Atheroma on the head

The localization of atheroma on the head occurs most often, which is due to its morphological features - the prevalence and connection of the sebaceous glands with the scalp (hair follicles).

Atheroma is a benign cyst of the sebaceous gland, which is formed for various reasons and is diagnosed in patients of any age and sex. Neoplasm has a typical structure for the cyst - a capsule and specific contents, detritus. Detritus in turn includes cholesterol crystals, epithelial cells, fat, keratinized particles.

[1], [2]

Causes of atheroma on the head

The etiology of athere is still not specified. Nevertheless, in the practice of medicine, the so-called "adipose" are often found, among them there may be benign tumors of different structure, histology. Atheromas are divided into the following types: 

1. Secondary cysts of the sebaceous glands, caused by the obturation of the outflow duct. Such neoplasms are called retentional, they are usually formed on those parts of the body where the hair grows, mainly on the head.
2. Epidermoid congenital cysts, due to a hereditary factor and having a more dense structure, both capsules and detritus.

The causes of atheroma on the head are associated with the developmental characteristics of the cyst, it is formed in the ducts of the sebaceous glands, mainly near the hair follicle, follicle. As a matter of fact, it is the obturized outflow channel, corked at the exit. Atheroma on the head can reach impressive sizes, up to 8-10 centimeters in diameter, since the scalp is densely saturated with glandulae sebaseae (alveolar glands) to 900 per square centimeter. The mechanism of subcutaneous cyst formation is explained by various factors, but the most common cause is damage, inflammation, follicle disease of the hair, most often seborrhea. As a result of the effect of the provoking factor, the gland duct narrows and is unable to adequately remove the sebaceous secret outward, onto the skin. In the process of increasing atheroma, the formation of its capsule, the structure of detritus begins to change, it becomes thicker, which as a result leads to a complete blockage of the outflow opening.

The most common causes of atheroma on the head are: 

• Damage to hair bulbs due to seborrhea.
• Damage to the sebaceous gland due to inflammation of the scalp.
• Genetic predisposition to the formation of benign retention cysts.
• Violation of metabolism (metabolism).
• Diabetes.
• Trauma of the sebaceous gland due to injury, cut, head injury.
• Gardner's syndrome (a rare hereditary disease).
• Hormonal, endocrine disorders.
• Violation of the rules of hygiene, care of the scalp.
• Use of chemicals for hair care (hair dye, chemical styling products, waving and so on).
• Hyperhidrosis (increased sweating, associated with hormonal dysfunction).
• The raised level of testosterone in connection with age, physiological changes in an organism - pubertal period, age after 45-50 years (at men).

[3], [4], [5], [6], [7]

Symptoms of atheroma on the head

Clinically, atheroma is manifested only when it becomes quite large, the early stage of its development, as a rule, is asymptomatic.

Symptoms of atheroma on the head are as follows: •

• Rounded seal on the scalp in any area.
• The surface of the atheroma is smooth, the skin does not change color or texture.
• The cyst during palpation is quite mobile, but it does not move, it is partially soldered to the skin in the zone of its localization.
• Atheroma always has clearly defined contours.
• Atheroma on the head is not manifested by pain sensations, if not damaged and not inflamed.
• The cyst can be opened spontaneously even without signs of inflammation, the contents leak in the form of a sebace secret, white color, a mushy consistence.
• Atheroma is prone to inflammation, so it often gets nagged with all the characteristic signs of a subcutaneous abscess.
• Inflamed atheroma is manifested by pain in the place of localization.
• The skin in the place of formation of the abscess is hyperemic, edematous.
• If the cyst is large, the purulent process develops rapidly, not only the local skin temperature but also the entire body rises.
• Atheroma with suppuration can be opened independently, with the expiration of pus out.
• A more serious condition is considered a subcutaneous dissection of an inflamed atheroma with signs of general intoxication of the body - headache, a drop in blood pressure, a sharp deterioration in the state of health.

A simple retention cyst on the head is not considered a serious disease, however, a large, large atheroma can not only deliver psychological or cosmetic discomfort, but also squeeze nearby blood vessels, provoking severe headaches.

Atheroma of the scalp

A theroma (epithelial retention cyst) is most often formed in those areas of the body where the hair follicles are located. Atheroma of the scalp is the most common localization of such neoplasms, which are considered benign and never degenerate into a malignant process.

The cyst of the scalp is formed due to the gradual, slow constriction of the duct of the sebaceous gland. It should be noted that on the head, according to the estimates of trichologists, an average of 100,000 hair grows on average. Considering that unlike sweat glands, glandulae sebaseae (sebaceous glands) are almost always connected with hair bulbs, atheroma on the scalp has all the conditions for its development. The reasons for the formation of such cysts are different, they can be associated with a metabolic disorder or hormonal dysfunctions, traumas of the scalp or seborrhea. In dermatology, the factors that provoke atheroma have been little studied, apparently due to the fact that such retention cysts are in any case to be removed, during which tissue is taken for histological examination. Actually, the histology determines the differential diagnosis and the nature of the so-called "wen" on the head.

In the clinical sense, the atheroma on the scalp is either a single neoplasm of a dense structure and a fairly large size, or multiple small cysts - atheromatosis. Atheroma does not hurt, if it is not inflamed, develops without obvious clinical signs, very slowly. Purulent atheromas are painful, prone to spontaneous dissection, often recur.

Treatment of the subcutaneous cyst of the sebaceous gland on the head is determined by the doctor, but it will only be surgical in 100% of cases. Modern medical technology allows you to remove atheroma for 25-40 minutes in an outpatient setting, virtually painless. The only drawback of the operation may be the need for partial removal (shaving) of the hair, but, as a rule, this method is used only for the enucleation of large cysts, when there is no way to use the radio wave method. Laser and radio wave removal of atheroma does not require such "sacrifices" from the patient, but these methods can be effective only in the treatment of small cysts that do not show signs of inflammation. Therefore, with the first atypical symptoms, the appearance of small seals in the scalp, you should consult a doctor, without waiting for the growth of the atheroma or its suppuration.

[8], [9], [10]

Atheroma at the back of the head

Atheroma forming in the occipital zone can be triggered not only by common causes - metabolic disorders, hormonal dysfunction, but also by purely domestic traumatic factors, for example, the constant wearing of a close headdress, or features of a female hairstyle (hair clips at the nape, hairpieces and so on ). As a result of constant mechanical action on the skin of the occiput, the function of the sebaceous glands changes, they narrow down due to poor nutrition of the tissues, are clogged, creating all conditions for the formation of internal capsules with greasy contents. Quite often an atheroma at the nape develops due to increased sweating or poor hygiene of the scalp. The cause of the appearance of a cyst is determined by a doctor, but more important is the differentiation of atheroma from similar in appearance signs.

Differential diagnosis of atheroma on the occiput suggests its difference from such soft-tissue subcutaneous diseases:

• Hemangioma of the occipital part of the head.
• Herniated hernia (rarely, since it has specific symptoms).
• Lipoma (true fatty, benign tumor).
• Lymphadenitis of the lower part of the occiput.
• The dermoid cyst.

Treatment of the sebaceous gland cyst suggests its removal. No other method gives a result, moreover, it can provoke the inflammatory process and suppuration of the atheroma. An inflamed cyst is treated more difficultly, as it is first opened, drained, and only after the clinical signs of the process subsided, an operation is performed. Consequently, the procedure is accompanied by repeated incisions of the skin, which inevitably leads to the formation of scars. Atheroma at the nape of the neck can be removed at any stage, but its neutralization is more effective when the tumor is small (up to 3 cm) and has no signs of suppuration.

[11], [12], [13], [14], [15]

Diagnosis of atheroma on the head

To diagnose the cyst of the sebaceous gland in the initial period of its development is practically impossible, because the neoplasm is formed asymptomatically. Typically, the patient turns to the doctor when the atheroma is already palpable and visible.

Diagnosis of atheroma on the head is carried out according to the following algorithm: 

• Primary visual examination of the scalp.
• Palpation, including nearby lymph nodes.
• Visual differentiation of atheroma from other neoplasms. The main criterion is the presence of a visible output, possibly a sealed opening of the sebaceous gland, which is not characteristic of a lipoma or dermoid cyst.
• To clarify the nature of the tumor, Doppler ultrasound, ultrasound cysts, CT or X-ray of the skull may be prescribed.
• Histological examination of atheroma tissue, the material is taken during the operation.

Diagnosis of an atheroma on the head should be differential, the cyst should be separated from such neoplasms: 

• Lipoma (subcutaneous tumor) - lies deeper than atheroma.
• Fibroma - more dense in structure, soldered to skin.
• Papilloma - has specific visual criteria.
• Hemangioma - a neoplasm from blood vessels, without clear contours, loose formations, determined by palpation.
• The dermoid is a congenital dense cyst.

The main differential criterion is a histological study that determines to within 100% atheroma or other benign neoplasms of the skin and subcutaneous tissue of the head.

[16]

Treatment of atheroma on the head

Atheroma is treated surgically. Any proposal of a conservative or non-traditional way should be considered incorrect and even dangerous. The sebaceous gland cyst is not able to resolve by definition, it is due to its morphology. The capsule of atheroma consists of epithelial cells, the contents of cholesterol, lipid, keratinized elements. Even spontaneous dissection of the suppurated cyst and its temporary decrease does not indicate complete cure. Over time, the sebaceous gland ducts will begin to become clogged again, the capsule will be regenerated and filled with detritus.

Treatment of atheroma on the head can be carried out by such methods: 

1. In a routine order, remove small cysts without signs of inflammation: 
   • Surgical method using a scalpel. 
   • Laser method of atheroma removal.
   • Radio wave method of subcutaneous cyst removal.
2. Emergency treatment of atheroma on the head during inflammation: 
   • Autopsy of the abscess.
   • Drainage.
   • Symptomatic treatment of local inflammation.
   • Enucleation of the cyst, more often with the help of a scalpel.
3. Rehabilitation period: 
   • When removing a simple atheroma of a small size, the sutures dissipate after 1-1,5 months without visible cosmetic defect.
   • The laser and radio wave method make it possible to carry out the procedure most sparing, the incision is minimal, the healing takes place after 5-7 days.
   • Purulent atheroma is most difficult in terms of healing after the procedure. Possible keloid scar, which remains for a long time

Thus, the earlier the atheroma is removed, the less risk of manifestations of purely cosmetic defects on the scalp.

Removal of atheroma on the head

Removal of the sebaceous gland cyst in the head region is not difficult, the only specific nuance may be the need to shave a certain part of the hair during the enucleation of a large atheroma, especially if it is inflamed or suppurated. The operations are performed on an outpatient basis under local anesthesia, general anesthesia is indicated only in extreme cases - children under 5-7 years old or patients with complications of other diseases.

Methods that can be used to remove atheroma on the head: 

1. Surgical method using a scalpel: 
   • The incision is made in the most protruding part of the cyst, detritus is squeezed out, the capsule is extracted with a special clamp.
   • The incision is carried out in the same way as described above, but the capsule is scraped by a special tool.
   • The incision is made without damage to the capsule, the skin is shifted, the cyst is removed.
   • There are several bordering incisions around the exit aperture of the cyst, the edges of the skin are placed in clamps, the cyst is removed within the limits of healthy tissues and superimposed vertical cosmetic sutures.
2. Laser removal of the atheroma on the head is an absolutely painless method, shown for the neutralization of small cysts.
3. The radiowave removal method is good in that it does not require the removal of hair in the place of atheroma formation.

It should be noted that many patients develop a false opinion about a completely untraumatic procedure when using a laser or a radio knife. This is not true, in any case, the skin is dissected, although in a more gentle and safe mode. The merit of new methods is undeniable: 

• Operation speed (up to 30 minutes).
• Minimal blood loss, because coagulation takes place in parallel.
• Fast tissue healing.
• Minimal scars that dissolve within a few weeks.
• Great cosmetic effect.
• Absence of relapses.

All other stages, which involve the removal of atheroma on the head - removal of detritus along with the capsule, are similar to the traditional method with the use of a scalpel. In addition, the laser is not indicated for the treatment of large atheromas, inflamed and suppurated cysts. The radio wave method has contraindications - the presence of pacemakers, metal implants, including dentures made of metal. The surgical method of removing the sebaceous gland cyst on the head is used for adult patients, children under 5-7 years of age are to be monitored. In children, atheroma is removed only in case of inflammation or other medical indications.

In general, an atheroma on the head is not dangerous either for the health or for the life of the patient. However, in addition to a cosmetic defect, such a cyst is a neoplasm capable of becoming inflamed or suppurated, which is fraught with complications in the form of an abscess of the scalp. Therefore, when there are atypical seals, zhirovikov should promptly contact a dermatologist, cosmetologist, trichologist, conduct a primary diagnosis and remove atheroma in the planned regime.