A painful lump on the scalp often prompts immediate concern. While unsettling, many underlying causes are benign and manageable. Understanding why a scalp lump hurts when pressed can help clarify its nature and guide appropriate next steps. This article provides a general overview of these common conditions.
Understanding Common Causes
Several common conditions can lead to a painful lump on the scalp.
Sebaceous Cysts
Sebaceous cysts, specifically epidermoid or pilar cysts, form from blocked hair follicles or skin glands. These benign, slow-growing lumps can become tender if they rupture, inflame, or get infected, often by Staphylococcus aureus, causing localized pain and swelling. They typically feel firm and movable beneath the skin surface.
Lipomas
Lipomas are soft, fatty tumors developing just beneath the skin. These benign growths are generally painless but can cause discomfort if they press on nearby nerves or become inflamed. They usually grow slowly and have a doughy or rubbery texture.
Folliculitis
Folliculitis, an infection of hair follicles, can also result in painful scalp lumps. This occurs when bacteria, frequently Staphylococcus aureus, infect follicles, leading to red, tender bumps that may contain pus. If the infection deepens, it can form an abscess, a larger, more painful pus collection requiring drainage. The affected area often feels warm to the touch due to inflammation.
Trauma
Physical trauma to the head can directly cause a painful lump, often a hematoma. This occurs when blood vessels rupture beneath the scalp, forming a collection of blood. The accumulated blood creates pressure, causing immediate pain and tenderness when touched. These lumps can vary in size and may show discoloration.
Swollen Lymph Nodes
Swollen lymph nodes can also appear as tender lumps, especially behind the ears or at the back of the head (occipital region). These small, bean-shaped glands swell in response to infections or inflammation in the head, scalp, or neck. As part of the body’s immune response, they become enlarged and sensitive, signaling an active fight against pathogens.
When to Seek Medical Attention
It is prudent to seek medical attention if a scalp lump exhibits certain concerning characteristics.
Concerning Characteristics
Persistent pain that does not subside or worsens, or any noticeable increase in the lump’s size, color, or shape, warrants professional evaluation.
Signs of Infection or Systemic Issues
Signs of infection (increasing redness, warmth, pus) or systemic symptoms (fever, chills) require prompt medical assessment. Accompanying neurological symptoms like numbness, limb weakness, vision changes, or severe headaches also necessitate immediate medical consultation. Unexplained weight loss occurring with a scalp lump is another concerning symptom.
New or Unexplained Lumps
Consulting a healthcare professional is also advisable if the lump is new, unexplained, or causes significant personal concern. Even without alarming symptoms, a professional opinion can provide reassurance and an accurate diagnosis.
Diagnosis and Treatment
Diagnosing a painful scalp lump typically begins with a thorough physical examination. The doctor assesses its size, texture, mobility, and tenderness, and inquires about its onset, duration, associated symptoms, and the patient’s medical history.
Diagnostic Tools
Depending on the initial assessment, imaging studies may be used for deeper understanding. An ultrasound provides detailed images of superficial lumps. CT scans or MRIs might be employed for deeper assessments, especially if concerns arise about underlying bone or brain structures. In some cases, a small tissue sample (biopsy) may be taken for microscopic analysis to determine cell nature, particularly if malignancy is suspected.
Treatment Approaches
Treatment for a painful scalp lump varies widely, depending on the underlying cause. Benign, non-troublesome lumps may simply be observed without intervention. Infections are commonly treated with antibiotics to eliminate the bacterial cause, while anti-inflammatory drugs manage pain and swelling. Abscesses or certain cysts often require drainage, where fluid or pus is removed. Persistent cysts, symptomatic lipomas, or suspicious growths typically necessitate surgical removal.