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Lumps, Bumps & Cysts

Lumps, Bumps & Cysts

There is a wide range of skin conditions that cause lumps, bumps, and cysts — a general term that typically refers to warts, skin tags, vascular birthmarks, fat deposits, and other types of skin growths — to appear either on the surface of the skin or just under the skin. While we recommend that patients consult our dermatology clinic at first sight of any new skin development, most skin lesions and growths develop over time and are harmless.

The following comprises a selection of the most common lumps, bumps, and cysts that patients develop over time. Gainesville Dermatology & Skin Surgery offers a complete range of clinical skin care and skin condition treatments, each of which comprises an individual-specific treatment plan created to accommodate each patient’s unique skin health requirements. Contact our office today to schedule a dermatologist appointment.

Keratosis Pilaris

Often considered a variant of normal skin, keratosis pilaris is a common, harmless skin condition that causes dry, rough patches and tiny bumps to appear on the surface of the upper arms, thighs, cheeks, and buttocks. The bumps are typically not painful, nor do they itch. These sandpaper-like bumps are a result of built-up keratin — a hard protein that protects the skin from infection — that forms a plug and blocks the openings of hair follicles. 

Cases of severe keratosis pilaris occur during seasonal changes, in which low humidity levels cause the skin to become dry. The condition usually disappears by age 30. Keratosis pilaris treatment comprises medicated creams containing chemical exfoliants — such as alpha hydroxy acid, lactic acid, salicylic acid, and urea — to loosen and remove dead skin cells and creams derived from vitamin A — topical retinoids — which promote cell turnover.

Molluscum Contagiosum

Molluscum contagiosum is a common skin condition that results from a viral infection of the skin and causes round, firm, and painless bumps — ranging in size from a pinhead to a pencil eraser — to appear on the skin’s surface. Molluscum contagiosum can spread to surrounding skin if scratched or itched and can be transmitted through person-to-person contact or contact with infected objects. The infection is most common in children but can affect adults as well.

Signs and symptoms of molluscum contagiosum include bumps on the skin that usually appear on the face, neck, armpits, arms, and tops of the hands in children, or on the genitals, lower abdomen, and inner thighs in adults if sexually transmitted. The condition generally gets better in six months to a year, but symptoms and signs can develop for up to 5 years. Molluscum contagiosum treatment options include scraping, cryotherapy, and cantharidin.

Lipoma

Similar to a cyst in appearance, a lipoma is a slow-growing lump comprised of fat cells that are typically situated in the subcutaneous skin layer, located between the skin and the underlying layer of muscle. Most lipomas are small — usually less than 2 inches in diameter, but may grow in size — and feel soft or doughy in texture, moving readily with slight pressure. Patients typically develop lipomas at middle age in the neck, shoulders, back, abdomen, and thighs.

A lipoma usually isn’t tender, but may cause pain if it grows and presses on nearby nerves or contains numerous blood vessels. The exact cause of lipomas isn’t fully understood, but genetic factors likely play a role in their development. A physical exam, biopsy, and X-ray may be performed to diagnose a lipoma. If the lump is bothersome, painful, or growing, lipoma removal may be recommended either through dermatology surgery or a liposuction procedure.

Folliculitis

Folliculitis is a common skin condition in which hair follicles become inflamed. The primary causes of folliculitis are fungal infections and bacterial infections, but other causes include viruses, fungi, and inflammation from ingrown hairs. Signs and symptoms include clusters of small red bumps or whitehead pimples that develop around hair follicles; pus-filled blisters that break open and become crusty; a large, swollen mass; and skin that is painful, itchy, or tender.

Patients may be diagnosed with superficial folliculitis — such as bacterial folliculitis, pseudomonas folliculitis, pseudofolliculitis barbae, and pityrosporum folliculitis — or deep folliculitis — such as sycosis barbae, gram-negative folliculitis, boils and carbuncles, and eosinophilic folliculitis. Folliculitis treatment includes minor surgery, laser hair removal, and medications, such as creams or pills to control infection, fight fungal infections, and reduce inflammation.

Warts

Warts are benign (non-cancerous) skin growths that result from exposure to the human papillomavirus (HPV). There are five types of warts — common warts, flat warts, plantar warts, filiform warts, and water warts (molluscum contagiosum) — and are characterized as skin-colored or gray-colored, hardened, raised, and calloused areas of skin. Warts may be spread either through direct contact with a wart or through exposure to an infected surface.

In many cases, warts go away without treatment within 1–2 years, but new warts may develop on other areas of the skin. For patients seeking professional wart treatment, a dermatologist may recommend several different approaches — such as freezing (cryotherapy), salicylic acid, trichloroacetic acid, minor surgery, or pulsed-dye laser treatments — to destroy the wart and stimulate the immune system to combat the virus. 

Epidermoid Cysts

An epidermoid cyst is a small, benign bump that develops beneath the skin, typically on the face, neck, and trunk. Signs and symptoms include a small, round bump under the skin, a tiny blackhead plugging the cyst’s opening, yellow cyst discharge, and (if inflamed or infected) redness, swelling, and tenderness to the area. Anyone can develop these cysts, but those that are past puberty, with certain genetic disorders, and with skin injuries are more susceptible.

Commonly mistaken for sebaceous cysts, epidermoid cysts can also result from damage to hair follicles or the epidermis. These slow-growing bumps are typically painless, but epidermoid cyst removal may be necessary if the growth becomes painful, ruptured, or infected. Treatment for epidermoid cysts may include injections to reduce swelling and inflammation, incisions and drainage to squeeze out the cyst’s contents, and minor surgery to completely remove the cyst.

Seborrheic Keratosis

Seborrheic keratosis is a common, noncancerous, wart-like skin growth characterized by a brown, black, or tan color and a waxy, scaly, and slightly raised appearance. These growths usually develop on the face, head, neck, chest, or back and may appear as a single growth or as multiple growths. Growths range in size from extremely tiny to more than 1 inch in diameter. Patients tend to develop more of these growths with age and over time.

The exact cause of seborrheic keratosis is unknown, but genetic traits may be a factor. While these skin growths are harmless and pose no threat of contagion, seborrheic keratosis removal may be beneficial for patients who are bothered by the appearance of the growths, as well as those with irritated skin growths due to clothing. Available treatment options include cryosurgery, curettage, electrocautery, ablation, and application of a hydrogen peroxide solution.

Cherry Angioma

The most prevalent type of angioma, a cherry angioma is a common, benign, mole-like skin growth that results from an overgrowth of small blood vessels, or capillaries. Cherry angiomas are most common in adults over 30, and they tend to increase in number as a person ages. The sudden appearance of many cherry angiomas may indicate another type of angioma that requires prompt medical examination by a dermatologist.

Cherry angiomas are small, smooth, and bright red bumps that vary in size from a pinhead to a quarter-inch in diameter. In most cases, these growths do not require treatment. Cherry angioma removal may be recommended, however, if the patient finds the growths aesthetically unappealing or the growths are subject to bleeding. Removal of the growths may be performed with laser excision, a shave biopsy, or electrocautery, and the procedure may cause scarring.

Dermatofibroma

Dermatofibromas are small, noncancerous skin growths that can develop anywhere on the body, but most commonly appear on the lower legs, upper arms, and upper back. Dermatofibroma nodules are more common in adults than in children and may be pink, red, grey, or brown, possibly changing color over time. They are firm and can feel like a stone under the skin. When pinched from the sides, the top of the growth may dimple inward.

Tenderness and itching with dermatofibromas may occur, but these growths are generally painless, and they rarely grow larger than a half-inch in diameter. In most cases, a single nodule develops. However, multiple nodules may be present at one time. While treatment is seldom required, some people may seek dermatofibroma removal through dermatology surgery if the growth is unsightly, painful, irritating, itchy, or in an inconvenient location.

Keratoacanthoma

Keratoacanthoma (KA) is a skin tumor that typically develops in sun-damaged skin. The lesion may develop and grow for a few months before shrinking and disappearing completely. A variant of non-melanoma skin cancer, keratoacanthoma may appear similar to squamous cell carcinoma (SCC), which is a more severe skin condition. Symptoms include a raised, dome-shaped lesion with a central depression on the face, neck, ears, arms, hands, or legs.

In most cases, KA goes away on its own, but this can take months. Keratoacanthoma treatment options depend on the location and size of the lesion and the patient’s health history. The most common treatment is minor surgery to remove the tumor. Other forms of treatment include cryosurgery to freeze the lesion, curettage to scrape or burn off the growth, and Mohs micrographic surgery to remove the lesion from the ears, nose, hands, and lips.

Neurofibroma

Similar to lipomas, neurofibromas are a common type of benign nerve tumor that forms soft bumps either on or under the skin. A neurofibroma can develop within a major or minor nerve anywhere in the body and may arise from several nerve bundles (plexiform neurofibroma). Symptoms are often mild or absent for patients diagnosed with neurofibromas. Pain or numbness to the affected area may occur if the tumor presses against or grows within nerves.

Observation of the tumor may be recommended for a single neurofibroma that does not cause any symptoms or is smaller than less than an inch in diameter. Neurofibroma treatment usually involves both monitoring and surgical excision — the type of operation performed depends on the location and size of the tumor and whether it is intertwined with multiple nerves. The primary goal of surgery is to remove the tumor without causing nerve damage.

Sebaceous Cysts

A skin cyst — typically referred to as a sebaceous cyst — is a closed, capsule-like skin growth that is generally filled with liquid or semisolid, similar to a skin blister. Sebaceous cysts may be caused by blocked oil glands or swollen hair follicles in the skin, and genetic traits might also play a factor in their development. Primary skin cyst symptoms include a small lump under the skin that is painless but may become inflamed and tender.

In most cases, sebaceous cysts can be ignored as they generally are not dangerous. If a small cyst becomes inflamed or if a larger cyst causes hair loss, discomfort, or pain, skin cyst treatment may be necessary to remediate the symptoms. Treatment depends on the type and location of the cyst and the degree of discomfort it causes. Cysts may be drained or aspirated, surgically removed, or biopsied to determine whether the cells are cancerous.