Ask the expert


I have a small lump on my head, should I be concerned?

I have a small lump on my head - it's been there for sometime. I can feel it with my fingers but when my friends look they can't really see anything. The lump feels quite hard?

20 February 2019

Lumps and bumps on the head can occur for a number of reasons. Here are 7 of the most common causes to help you identify what you may have.

Generally, if you detect any lumps or sores that appear suddenly, seem to change in appearance or become painful, you should seek a medical opinion. The clinician will be able to monitor any changes and, if necessary, investigate further by means of biopsies or other medical imaging tests.

9 of the most likely causes of a lump on your head

1. Head injury

If you’ve recently had a trauma to your head, the most obvious cause could be bleeding under the skin and swelling due to the injury sustained. This kind of bump should ease gradually over a week or two.

  • For minor head injuries apply ice to reduce swelling. Any open wound should be cleaned and dressed. Use paracetamol if you’re safe to, avoid drugs like ibuprofen, and always use as directed.
  • Watch for signs of concussion such as passing out, nausea and vomiting, visual disturbances or double vision, headache, extreme drowsiness and memory loss. Concussion symptoms can continue for a few weeks. Seek medical assistance if symptoms persist beyond this period or seem to be getting worse.
  • Severe head injuries require immediate medical attention. Check out our factsheet now so you know what to look out for and can act quickly if you ever need to.  

2. Sebaceous cysts

This is a general category for two types of cysts that affect the skin -- epidermoid cysts and pilar cysts.

3. Epidermal cysts

These affect the epidermis layer of the skin and are made up of keratin and fat. They are generally found on the face, neck, shoulders, chest and upper body and can be triggered by acne or mild injuries to the skin.

  • Look for a slowly developing cyst with a rounded appearance, often no larger than 5cms in size
  • Usually not painful unless they are burst or become infected
  • Usually not of a cancerous nature
  • These cysts tend to disappear without treatment but if need be, can be treated with antibiotics, steroid injections or excision.

4. Pilar cysts

This is a keratin filled cyst originating from the outer hair root sheath/hair follicle.

  • Look for these on the scalp and around hairline areas; they can be difficult to distinguish from epidermal cysts in appearance and size
  • They run in families
  • Non-cancerous
  • Often will disappear without treatment
  • Treatment if needed will be with antibiotics (if infected) or excision.

5. Folliculitis

This occurs when there is inflammation of the hair follicles.

  • Look for clusters of red bumps or white-headed pimples that develop around follicles. Most commonly seen on the scalp but can affect the face, thighs and anywhere with hair
  • Most commonly caused by an infection of the hair follicles by bacteria, fungi, viruses and even inflammation from ingrowing hairs
  • People with diabetes are more susceptible
  • Treatment usually consists of antibiotic and antifungal treatment and improving cleanliness
  • Avoid friction, build-up of sweat and shaving can help the skin recover
  • Avoid perfumed toiletries can also help.

6. Pilomatrixoma

This is an uncommon, usually harmless, hair follicle tumour that occurs due to an overproduction of matrix hair cells.

  • Look for a single skin coloured or purple lesion which becomes dome-like and can grow to several centimetres in size
  • Generally seen in children but becoming more common in young adults
  • Often seen in the scalp and neck areas as individual lumps rather than clusters
  • Treatment usually involves biopsy and complete removal of the lesion.

7. Lipoma

These can grow under the skin as well as internally within the body.

  • Look for a soft, fatty, moveable lump and grow slowly up to a couple of centimetres in size
  • Usually harmless
  • They usually appear on various parts of the body but are seen less commonly in the areas of the scalp and neck.
  • If these lumps grow, become larger or firmer to touch then they should be investigated to eliminate the presence of cancerous cells.
  • Most lipomas do not need to be removed.

8. Seborrhoeic keratoses

This is the most common type of benign skin tumour.

  • Look for a scaly brown plaque which may appear slightly greasy
  • This is most common in adults particularly as ageing occurs: over 90% of adults over the age of 60 years have one
  • If these appear rapidly and in large quantities or change in appearance or become inflamed then they need investigating to rule out a cancerous origin
  • These can often be left, but if treatment is necessary can be excised or removed by cryotherapy.

9. Bony growth

A bony growth (or exostosis) is generally a benign bone tumour and is very rarely seen on the skull area.

  • Can be caused by long term irritations, osteoarthritis, infection or trauma
  • Can cause chronic pain.

Answered by the Health at Hand team.

Further reading

Lumps and swellings – NHS factsheet
Concussion – NHS Factsheet
Minor head injury – NHS factsheet
Severe head injury – NHS factsheet

Useful resources

Musculoskeletal centre – AXA Health

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