Small Hard Bumps on the Scalp: Possible Causes and Concerns

Small lump on the head?

Hello doctor, about 5.6 years ago during middle school, I had a round patch of hair loss on the top of my head.
The bald area has a slightly raised, firm lump with a diameter of about 4.5 centimeters.
I didn't pay much attention to it at the time and only consulted a dermatologist because the lump was not painful, so I didn't see a doctor again.
It hasn't changed in size since then, but I recently found information suggesting it could possibly be a tumor, so I would like to ask what kind of condition this might be.

Miss Yang, 20~29 year old female. Ask Date: 2021/06/16

Dr. Li Zhonghuai reply Surgery

Hello! It is recommended to consult a general surgeon and undergo an ultrasound evaluation.
Take care! Changhua Hospital cares about you!

Reply Date: 2021/06/16

More Info

When it comes to small hard bumps on the scalp, particularly in the context of a history of alopecia areata (the round patches of hair loss), there are several potential causes and concerns that should be considered.
Firstly, the bump you described, which has been stable in size for several years and is not painful, could be a benign condition. Common benign scalp lesions include seborrheic keratosis, which are non-cancerous growths that can appear as small, raised bumps on the skin. These are often brown or black and can vary in size. Another possibility is a dermatofibroma, which is a firm, raised bump that can occur on the scalp and is typically harmless.
Additionally, given your history of alopecia areata, it is worth considering that the bump could be related to the condition itself. Alopecia areata can sometimes be associated with other skin changes, including the formation of small bumps or nodules. These are usually not harmful but can be concerning for the individual experiencing them.

However, the concern about the possibility of a tumor is valid, especially since you mentioned that you have done some research and found that it could be a tumor. While the likelihood of a malignant tumor (cancer) is low, especially given the stability of the bump over time, it is still important to consider this possibility. Skin cancers, such as basal cell carcinoma or squamous cell carcinoma, can present as hard bumps on the scalp. These types of cancers are more common in areas of the skin that have been exposed to the sun, and they can sometimes appear as non-healing lesions or bumps.

To address your concerns, it is advisable to consult a dermatologist for a thorough examination of the bump. The dermatologist may perform a physical examination and, if necessary, a biopsy to determine the nature of the bump. A biopsy involves taking a small sample of the tissue for laboratory analysis, which can provide definitive information about whether the bump is benign or malignant.

In summary, while the small hard bump on your scalp may be benign, such as a seborrheic keratosis or dermatofibroma, it is essential to have it evaluated by a healthcare professional to rule out any serious conditions. Regular monitoring of the bump for any changes in size, shape, or color is also important. If you notice any new symptoms, such as pain, itching, or bleeding, it is crucial to seek medical attention promptly. Early diagnosis and treatment are key to managing any potential skin issues effectively.

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