Ask the expert


Lump on scalp

Hi, a lump has appeared on my scalp today. I can move it and it's sore to touch, causing a headache sort of pain. I'm just wondering what it could be please?

22 August 2019

Thank you for writing in to Ask the Expert.

You say that this lump has only just occurred, so from what you describe it sounds like this lump could be due to the presence of a blocked hair follicle or sebaceous cyst.

We enclose some details of what lumps caused by these minor ailments look like.

Sebaceous cysts

Sebaceous cysts are a general category for two types of cysts that effect the skin: epidermoid cysts or pilar cysts.

Epidermal cysts

  • Affect the epidermis layer of the skin and are made up of keratin and fat
  • Are generally found on the face, neck, shoulders, chest and upper body
  • Can be triggered by acne or mild injuries to the skin
  • Tend to develop slowly, have a rounded appearance and often are no larger than 5cms in size
  • Tend not to be overly painful unless they are burst or become infected.
  • Usually not of a cancerous nature
  • Tend to disappear without treatment but if need be can be treated with antibiotics, steroid injections or excision.

Pilar cysts

  • Have a lining made up of cells similar to hair follicles
  • Are found mainly around the scalp and hairline areas
  • Are difficult to distinguish from epidermal cysts in appearance and size
  • Are non-cancerous of nature.
  • Often disappear without treatment.
  • May be treated with antibiotics or excision, if required.

Blocked hair follicles or folliculiti

  • Are commonly seen on the scalp but can affect the face, thighs and axillary area (armpit)
  • Occur when there is inflammation of the hair follicle and present as a red pustule with a hair at the centre of it
  • Other symptoms can be a red rash and itching of the skin
  • Tends to occur as a result of friction but those with diabetes are more prone to these too.
  • Treatment usually consists of antibiotic and antifungal treatment and improving cleanliness.
  • Trying to avoid friction to the area and shaving can help the skin recover
  • Taking care with perfumed toiletries can also help.

There are other causes of lumps and bumps on the head but these are usually associated with head injury, fatty deposits or skin changes due to ageing or sun exposure.

Next steps

Because this lump has happened suddenly and is painful to touch, we'd suggest that you get it reviewed by your GP as soon as possible.

Your GP will be able to assess the cause of this painful lump and will if necessary treat it by the appropriate means.

Depending on the cause of the lump treatment may include antibiotics or minor surgery within a minor surgery clinic held at a local GP facility.

We hope this gives you some reassurance.

Answered by the Health at Hand team.

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