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Painful Scalp Bump

An illustration of a grimacing person with no hair and many bumps on the scalp. Yellow lightning bolts emanate from the bumps. The person is wearing a yellow spotted t-shirt.
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Painful scalp bumps are usually non-serious and easily treatable. The common culprit of painful bumps on the scalp is inflammation from eczema or acne which can cause pimples on the scalp. Infected hair follicles or allergens from shampoos or hair products can also cause painful and itchy bumps on the scalp. Read more below for causes and treatment options.

9 most common cause(s)

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Skin cyst
Skin Abscess
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Pimples
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Melanoma
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Lipoma
Basal Cell Carcinoma
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Whitehead
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Boil (furuncle)
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Atypical mole

Symptoms of painful sores or bumps on the scalp

Scalp pain can likely be disconcerting; add the presence of a palpable bump and worry can increase. However, there are many benign causes for a painful scalp bump, and the resolution of your symptoms can likely follow once it is identified. It is still important to keep in mind the following characteristics as well as if your symptoms worsen or persist.

Characteristics

Often a painful scalp bump is associated with inflammation and other symptoms such as:

  • Multiple bumps
  • Skin that feels warm to the touch
  • Flaking or itching
  • Redness
  • Tenderness
  • Blisters that burst or cause crusting
  • Burning
  • Pain that spreads from the scalp to the face, jaw, neck or shoulders

Are painful scalp bumps serious?

It may be difficult to find at-home relief that does not require painkillers, and for some people, the soreness, pain and associated symptoms can be very embarrassing.

Despite the inconvenience, a painful scalp bump is usually not life-threatening. It is important to take note of when symptoms begin and any associated triggers, especially if you have experienced painful scalp bumps before. Such observations may help you and your physician find the cause and appropriate treatment.

What are painful bumps on the scalp?

The overwhelming majority of scalp pain cases can be attributed to causes that lead to inflammation/infection or put direct pressure or tension on the scalp. Regardless of the condition, most causes of painful scalp bumps are benign and easily treatable once proper medical attention is obtained. Causes can be categorized as medical or environmental.

Medical

Medical causes of painful scalp bumps include:

  • Dermatologic: Skin conditions such as eczema or acne can cause inflammation of the scalp. This inflammation can cause multiple bumps that result in excessive itching/scratching, tenderness, and pain.
  • Infectious: When the hair follicles become infected by bacteria or fungus, they can become inflamed and turn into small red bumps or pimples that can grow and swell without treatment. This specific type of infection is known as folliculitis and can be caused by many different bacteria, fungi, and sometimes viruses.
  • Allergens: Even the scalp is susceptible to allergic reactions. If the scalp comes into contact with common irritants such as jewelry or fabrics, soaps, shampoos or hair accessories that your body does not agree with, a rash of multiple, small red bumps may develop. Severe reactions may result in swelling of the bumps and larger blisters that can be painful and tender.

Environmental

Environmental causes of scalp bumps include:

  • Tension: Hairstyles such as ponytails or braids can cause strain and tension to the scalp that may result in small, painful bumps.
  • Trauma: Any situation where your scalp is hit or cut can result in a palpable bump or knot on the scalp. This cause is usually the most obvious and will often resolve on its own.

This list does not constitute medical advice and may not accurately represent what you have.

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Whitehead

Whiteheads are caused by hair follicles becoming clogged with oil & dead skin cells. When the clogged pore is closed to the air by a layer of skin cells, the oil/dead skin cells remains white (as opposed to a blackhead).

Though large whiteheads can be removed by a dermatologist, most cases can be treated with proper hygiene and over-the-counter medications/treatments. Look for products containing benzoyl peroxide or salicylic acid.

Rarity: Common

Top Symptoms: small facial lump, yellow or white facial bump

Symptoms that always occur with whitehead: small facial lump, yellow or white facial bump

Urgency: Self-treatment

Skin cyst

A cyst is a small sac or lump, filled with fluid, air, fat, or other material, that begins to grow somewhere in the body for no apparent reason. A skin cyst is one that forms just beneath the skin.

It's believed that skin cysts form around trapped keratin cells – the cells that form the relatively tough outer layer of the skin.

These cysts are not contagious.

Anyone can get a skin cyst, but they are most common in those who are over age 18, have acne, or have injured the skin.

Symptoms include the appearance of a small, rounded lump under the skin. Cysts are normally painless unless infected, when they will be reddened and sore and contain pus.

Diagnosis is made through physical examination. A small cyst can be left alone, though if it is unsightly or large enough to interfere with movement it can be removed in a simple procedure done in a doctor's office. An infected cyst must be treated so that the infection does not spread.

Rarity: Common

Top Symptoms: skin-colored armpit bump, marble sized armpit lump, small armpit lump

Symptoms that always occur with skin cyst: skin-colored armpit bump

Urgency: Wait and watch

Skin abscess

A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.

Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.

If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.

Diagnosis is made through physical examination.

A small abscess may heal on its own, through the body's immune system. But some will need to be drained or lanced in a medical provider's office so that the pus can be cleaned out. Antibiotics are usually prescribed.

Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.

Rarity: Common

Top Symptoms: rash with bumps or blisters, red rash, red skin bump larger than 1/2 cm in diameter, pus-filled rash, rash

Symptoms that always occur with skin abscess: rash with bumps or blisters

Urgency: Primary care doctor

Pimple

Pimples are also called comedones, spots, blemishes, or "zits." Medically, they are small skin eruptions filled with oil, dead skin cells, and bacteria.

Pimples often first start appearing at puberty, when hormones increase the production of oil in the skin and sometimes clog the pores.

Most susceptible are teenagers from about ages 13 to 17.

Symptoms include blocked pores that may appear flat and black on the surface, because the oil darkens when exposed to the air; blocked pores that appear white on the surface because they have closed over with dead skin cells; or swollen, yellow-white, pus-filled blisters surrounded by reddened skin.

Outbreaks of pimples on the skin can interfere with quality of life, making the person self-conscious about their appearance and causing pain and discomfort in the skin. A medical provider can help to manage the condition, sometimes through referral to a dermatologist.

Diagnosis is made through physical examination.

Treatment involves improving diet; keeping the skin, hair, washcloths, and towels very clean; and using over-the-counter acne remedies.

Rarity: Common

Top Symptoms: pink or red facial bump, small facial lump, painful facial bump, marble sized facial lump

Symptoms that always occur with pimple: pink or red facial bump

Urgency: Self-treatment

Melanoma

Melanoma is the most serious type of skin cancer. Often the first sign of melanoma is a change in the size, shape, color, or feel of a mole. Most s have a black or black-blue area. Melanoma may also appear as a new mole. It may be black, abnormal, or "ugly looking."

You should visit your primary care physician. Surgery is the first treatment of all stages of melanoma. Other treatments include chemotherapy and radiation, biologic, and targeted therapies. Biologic therapy boosts your body's own ability to fight cancer. Targeted therapy uses substances that attack cancer cells without harming normal cells.

Rarity: Rare

Top Symptoms: brown-colored skin changes, atypical features of a facial bump, black-colored skin changes, growing facial lump, large facial lump

Symptoms that always occur with melanoma: atypical features of a facial bump

Urgency: Primary care doctor

Lipoma

Lipoma is a word that translates as "fatty tumor," but a lipoma is not cancer. It is simply a growth of fat between the muscle layer and the skin above it.

The exact cause is not known. The condition does run in families and is associated with other unusual syndromes such as adiposis dolorosa, which is similar. Lipomas most often appear after age 40.

Symptoms include a soft, easily moveable lump beneath the skin, about two inches across. A lipoma is painless unless its growth is irritating the nerves around it. They are most often found on the back, neck, and abdomen, and sometimes the arms and upper legs.

It is a good idea to have any new or unusual growth checked by a medical provider, just to make certain it is benign.

Diagnosis is made through physical examination, biopsy, and imaging such as ultrasound or CT scan.

Most of the time, treatment is not necessary unless the lipoma is unsightly or is interfering with other structures. It can be removed through surgery or liposuction.

Rarity: Uncommon

Top Symptoms: skin-colored groin bump, marble sized groin lump, small groin lump

Symptoms that always occur with lipoma: skin-colored groin bump

Urgency: Wait and watch

Boil (furuncle)

A furuncle, also called a boil, is infection of a hair follicle. The infection forms under the skin at the root of the hair and may occur anywhere on the body.

The infection is caused by bacteria, most often Staphylococcus aureus or "staph." Irritation caused by clothes or anything else rubbing the skin can cause the skin to break down and allow bacteria to enter.

Staph bacteria are found everywhere. Frequent and thorough handwashing, and otherwise maintaining cleanliness, will help to prevent its spread.

Most susceptible are those with a weakened immune system; diabetes; and other skin infections.

Symptoms include a single bump under the skin that is swollen, painful, and red, and contains pus.

It is important to treat the boil, since infection can spread into the bloodstream and travel throughout the body.

Diagnosis is made through physical examination and sometimes fluid sample from the boil.

Treatment may involve incision and drainage of the infection, followed by creams to apply to the site of the boil and/or a course of antibiotic medicine.

Rarity: Uncommon

Top Symptoms: pink or red facial bump, small facial lump, painful facial bump, marble sized facial lump, constant skin changes

Symptoms that always occur with boil (furuncle): pink or red facial bump

Symptoms that never occur with boil (furuncle): fever

Urgency: Self-treatment

Basal cell carcinoma

Basal cell carcinoma (BCC) is the most common kind of skin cancer. It can develop almost anywhere on the body. It appears as abnormal spots or bumps on the skin. These bumps are often pink, red, or skin-colored and sometimes have a shiny surface. The main risk factor for developing this condition is prolonged exposure to ultraviolet (UV) radiation. Sun exposure and tanning beds are both sources of UV radiation. People with a history of sunburns, previous skin cancer, and a weakened immune system are at higher risk for this condition.

Most cases of BCC can be easily treated because they grow slowly. Though if not treated, it can spread inside the body. Your provider will do a skin exam and possibly skin sample test, known as a biopsy. Treatment will depend on where the cancer is, its size, and your medical history. Some treatment options include cutting out the bump, freezing it, or using medicated skin cream.

Rarity: Uncommon

Top Symptoms: facial skin changes, pink or red facial bump, small facial lump, painless facial bump, growing facial lump

Urgency: Primary care doctor

Atypical mole

Moles are growths on the skin. They happen when pigment cells in the skin, called melanocytes, grow in clusters. Certain moles are considered "atypical" because of their size and characteristics, which require careful watching and possibly even biopsy in order to monitor for development into cancer. Atypical moles, also called dysplastic nevi deserve more attention than normal moles.

You should go see your primary care doctor to examine the mole. He or she can determine if next steps are necessary.

Rarity: Uncommon

Top Symptoms: severe abdominal lump, brown-colored skin changes, moderate abdominal lump, atypical abdominal bump features, growing abdominal bump

Symptoms that always occur with atypical mole: black or brown abdominal bump, atypical abdominal bump features

Urgency: Primary care doctor

Treatments for painful bumps or sores on the scalp

Often, painful scalp bumps can be constant and many people want fast relief. Fortunately, there are several at-home treatments, and if those are ineffective, further medical treatments are available.

At-home treatments

After making an appointment with your physician, try these at-home remedies to help alleviate your symptoms:

  • Resist scratching: If you are experiencing symptoms of flaking or itching along with your scalp pain, resist the urge to scratch your scalp. Often scratching may seem to provide temporary relief, but in the long run, it can exacerbate inflammation and make your scalp pain worsen.
  • Be gentle with your hair: Minimize hairstyles such as high ponytails or braids that cause tension to the scalp. Often the prolonged use of such hairstyles can lead to hair loss or receding hairline in addition to the pain.
  • Avoid allergens: These may be triggering your symptoms. Use unscented lotions and shampoos and minimize the use of cheap jewelry or accessories that may cause an allergic reaction.

Medical treatments

Painful scalp bumps will often not go away with simple lifestyle changes; they usually require treatment. Depending on the cause of your bump or bumps, your physician may suggest the following treatments:

  • Skin creams or steroids: Dermatologic conditions such as eczema or acne that causes bumps can be treated with topical skin creams and steroids. If your dermatologic condition is very serious, your physician may prescribe systemic treatment.
  • Antibiotics and/or antifungals: If your scalp bumps are due to a follicular infection, your physician will prescribe antibiotics that specifically target the causative bacteria or antifungal medications, shampoos, or pills.

Seek immediate treatment in the emergency room or call 911 for the following

If your pain is significant, it is important to seek care promptly. Complications such as the spreading of the infection, increased swelling or development of boils under the skin, scarring or permanent skin damage, and permanent hair loss can all arise if your symptoms are not properly treated.

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FAQs about painful scalp bump

Is it normal for my scalp bump to ooze or bleed?

Yes, it is normal for the bumps to ooze or bleed especially if they are caused by infection. Often, scalp bumps are itchy, and scratching may exacerbate oozing and bleeding by causing breaks in the skin.

Is it normal to have multiple painful scalp bumps?

Yes, it is normal to experience multiple painful bumps in the setting of infection or dermatologic skin disorders. Allergens can also cause multiple eruptions on the scalp. Traumatic causes usually result in one, singular bump rather than multiple.

Are there treatments for my painful scalp bumps I can use at home?

There are many creams, pills, and shampoos that you can buy over-the-counter that can help combat mild fungal infections of the scalp. For bacterial infections, you need a prescription in order to get the right antibiotic.

What can I do to prevent the development of painful scalp bumps?

Preventing bacterial and infectious causes of painful scalp bumps involves keeping the scalp clean and aerated. Wash your hair regularly with unscented, chemical-free shampoos and keep the skin protected as much as possible.

Are my painful scalp bumps chronic or temporary?

Your painful scalp bumps are most likely temporary. Many of the causes of this condition are easily identified and treated. Make an appointment with your physician promptly in order to get appropriate care.

Questions your doctor may ask about painful scalp bump

  • What color is the bump?
  • Any fever today or during the last week?
  • Are you experiencing a headache?
  • Is there something coming out of the bump?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

  1. Sun KL, Chang JM. Special types of folliculitis which should be differentiated from acne. Dermatoendocrinol. 2017;9(1):e1356519. Published 2017 Sep 27. doi:10.1080/19381980.2017.1356519. NCBI Link
  2. Acne-Like Breakouts Could Be Folliculitis. American Academy of Dermatology. AAD Link
  3. American Osteopathic College of Dermatology. AOCD Link
  4. Bumps on Scalp: Everything You Need To Know. STD.GOV Blog. Published August 23, 2017. STD.GOV Blog Link