Patient information · Minor surgery and dermatology
Skin lumps
cysts, lipomas, skin tags — and the ones to check
Most lumps under the skin are harmless. The three commonest by far are cysts, lipomas and skin tags, and none of them needs removing unless it bothers you. The purpose of an assessment is to be sure which one you have, because a small number of lumps are not what they appear.
Have a lump assessed promptly if it is
- growing quickly, or has changed in the last few weeks
- larger than 5cm, or deep and firmly fixed to the tissue beneath
- hard, irregular or immobile rather than soft and mobile
- painful without being infected, or causing numbness or tingling
- hot, red, spreading with fever — an abscess needing same-day drainage
- in a child, or accompanied by weight loss, night sweats or swollen glands
Rapidly growing, deep or large lumps — particularly above 5cm and below the fascia — need imaging before removal, because a small proportion are soft tissue sarcomas. Any lump that does not fit the pattern of a simple cyst or lipoma should be scanned rather than simply excised.
Telling them apart
- Epidermoid cyst — a firm, round lump in the skin, often with a small dark central punctum. Contains keratin, can smell unpleasant if it discharges, and can become inflamed or infected.
- Lipoma — a soft, doughy, mobile lump of fat beneath the skin. Slow-growing, painless, and can occur anywhere. Often multiple.
- Skin tag — a small soft flap of skin on a stalk, usually in armpits, neck, groin or under the breasts. Harmless; associated with friction, weight and sometimes insulin resistance.
- Ganglion — a firm, smooth swelling near a joint or tendon, usually the wrist. Fluid-filled and often fluctuates in size.
- Abscess — hot, red, exquisitely tender and enlarging over days. This needs drainage, not observation.
Do not squeeze a cyst
Squeezing forces contents into the surrounding tissue, which triggers intense inflammation and often infection — turning a small painless lump into a hot, painful mess that then cannot be removed cleanly for several weeks. It also leaves a worse scar. If a cyst becomes inflamed, come and have it looked at rather than attacking it.
When removal is worth it
- it is catching on clothing, jewellery or a razor
- it is repeatedly becoming inflamed or infected
- it is growing, or you want the diagnosis confirmed
- it is uncomfortable, unsightly or affecting your confidence
- it is pressing on something — a nerve, a joint, a waistband
What removal involves
- Local anaesthetic, injected around the lump. Sharp for a few seconds, then numb.
- Cysts are removed with the sac intact — leaving any of the wall behind is why they recur.
- Lipomas are removed through an incision over the lump; larger ones leave a longer scar.
- Skin tags are removed by snipping, freezing or cautery, often several in one visit, and usually without stitches.
- Most procedures take 15 to 30 minutes and you go home straight away.
- Anything removed is sent for laboratory examination as a matter of routine, so the diagnosis is confirmed rather than assumed.
Afterwards
- Keep the wound dry for 48 hours, then shower and pat dry.
- Stitches, if used, come out in 5 to 14 days depending on the site.
- Avoid heavy lifting, stretching the area or the gym for one to two weeks.
- Some bruising and firmness under the scar for several weeks is normal.
- Every removal leaves a scar — usually a fine line that fades over 12 to 18 months. Protect it from sun for the first year.
Why come to us. We assess and remove skin lumps in clinic under local anaesthetic, generally within the same week, with no referral and no waiting list. Ultrasound is available on site where a lump needs imaging before anything is done — which matters, because not every lump should simply be cut out. Every specimen goes for laboratory analysis, our dermatology and minor surgery teams work from the same clinical record, and all fees are published.
Assessed and removed in the same week
Ultrasound on site, specimens analysed, fees published. Seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.