A mysterious bump shows up on your skin and you have no clue what it is or whether you should be worried. What happened? Is it serious? How can I get rid of it?
Our skin serves as the body’s first line of defence against the external environment. As such, it gets exposed to various elements that can cause growths to develop.
There are many types of lumps and bumps that can appear on our skin. Most of the time, they are harmless – but some may be painful or be a symptom of a more serious condition. It’s important to know what to look out for, so you can keep an eye on it and seek medical advice from a skin dermatologist when necessary.
Common skin growths you might encounter
Skin lumps and bumps are areas of abnormally raised skin, which occur either on the surface of the skin or protruding from under the skin. It may also be an abnormally coloured area on the skin.
Skin lumps can also develop with greater frequency as we get older, appearing more in certain areas with active sweat glands (e.g. the face and chest area), and those who have had a lot of sun exposure.
Apart from moles and keloids, we share other types of skin growths that are also common in individuals. This is by no means an exhaustive list, but it can give you a head-start in helping you care for your own skin health.
Dermatofibroma:
Commonly found on legs and arms, dermatofibromas are small nodules that contain scar tissue.
This firm skin tumour often appears as a pink, brown, yellow, or darkly pigmented bump, which is caused by a benign proliferation of fibroblast cells (the main cells in connective tissue) as a reaction to minor trauma/injury or insect bites.
Treatment: treatment is considered for cosmetic reasons or for histologic diagnosis (as it can be confused with melanomas). A punch biopsy or excisional biopsy is usually used to ensure complete removal of the lesion.
Sebaceous Hyperplasia:
These are painless, tiny growths that typically look like yellow dome-shaped papules with a central indentation, and are very common in middle-aged and elderly persons.
Most lesions range from 2 to 4 mm in diameter and often occurs on the forehead, nose and cheeks. They are caused by enlarged sebaceous glands that are trapped with sebum, and are sometimes confused with basal cell carcinoma.
Treatment: Treatment of sebaceous hyperplasia is usually for cosmetic reasons. There are several options that can remove the glands or control sebum build-up, such as electrosurgery, carbon dioxide laser and isotretinoin.
Keratoacanthoma:
Keratoancanthomas occur when cells in a hair follicle grow abnormally. Sun damage or UV radiation from sun exposure is the biggest risk factor in keratoacanthomas.
They are fast growing, dome-shaped bumps with a distinctive crater that has keratin inside. This red or skin-coloured lump often starts in a hair follicle and grows between 1-2 cm in diameter.
This condition is more common in fair-skinned people aged 60 and over. The cells of keratoacanthoma often resemble closely to those of squamous cell carcinoma, a type of skin cancer, so your doctor may wish to perform a biopsy for diagnosis.
Treatment: Keratoacanthomas are harmless in most cases, and some lesions may even spontaneously regress over time. Treatment is however usually recommended due to its resemblance to squamous cell carcinoma1. Lesions are usually biopsied to evaluate for underlying squamous cell carcinoma, and can be treated downstream with curettage and electrodessication it they are found to be benign keratoacathoma. Complete excisions are sometimes warranted, and Mohs micrographic surgery may be considered with aggressive larger tumors in cosmetically sensitive areas for tissue-sparing effect.
Lipoma:
Due to an overgrowth of fat cells, these soft, fatty tissue tumors present as nodules under the skin’s surface. Lipomas are typically slow-growing and painless, but can be tender to touch if they are pushed against a nerve or blood vessel.
They appear commonly on the trunk, arms, shoulders and neck, with a typical size of around 2-3 cm. Lipomas are more likely to occur in people aged between 40 and 60 years old, but other risk factors also include obesity, high cholesterol and diabetes.
Treatment: While lipomas are usually harmless, people might want to opt for a removal via excision if they are large or growing too quickly, cause pain or discomfort, suspicious of malignant change, or for cosmetic improvement.
Epidermal Cyst:
Also known as epidermoid cysts, these benign cysts form when surface skin cells build up and move deeper into the skin’s dermis layer. This abnormal growth of cells may be caused by a damaged hair follicle or oil gland.
The cells form the walls of the cyst and secrete the protein keratin, a soft “cheesy” substance into the interior. These cysts most commonly occur on the face, neck, and back. They range from a few mm to several cm in diameter and are generally painless and slow-growing – but can become painful if infected or inflamed.
Treatment: The contents of the cyst and its wall can be surgically removed via a minimal excision technique. The inflamed cyst can be drained first before removing the cyst sac to reduce chances of recurrence.
Seborrheic Keratosis:
These non-cancerous skin growths have a scaly, or wart-like appearance and range in colour from tan to brown and black. They are frequently seen in older individuals, or those with a family history of the condition.
They can share the same resemblance as an atypical mole or melanoma (a type of skin cancer), but seborrheic keratoses tend to be rougher than melanomas. The latter also vary more in colour such as browns, grays, blues and reds.
Treatment: An excisional biopsy may be performed on these growths to check for melanoma. These lesions can also be removed by cryosurgery, curettage, electrocautery or laser treatments for cosmetic reasons, or if they become irritated or itchy.
Seek dermatological care
Certain skin growths and bumps are harmless which can be left alone. Otherwise, it is possible to have them removed if you don’t like how they look like or they bring discomfort.
Diagnosis can include the patient’s clinical history and examining the morphologic characteristics of each lesion: slightly raised, papular or subepidermal2. The ability to diagnose and treat various benign tumours properly, and distinguish them from malignant lesions is a crucial skill for a dermatology specialist.
Where diagnosis is uncertain for any lesion, a biopsy will be required for histopathologic examination to rule out malignancy.
Treatment options that are available
Always speak with your doctor to receive a proper diagnosis and advice on treatment. Treatment options vary for the condition you have, your preference and its suitability. These include:
Cryotherapy: also referred to as cryosurgery or cryoablation. This minimally invasive procedure uses cold liquid nitrogen to freeze surface skin lesions.
Surgical excision: involves the use of a scalpel or other cutting instrument to remove entire skin growths.
Electrocautery: mild electric current runs through a small probe to treat or destroy tissue on the skin’s surface, without entering your body.
Laser treatment: carbon dioxide resurfacing laser is useful to remove the top layer of the skin safely with minimal invasiveness.
Intralesional steroid injection: the injection contains corticosteroid and is carried out in different strengths, directly into the lesion or below the skin.
It is always wise to do a regular skin check-up at home and with a doctor to help you keep track of your skin’s health. While some may be harmless, others can be indicators of a much more serious condition.
From benign skin growths to cancerous skin problems, we cater to each and every type of skin condition with utmost care and compassion at Angeline Yong Dermatology. Our dermatology clinic has on-site surgical facilities to carry out specialised procedures including cryotherapy and surgical excisions for benign lesions as well as skin cancer treatments.
Dr Angeline Yong is a dual fellowship-trained dermatological surgeon with subspecialty interests in Cosmetic Dermatology and Mohs Micrographic Surgery. She can deliver a comprehensive, tailored care with the most suitable management for various skin growths for health and aesthetic reasons.
If you have a skin lump or bump that you’re worried about, contact us today and book a consultation with Dr Yong!
Reference:
1. Zito PM, Scharf R. Keratoacanthoma. [Updated 2020 Feb 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499931/
2. Luba MC, Bangs SA, Mohler AM, Stulberg DL. Common benign skin tumors. Am Fam Physician. 2003;67(4):729-738.