Wednesday, December 31, 2003
Pilar cysts
It may come as a surprise to you that TigerHawk gets pilar cysts, known colloquially to their victims as "head bumps." They are weird little pockets of keratin that form under the scalp. There is nothing dangerous about them, but they get bigger and bigger until they are annoying. They get in the way of the comb, for example, and I at least tend to prod them with my fingers when I have nothing else to do.
Head bumps run in families, but only randomly. My mother has had them, but a couple of years ago I mentioned to my brother that I was going to the dermatologist to have a couple of head bumps removed, and he wondered "what the fuck are you talking about?" So he apparently does not get head bumps.
I know people who have them pulled at their earliest manifestation, but I usually wait until they get a little bigger. Indeed, I had one pulled yesterday, and the incision point is mildly throbbing this morning, so the topic is on my mind.
Basically, the dermatologist numbs the area of the scalp under which the cyst squats, makes a small incision, and generally can remove the cyst "intact." If you get them removed early they are about the size of a pea, but because I generally put off annoying surgical procedures mine get somewhat larger. My standard is probably the size of a kidney bean, but a couple of years ago I had one about the size of a grape, which provoked some surprised commentary from the otherwise laconic doctor.
What I can't figure out is why insurers pay to have these things removed. They are harmless, and naturally occuring. It seems to me that their extraction is a matter of aesthetics, rather than medical necessity, and as an employer I wonder why we pay for this procedure. My dermatologist quite candidly wonders the same thing. I suppose that reimbursement for the removal of pilar cysts is a minor example of our national confusion over the depth and breadth of health care coverage.
Head bumps run in families, but only randomly. My mother has had them, but a couple of years ago I mentioned to my brother that I was going to the dermatologist to have a couple of head bumps removed, and he wondered "what the fuck are you talking about?" So he apparently does not get head bumps.
I know people who have them pulled at their earliest manifestation, but I usually wait until they get a little bigger. Indeed, I had one pulled yesterday, and the incision point is mildly throbbing this morning, so the topic is on my mind.
Basically, the dermatologist numbs the area of the scalp under which the cyst squats, makes a small incision, and generally can remove the cyst "intact." If you get them removed early they are about the size of a pea, but because I generally put off annoying surgical procedures mine get somewhat larger. My standard is probably the size of a kidney bean, but a couple of years ago I had one about the size of a grape, which provoked some surprised commentary from the otherwise laconic doctor.
What I can't figure out is why insurers pay to have these things removed. They are harmless, and naturally occuring. It seems to me that their extraction is a matter of aesthetics, rather than medical necessity, and as an employer I wonder why we pay for this procedure. My dermatologist quite candidly wonders the same thing. I suppose that reimbursement for the removal of pilar cysts is a minor example of our national confusion over the depth and breadth of health care coverage.
2 Comments:
By 
Flea, at
Tue Jun 12, 08:16:00 PM:
Dude, I think I have a pilar cyst, tho I've never heard of them before. In fact, I've had this for more than a decade, but only recently has it seemed to be bigger (about grape size). How nice to know that it's probably nothing serious! Thanks!
By 
, at
Fri Jul 18, 12:48:00 PM:
Insurance should, and does, cover them because they are NOT always benign, and should be looked at. Preventing one serious case of cancer pays for a WHOLE LOT of very low-cost incisions/removals of benign bumps. And that doesn't even consider the non-monetary costs...
