

Avoid

Avoid: Squeezing spots or shaving across inflamed bumps
This can worsen irritation and spread infection.

Treatment differences

Evidence labels come from each condition’s own treatment list.

Treatment

● Pilar Cyst

● Scalp Folliculitis

Prescription topicals

None listed

Cause-specific prescription treatment

Listed

A clinician can choose antibacterial, antifungal or anti-inflammatory treatment after assessing the pattern.

Procedures

Excision

Listed

Can remove a symptomatic or troublesome cyst and its wall; the specimen may be examined.

None listed

Outlook

Long term

Pilar cysts are usually benign and often remain unless removed. A painful or inflamed cyst needs assessment; recurrence is possible if the cyst wall is not completely removed.

Treatment can settle inflamed follicles, but some forms recur and need maintenance. Painful deep lesions, scarring or hair loss need assessment because the course differs between scalp disorders.