You’ve had this lump on the top of your head for years and have thought nothing of it—until recently because it’s suddenly getting bigger.

“Lumps on the scalp are most likely cysts that have formed,” says Walter Gaman, MD, FABFM, board certified in family medicine and the author of several award-winning books including “Age to Perfection: How to Thrive to 100, Happy, Healthy, and Wise.”

“These cysts may have formed because a hair follicle became clogged or infected at one point,” continues Dr. Gaman, who is board certified in family medicine. “Some cysts may remain small, while others can grow.”

A lump on the top of the head that feels as though it’s getting bigger can be quite alarming for people who are prone to worrying about melanoma – which can form on the scalp.

Many benign conditions in addition to cysts can cause a lump feeling on the scalp or top of the head under one’s probing fingertips.

Or, the lump on the top of the head may be discovered by accident when one is rubbing their scalp.

And the term “lump” is open to subjective interpretation. For some people it’s a tiny little bump that feels like a pimple.

In addition to a cyst, this might be a harmless skin growth called a seborrheic keratosis (that can be seen if it’s located – which could require tedious angling with a hand mirror in conjunction with positioning your backside to a wall mirror – plus finger work to move your hair out of the way) that’s common in the population over age 40.

A small lumpy feeling under the fingertips can also be caused by dandruff or flaking skin.

Or, the lump might seem like something under the skin that’s much larger – something that can’t be seen but can surely be felt.

“Cysts are often fluid filled and can move ever so slightly below the skin,” says Dr. Gaman. “If they become hot, change size suddenly or drain, they may be infected and require antibiotics or drainage.

“If the lump is toward the back of the scalp, it may be from a lymph node. These can swell during or following an infection such as a sinus infection, ear infection or other illness. These normally go down after treatment.”

“Lumps on the head are almost always benign. Since one can’t look at the top of their own head, it’s a good idea to have someone look at the lump or bump and describe it.”

Melanoma Revisited
Dr. Gaman explains, “If it’s discolored or looks like a large mole, it’s best to have a physician look at it. This type of lump may need to be biopsied, especially if it has asymmetrical edges.

“Most normal colored lumps that are not hot or draining are really nothing to worry about.

“If the lump is new, if it has grown suddenly or if it is accompanied by a fever or other symptoms, seek advice from a medical professional.”

You should have a clinical exam of your entire scalp—even if you have super thick hair—every year by both a dermatologist and your primary care physician. This way you’ll have two sets of eyes doing the inspection.

walter gaman, md

Dr. Gaman is a partner at Executive Medicine of Texas and is with the Staying Young Radio Show 2.0 podcast.