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

Finding a new lump or bump on the head can be a cause for concern, but in most cases, it's nothing to worry about. However, it's always a good idea to have any lump or bump checked out by a GP. They can assess the situation, provide advice on symptom management, and refer you to appropriate treatment if necessary.

In this article, we'll discuss the likely causes of a lump on the head, when to see a GP, and potential treatment options.

When to see your GP

If you notice any of the following, it's important to schedule an appointment with your GP:

1. Your lump is increasing in size.
2. Your lump feels hard and doesn't move under the skin.
3. Your lump is painful, red, hot, or shows signs of infection.
4. Your lump persists for more than two weeks.
5. Your lump returns after previous removal.

Common causes of a lump on your head

1. Head injury

If you've recently experienced trauma to your head, a bump may develop due to bleeding under the skin and swelling. Typically, this type of bump should gradually reduce over a week or two.

• For minor head injuries - you can apply ice to reduce swelling. Clean and dress any open wounds. If safe for you, use paracetamol for pain relief, avoiding drugs like Ibuprofen. Always follow the recommended dosage.
• Look out for signs of concussion - such as passing out, nausea and vomiting, visual disturbances or double vision, headache, extreme drowsiness, and memory loss. If you suspect a concussion, seek medical attention immediately. Concussion symptoms can persist for a few weeks but should gradually lessen. If symptoms persist or worsen, seek medical assistance.
• Severe head injuries require immediate medical attention. Familiarise yourself with the signs to recognise them quickly if the need ever arises.

2. Epidermal cysts

These cysts develop in the outer layer of the skin and consist of keratin and fat. They are commonly found on the face, neck, shoulders, chest, and upper body. Acne or minor skin injuries can trigger their formation.

• Look for a slowly developing cyst with a rounded appearance, usually no larger than 5cm.
• They are typically not painful unless burst or infected.
• Most epidermal cysts are not cancerous and tend to disappear without treatment. However, antibiotics, steroid injections, or excision can be considered if necessary.

3. Pilar cysts

Pilar cysts are filled with keratin and originate from the outer hair root sheath or hair follicle.

• These cysts are commonly found on the scalp and around the hairline, and they can resemble epidermal cysts in appearance and size.
• Pilar cysts tend to run in families and are usually non-cancerous.
• Often, they will disappear without treatment. Antibiotics may be prescribed if an infection occurs, or excision can be performed if needed.

4. Folliculitis

Folliculitis occurs when the hair follicles become inflamed.

• Look for clusters of red bumps or white-headed pimples around hair follicles, commonly seen on the scalp but can appear on the face, thighs, or other hairy areas.
• Bacterial, fungal, viral infections, and inflammation from ingrown hairs are common causes, with individuals with diabetes being more susceptible.
• Treatment often involves antibiotics, antifungal medications, and improving cleanliness. Avoiding friction, sweat build-up, and shaving can aid in the recovery of the skin. Also use non-perfumed toiletries.

5. Pilomatrixoma

Pilomatrixoma is an uncommon, usually benign hair follicle tumour resulting from an overproduction of matrix hair cells.

• Look for a single, skin-coloured, or purple lesion that becomes dome-like and can grow several centimetres in size.
• While it is often observed in children, it is becoming more common in young adults.
• Pilomatrixomas typically appear as individual lumps in the scalp and neck regions.
• Treatment usually involves a biopsy and complete removal of the lesion.

6. Lipoma

Lipomas can develop under the skin or internally within the body.

• Look for a soft, fatty, and movable lump that grows slowly, usually up to a couple of centimetres in size.
• Lipomas are generally harmless and can appear on various parts of the body, but they are less common on the scalp and neck.
• If lipomas grow larger, become firmer, or show signs of cancerous cells, further investigation is recommended. In most cases, lipomas do not require removal.

7. Seborrheic keratoses

Seborrheic keratoses are the most common type of benign skin tumour.

• Look for scaly brown plaques that may appear slightly greasy.
• This condition is most common in adults, especially as they age, with 75% of the population affected by it by the age of 70.¹
• Rapid appearance, significant quantity, changes in appearance, or inflammation should be investigated to rule out malignancy.
• Seborrheic keratoses can often be left untreated, but if necessary, they can be excised or removed through cryotherapy.

8. Bony growth

Bony growths, or exostoses, are usually benign bone tumours rarely found on the skull.

• They can be caused by long-term irritation, osteoarthritis, infection, or trauma.
• Bony growths can lead to chronic pain.

Malignancy risk

While rare, a small lump on the head can sometimes be a sign of a malignant tumour. Cancerous head lumps are typically hard and painless to the touch, often growing steadily over time.

Sometimes, it can be challenging to determine the nature of a lump, whether it's a cyst, lipoma, or something more serious. Consulting with your doctor for a thorough examination is crucial.

Treatment

Once diagnosed, your GP will guide you on how to manage the lump on your head. This might involve monitoring, management at the GP surgery with antibiotics or topical creams, or small local excision if required.

Further investigations or referrals to specialists, such as dermatologists or head and neck surgeons, may be recommended for diagnosis. This could involve biopsies and scans to determine the appropriate treatment.

While most lumps on the head are harmless, it's essential to have them evaluated by a GP. Understanding the common causes, recognising concerning symptoms, and seeking medical advice promptly can help ensure proper management and, if necessary, appropriate treatment.

Remember to consult your GP for any persistent or worsening symptoms.

For more information, refer to the relevant NHS factsheets provided below.

*Information provided and reviewed by the AXA Health 24/7 health support line, for members.

References

1. Seborrhoeic keratosis - British Association of Dermatologists 

Further reading

• Lumps – NHS factsheet
• Head injury and concussion – NHS Factsheet