Persistent Bumps on the Scalp: Causes and When to Seek Help

A lump on the head that has not resolved for a long time?

Hello doctor, I experience pain in my head when I lie on my right side while sleeping.
I have noticed a lump on my head that feels like a bump from a hit, about the height of a mosquito bite but approximately 5 cm wide.
I previously had some skin irritation on my scalp from scratching, and I'm wondering if that could have caused inflammation.
I have visited a clinic where the doctor noted some redness suggestive of inflammation.
I also consulted a dermatologist, but the lump was not painful upon palpation; it only hurts when I sleep.
Additionally, I have folliculitis, which is painful when pressed, so I'm uncertain if the red swollen lump is painful since the doctor suggested the pain might be due to the folliculitis.
I occasionally experience head pain, especially when wearing a helmet or while sleeping, which feels like nerve pain and can sometimes be widespread but is not extremely painful.
I have been applying ice to the lump, which seems to reduce its size a bit, but it returns when I stop icing it.
I would like to know what the lump on my scalp might be and if I should visit a larger hospital for further evaluation.
Thank you!

Ms. Huang, 20~29 year old female. Ask Date: 2015/06/24

Dr. Li Qinglong reply Surgery

Hello, regarding your concerns about folliculitis and skin inflammation, I recommend that you consult a dermatologist at a hospital for an initial evaluation.
If there are any other issues, the doctor can refer you to other specialists to further confirm whether the problems are due to skin breakdown and inflammation.
Thank you.

Reply Date: 2015/06/24

More Info

Understanding persistent bumps on the scalp can be quite concerning, especially when accompanied by pain and inflammation. Based on your description, it seems that you are experiencing a bump on your scalp that is approximately 5 cm wide and has a height similar to that of a mosquito bite. The fact that you have previously scratched your scalp, leading to broken skin, could indeed contribute to inflammation or infection in that area.

There are several potential causes for the bump you are experiencing:
1. Folliculitis: This is an inflammation of the hair follicles, which can occur due to bacterial or fungal infections. Given that you have a history of folliculitis, it is possible that the bump is related to this condition. Folliculitis can cause red, painful bumps that may be itchy or tender to the touch.

2. Cysts: Sebaceous cysts are common on the scalp and can appear as bumps. These cysts are usually benign and filled with keratin. They may become inflamed or infected, leading to pain and redness.

3. Lipomas: These are benign tumors made of fat tissue that can develop under the skin. They are generally painless but can cause discomfort if they press on surrounding tissues.

4. Trauma or Contusion: If you have bumped your head or experienced any trauma, it could lead to a localized swelling or hematoma, which may be painful, especially when pressure is applied.

5. Infection: If the bump is red and inflamed, it could be a sign of an infection, particularly if you have a history of scratching the area. Infections can cause localized pain and swelling.

Given that you have already consulted with doctors and received some assessment, it is important to consider the following steps:
- Monitor Symptoms: Keep track of any changes in the bump, including size, color, and pain levels. If the bump becomes increasingly painful, larger, or shows signs of pus or drainage, it may require more immediate attention.

- Ice Therapy: You mentioned that applying ice helps reduce the swelling. Continue to use ice packs for short periods to manage inflammation and discomfort.

- Avoid Scratching: Since you have a history of scratching the area, try to avoid further irritation. Keeping the scalp clean and avoiding tight headgear that could exacerbate the pain is advisable.

- Follow-Up with a Specialist: If the bump persists, worsens, or if you experience additional symptoms such as fever, significant pain, or drainage, it would be prudent to seek a second opinion from a dermatologist or a specialist in scalp conditions. They may recommend imaging studies, such as an ultrasound, to better understand the nature of the bump.

- Consider Other Factors: Since you mentioned experiencing pain when wearing a helmet or during sleep, it may be worthwhile to evaluate your sleeping position and any potential pressure points that could be contributing to your discomfort.

In summary, while the bump on your scalp could be due to several benign causes, persistent pain and inflammation warrant further investigation. Consulting with a healthcare professional who can perform a thorough examination and possibly conduct additional tests will help determine the exact cause and appropriate treatment. Your health and comfort are paramount, so do not hesitate to seek further medical advice if needed.

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