Scalp Lipomas: Treatment Options and When to Seek Help

Scalp sarcoma

Hello Dr.
Ke: I have a small tumor located on the scalp behind my right ear (covered by hair), approximately the size of a green bean.
It is not painful or itchy and has been present for several years, with a slight increase in size (it was smaller when first discovered).
I would like to ask Dr.
Ke: 1.
There are claims online that one can tie hair or a thin string around the base of the tumor to cut off its blood supply and nutrient flow, causing it to fall off in about one to several weeks.
Should I attempt this method? 2.
Since the tumor is not painful or itchy and has only slightly increased in size over the years, it does not significantly affect my daily life.
Is active treatment or removal necessary? If so, can a general dermatology clinic handle this, or should I go to a larger medical facility for treatment? Thank you, Dr.
Ke.

Axiang, 30~39 year old female. Ask Date: 2018/08/17

Dr. Ke Fangxu reply Surgery

1.
Please do not do this.
I have seen many cases in the outpatient clinic where the sarcoma did not fall off after such actions, but instead resulted in infection and inflammation.

2.
If you want to remove it, please let a general surgeon perform the excision.
Dermatology clinics typically do not perform such surgeries; a small to medium-sized hospital would be appropriate.

Reply Date: 2018/08/17

More Info

When it comes to scalp lipomas, it’s important to understand what they are, how they can be treated, and when it’s necessary to seek medical attention. A lipoma is a benign tumor made up of fat tissue, typically soft to the touch, movable, and painless. They can vary in size and are often found just beneath the skin. In your case, the lipoma located behind your right ear has been present for several years and has only slightly increased in size, which is a common characteristic of lipomas.

Treatment Options
1. Observation: Since your lipoma is not causing any pain or discomfort, and has only slightly increased in size, many healthcare providers may recommend a watchful waiting approach. This means monitoring the lipoma for any changes in size, shape, or symptoms. If it remains asymptomatic, treatment may not be necessary.

2. Surgical Removal: If the lipoma becomes bothersome, painful, or if there are concerns about its nature (though lipomas are typically benign), surgical removal is the most common treatment. This procedure is usually straightforward and can often be performed in an outpatient setting. A dermatologist or a general surgeon can typically handle this type of procedure.
3. Non-Surgical Methods: There are anecdotal methods circulating online, such as tying off the base of the lipoma with hair or string to cut off its blood supply. However, this method is not medically recommended. It can lead to complications such as infection, inflammation, or even necrosis of the tissue, and it is unlikely to effectively remove the lipoma.

When to Seek Help
You should consider seeking medical advice if:
- The lipoma changes in size, becomes painful, or shows signs of infection (such as redness, warmth, or drainage).

- You have concerns about the nature of the growth, especially if it starts to feel hard or fixed in place, as these could be signs of a different type of tumor.

- You are experiencing psychological distress due to the appearance of the lipoma, even if it is not physically bothersome.

Medical Consultation
For your specific case, since the lipoma is small, asymptomatic, and has been stable for years, it may not require immediate treatment. However, if you decide to have it removed for cosmetic reasons or due to any changes, a visit to a dermatologist would be appropriate. Most dermatology clinics can handle the excision of lipomas, and they can provide you with a thorough evaluation and discuss the risks and benefits of removal.

Conclusion
In summary, while your scalp lipoma does not currently require treatment, it’s essential to monitor it for any changes. Surgical removal is a safe and effective option if you choose to pursue it later. Avoid unproven methods like tying off the lipoma, as these can lead to complications. If you have any concerns or if the lipoma changes, don’t hesitate to consult a healthcare professional for personalized advice.

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