Recurring Underarm Lumps: Causes and Treatment Options

Axillary mass

Ten years ago, I had a cyst under my armpit that was surgically removed.
The doctor mentioned it was not malignant, but the diagnosis report only stated "tumor excision." A few years later, it recurred, and I started seeing a dermatologist regularly.
At times, it would grow as large as a tennis ball.
It would go from a hard lump to a red, pimple-like lesion with pus that could be drained.
The dermatologist would inject medication, drain the pus, and prescribe antibiotics, which would help resolve the issue.
A family member has a similar condition; whenever they stay up late and feel particularly fatigued, this situation arises repeatedly.
Recently, I noticed another hard lump under my other armpit, about one centimeter in size, but it hasn't grown or produced pus.
The dermatologist has been administering anti-inflammatory injections every two weeks, and after six injections, it still hasn't resolved.
I'm unsure whether to continue seeing the dermatologist.
I asked the doctor which department I should consult at the hospital, and the dermatologist said that if I undergo surgery, it would likely recur.
They suggested that while the lump is still small, it might be beneficial to inject it, as it resembles a fibrous cyst, and mentioned that some individuals are more prone to developing such conditions.
Could you please provide some advice?

mei, 30~39 year old female. Ask Date: 2020/06/12

Dr. Chen Sirong reply Oncology

May, 33 years old, female, can visit the general surgery breast clinic.
Thank you for your message.
Taoyuan Hospital, Dr.
Chen Sih-Rong.

Reply Date: 2020/06/12

More Info

Recurring underarm lumps can be a frustrating and concerning issue, especially when they have a history of surgical removal and recurrence. Based on your description, it seems that you have been dealing with a condition that may involve sebaceous cysts, fibromas, or possibly hidradenitis suppurativa, which can cause painful lumps in the underarm area.

Causes of Recurring Underarm Lumps
1. Sebaceous Cysts: These are non-cancerous lumps beneath the skin that can occur when sebaceous glands become blocked. They can become inflamed or infected, leading to redness, swelling, and pus formation.

2. Hidradenitis Suppurativa: This is a chronic skin condition characterized by lumps in areas where skin rubs together, such as the underarms. It can lead to painful abscesses and scarring.

3. Fibromas: These are benign tumors made of fibrous or connective tissue. They can recur after removal and may not always require surgical intervention unless they cause discomfort.

4. Infections: Bacterial infections can lead to the formation of lumps that may require antibiotics and drainage.

5. Genetic Predisposition: As you mentioned that a family member has a similar condition, there may be a genetic component that predisposes individuals to develop these lumps.

Treatment Options
1. Observation: If the lumps are not causing significant discomfort or complications, a watchful waiting approach may be appropriate. Regular monitoring can help track any changes in size or symptoms.

2. Medications: Since you have been receiving injections and antibiotics, continuing this treatment under the guidance of your dermatologist may help manage inflammation and infection.
3. Drainage: For lumps that become painful or filled with pus, drainage may be necessary. This can be done in a clinical setting to prevent complications.

4. Surgical Removal: If the lumps are recurrent and bothersome, surgical excision may be considered. However, as your dermatologist mentioned, there is a risk of recurrence even after surgery.
5. Lifestyle Modifications: Maintaining a healthy lifestyle, including proper hygiene, a balanced diet, and adequate sleep, may help reduce flare-ups. Avoiding tight clothing and irritants in the underarm area can also be beneficial.

6. Referral to a Specialist: If the condition persists or worsens, consider seeking a second opinion from a specialist, such as a dermatologist or a surgeon with experience in treating skin conditions. They may offer additional insights or treatment options.

Prognosis and Considerations
The prognosis for recurring underarm lumps largely depends on the underlying cause. Conditions like sebaceous cysts and fibromas are generally benign and manageable, while hidradenitis suppurativa can be more challenging and may require ongoing treatment.
It's essential to communicate openly with your healthcare provider about your symptoms, treatment effectiveness, and any concerns you have regarding the lumps. If you notice any significant changes, such as increased size, pain, or systemic symptoms like fever, seek medical attention promptly.

In conclusion, while it can be disheartening to deal with recurring lumps, there are various treatment options available. A collaborative approach with your healthcare team will help you find the most effective management strategy for your condition.

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