Cysts, Lumps, Bumps, and Your Skin

There are a number of skin conditions that cause lumps and bumps to appear on the surface or just below the skin. This article covers some of the most common ones, and includes the following:

• Skin cysts (also called epidermoid cysts)
• Cherry angioma
• Dermatofibromas
• Folliculitis
• Keratoacanthoma
• Keratosis pilaris
• Lipomas
• Neurofibromas

Skin Cysts

Cysts are noncancerous, closed pockets of tissue that can be filled with fluid, pus, or other material.

Cysts are common on the skin and can appear anywhere. They feel like large peas under the surface of the skin. Cysts can develop as a result of infection, clogging of sebaceous glands (oil glands), or around foreign bodies, such as earrings.

What Are the Symptoms of Skin Cysts?

Skin or epidermoid cysts usually are:

• Slow-growing
• Painless
• Smooth to the touch when they are rolled under the skin

How Are Skin Cysts Treated?

Cysts usually do not cause pain unless they rupture or become infected or inflamed. Most cysts do not disappear on their own without treatment. Some cysts may need to be drained to relieve symptoms. That involves piercing the cyst with a scalpel and draining it. That doesn't cure the cyst, however. Some inflamed cysts can be treated with an injection of cortisone medication to cause it to shrink. Cysts that do not respond to other treatments or reoccur can be removed surgically if they cause troublesome symptoms.

Cherry Angioma and Your Skin

A cherry angioma is a smooth, cherry-red bump on the skin. The size of the growths can vary from the size of a pinhead to about a quarter inch in diameter.

Although cherry angiomas usually appear on the trunk of the body, they can occur nearly anywhere.

The cause of cherry angiomas is not known.

The growths usually appear on people over age 40. In children, these lesions are called port-wine stains.

How Is a Cherry Angioma Treated?

In most cases, cherry angiomas do not require treatment. If they are cosmetically unappealing or are subject to bleeding, angiomas may be removed by lasers, shave biopsy, or electrocautery -- the process of burning or destroying tissue by use of a small probe with an electric current running through it. Removal may cause scarring. Learn more about red birthmarks and your skin.

Dermatofibromas and Your Skin

Dermatofibromas are harmless round, red-brownish skin growths that are most commonly found on the arms and legs of adults. Dermatofibromas contain scar tissue and feel like hard lumps in the skin.

Sometimes dermatofibromas appear after injury, like a bug bite or after bumping your arm or leg.

What Are the Symptoms of Dermatofibromas?

The symptoms of dermatofibromas include:

• A red, brown, or purple growth that can change colors over time
• A growth that is as small as a BB pellet
• Tenderness, pain, and itching; however, growths are usually painless
• A dimple that appears when the growth is pinched

How Are Dermatofibromas Treated?

In most cases, there is no need to treat dermatofibromas. However, the growths can be removed surgically or can be flattened by being frozen with liquid nitrogen. See a photo of what a dermatofibroma looks like.

Epidermoid Cysts and Your Skin

Epidermoid cysts, also called sebaceous cysts or skin cysts, are benign (non- cancerous) skin cysts formed by an outpouching from the hair follicle. Most commonly, epidermoid cysts are found on the genitals, chest, and back; but, they also can occur in other areas of the skin.

What Are the Symptoms of Epidermoid Cysts?

In general, epidermoid or skin cysts have a round appearance. A dark portion of the cyst is visible on the skin. If the cysts become infected, they will become red and tender. When the cysts are squeezed, they can produce a cheesy white discharge.

How Are Epidermoid Cysts Treated?

The effective treatment of epidermoid cysts requires that the sac of the cyst be completely removed. If the cyst is squeezed and the discharge is forced out without removing the sac, the cyst will return. Usually, a doctor will be able to remove the cyst by making only a small incision in the skin. Antibiotics may be prescribed to treat infected cysts and intralesional steroid injections help with swelling and inflammation. Learn more about skin cysts.

Folliculitis and Your Skin

Folliculitis is an inflammation of the hair follicles. It can be caused by an infection in the hair follicles, by chemical irritation or by physical irritation (for example, shaving or friction from clothing). Typical body sites that are involved in folliculitis include the face, thighs, and scalp.

Folliculitis is more common in people who have diabetes. It also is more common in people who are obese or have compromised immune systems.

What Are the Symptoms of Folliculitis?

The main lesion in folliculitis is a papule or pustule with a central hair. The hair shaft in the middle of the lesion may not be seen.

Other signs and symptoms include:

• Multiple red pimples and/or pustules on hair-bearing areas of the body
• Itching skin

How Is Folliculitis Treated?

Topical antibiotics, oral antibiotics, or antifungal drugs may be used to treat infections associated with folliculitis, depending on the underlying cause. Treatment also involves preventing further damage to the hair follicles. Steps that can help achieve this goal include:

• Minimizing friction from clothing
• Not shaving in the affected area, if possible. If shaving is necessary, use a clean new razor blade or an electric razor each time. Also moisturize the hair before shaving, and shave in the direction of the growth of the hair
• Keeping the area clean

See a photo of what folliculitis looks like.

Keratoacanthoma and Your Skin

A keratoacanthoma occurs when cells in a hair follicle do not grow normally. The growth may be triggered by a minor skin injury in an area that previously had suffered sun damage. Ultraviolet radiation from sun exposure is the biggest risk factor in keratoacanthomas.

A keratoacanthoma usually will appear on sun-damaged skin as a thick growth that has a central crusted plug.

Keratoacanthomas appear most often in people who are over the age of 60 and they are considered a low-grade skin cancer.

What Are the Symptoms of a Keratoacanthoma?

Keratoacanthomas are rapidly growing, red, dome-shaped bumps with central craters. Some keratoacanthomas can grow to extremely large sizes, occasionally 1 to 3 inches in diameter.

How Are Keratoacanthomas Treated?

Keratoacanthomas can be removed by:

• Cryotherapy (freezing the growth with liquid nitrogen)
• Curettage (scraping and burning off the growth)
• Surgical removal
• Injection of a cancer drug directly into the lesion

Keratosis Pilaris and Your Skin

Keratosis pilaris (commonly called KP) appears as "chicken skin bumps" on the skin. These bumps usually appear on the upper arms and thighs. They also can appear on the cheeks, back, and buttocks. Keratosis pilaris, while unattractive, is harmless.

What Are the Symptoms of Keratosis Pilaris?

This disorder appears as small, rough bumps. The bumps are usually white or red, but do not itch or hurt. Keratosis pilaris is usually worse during the winter months or other times of low humidity when skin becomes dry. It also may worsen during pregnancy or after childbirth.

How Is Keratosis Pilaris Treated?

Although the condition may remain for years, it gradually improves before age 30 in most cases. Treatment of keratosis pilaris is not medically necessary; but, individuals with this condition may want to seek treatment for cosmetic reasons.

The initial treatment of keratosis pilaris should be intensive moisturizing. A cream such as AmLactin or Lac-Hydrin can be applied after bathing, and then re- applied several times a day. Other treatments may include:

• Medicated creams containing urea (Carmol-20) or alpha-hydroxy acids (Aqua Glycolic, Lacticare) applied twice daily
• Efforts to unplug pores by taking long, hot soaking tub baths and then rubbing and exfoliating the areas with a coarse washcloth or stiff brush

Lipomas and Your Skin

Lipomas are subcutaneous soft tissue tumors that usually are slow-growing and are harmless. They have a soft, rubbery consistency. Lipomas tend to form on the trunk, shoulders, neck, but can appear elsewhere on the body.

What Are the Symptoms of Lipomas?

Lipomas can appear as solitary nodules or in groups. Most lipomas are less than 5 cm in diameter and have no symptoms, but they can cause pain when they compress nerves.

How Are Lipomas Treated?

Lipomas are not removed unless there is a cosmetic concern, a compression of surrounding structures, or an uncertain diagnosis. Lipomas generally do not infiltrate into surrounding tissue so they can be removed easily by excision.

There are alternatives to standard excision. One is to manually squeeze the lipoma through a small incision. This technique is useful in areas with thin dermis, such as the face and extremities. Liposuction-assisted lipectomy also can be used to remove large lipomas with minimal scarring. Lipotherapy is another option. In this, a fat dissolving drug called deoxycholic acid (Kybella) is injected directly into the lipoma, leaving no scarring. Learn more about lipomas.

Neurofibromas and Your Skin

Neurofibromas are soft, fleshy growths that occur on or under the skin, sometimes even deep within the body. These are harmless tumors; however, they can turn malignant or cancerous in rare cases.

What Are the Symptoms of Neurofibromas?

The symptoms of neurofibromas may vary, depending on the locations and the sizes of the tumors. Symptoms can include:

• A painless, slow-growing mass
• Occasional pain
• Electric-like "shock" when the affected area is touched
• Neurological problems if the tumor involves a major motor or sensory nerve or a nerve that is compressed between the tumor and a hard structure

How Are Neurofibromas Treated?

If the tumor is not causing any symptoms, no treatment is necessary. However, doctors may choose to surgically remove the neurofibroma if it is affecting a major nerve. In most cases, neurofibromas are treated successfully and do not recur. See a photo of what neurofibromas looks like.

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