Dr. Pimple Popper Removes a ‘Macadamia Nut’ Pilar Cyst in New Video

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Close-Up Of Macadamia Nuts On Table

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• In a new video, Dr. Pimple Popper removes a large pilar cyst from a patient’s scalp.
• Pilar cysts form when clogged hair follicles cause a buildup of keratin.
• They’re fairly common in older adults, and usually benign.


Nobody gets in a patient’s head like Dr. Pimple Popper. In a new video clip published on Instagram Wednesday, dermatologist Sandra Lee, MD, host of TLC’s “Dr. Pimple Popper,” removes a large pilar cyst from the top of a patient’s scalp.

The clip opens with a standard shot of Dr. Lee in the middle of a familiar-looking procedure, preparing to cut into a small pocket containing the pilar cyst. A few cuts and squeezes later, and she extracts a large white growth that she likens to a certain staple of the snack aisle. “This is a nice macadamia nut,” she says, adding that, “if it falls, it’ll be a meatball.” See for yourself here:

In addition to vaguely resembling a macadamia nut, the growth that she seizes and extracts is also known as a pilar cyst. A pilar cyst—also known as a trichilemmal cyst—is a typically harmless lump filled with fluid that forms when a hair follicle is blocked, according to MedicalNewsToday. They tend to form in older adults—usually in women over the age of 45, though there can be genetic links that increase the likelihood of appearing in younger people. They’re also so common that they’ve become something of a fixture of Dr. Pimple Popper’s Instagram videos.

As for that cheese-like gunk inside the cyst? That’s usually nothing more than a harmless buildup of keratin, a type of protein that’s crucial to forming hair, skin, and nails. Cutting out the sac wall helps decrease the odds that the cyst will ever make an unwelcome return.

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