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What’s that lump?

Mystery body bumps aren’t always serious – but they should always be taken seriously. Here, we tell you how…

Unexplained lumps are among the most common conditions seen by doctors, particularly in sexual health clinics. And it’s easy to understand why. Discovering a new bump can create panic in many of us. ‘How  long has it been there?’, ‘Why is it there?’ and ‘What does it mean?’  are questions that flood the mind. Rest assured, however, that in most cases there’s nothing to worry about.

‘The vast majority [of lumps] have either harmless or easily treatable causes,’ says Dr Christian Jessen. ‘That said, you should always see your doctor with a lump, particularly if it’s new or has grown. Your GP will be able to rule out unlikely but deadly causes, such as cancer.

‘And if there is a more serious cause for the lump,’ continues Dr Christian, ‘the earlier you get treated, the better the outcome.’

We’ve gone from top to toe to identify the possible lumps and bumps that can crop up, got advice on what they might mean (and not mean), and have the lowdown on the latest treatment options.


FACE, HEAD AND NECK
Sebaceous cyst
‘Also known as epidermoid cysts, most of us will have one of these at some point,’ says Dr Christian. Smooth, round lumps, they’re often found on the scalp, neck and face, though they can also appear on the chest or upper back, and, in men, the scrotum.

‘Epidermoid cysts most commonly affect people in their twenties and thirties, and are twice as likely on men,’ he adds. ‘The size can vary from that of a small pea to a few centimetres wide and some may slowly grow over a few months. If punctured, a cheese-type fluid will sometimes seep from the cyst. They’re not cancerous, and can usually be left if they’re not bothering you. But if they are large or obvious, they can be removed under local anaesthetic – see your GP.’

Acne
One of the most common skin complaints in the world, acne can sometimes involve large, painful lumps under the skin, most commonly on the face, neck and back. Although acne is associated with teenagers, a large percentage of sufferers continue to be affected into their twenties, thirties and even their forties. In fact, it’s believed adult acne is on the rise in women, possibly because of increased stress levels. ‘If a particularly large, painful lump is bothering you, see your GP as it may need to be lanced,’ says Dr Christian.

‘In general, for acne there are lots of treatments that can be offered, from topical lotions to the contraceptive pill, so do talk to your doctor.’

Mouth lumps
There are many harmless lumps and bumps that can appear in the mouth area – cold sores and ulcers being two of the most common. ‘However, if you have a persistent bump in your mouth, no matter how small, and especially if painless, you should always see your GP,’ advises Dr Christian. ‘Rarely, these can be signs of oral cancer. You’re
at particular risk of this if you drink and smoke.’

Dentists are trained to look out for signs of oral cancer, so there’s another incentive for your  six-monthly check-ups.


BREASTS
Breast cancer
For women under 40, nine out of 10 breast lumps found are not cancerous. That said, you should  see your doctor as soon as you can if you do find a lump, or notice any unusual rashes, swellings, puckering or shape changes in your breasts.

Fibroadenomas
Sometimes known as ‘breast mice’ because they can be moved around, fibroadenomas are harmless lumps of tissue commonly found in the breasts. They’re usually 1-3cm in size, though they can become larger or disappear altogether. They are nothing to worry about, but they can be surgically removed if they bother or worry you.

Cysts
Breast cysts are fluid-filled sacs that develop in the breast tissue. They’re most common in women over 35 and who haven’t yet reached menopause, though many of us could have them without ever knowing. They can feel soft if they’re near the surface, and harder if they’re deeper into the breast tissue. However, they can also be uncomfortable,even painful, and you may notice they’re more tender before your period.

‘Breast cysts are nothing to worry about, but if you have one and it is bothering you, it can be drained by a specialist, or removed,’ says Dr Christian.


TRUNK
Boils and carbuncles
These can occur anywhere on the body, but are common in places where there’s friction between the skin and clothing, such as under the arms.

‘It’s an inflamed swelling normally caused by infection to the hair follicle,’ says Dr Christian. ‘Boils are filled with pus and are often very painful; if a network of boils joins together, you may end up with a carbuncle. There are many causes, but stress and lowered immunity can make you more vulnerable. A boil will normally clear on its own – never try to burst it yourself. If it’s very sore, see your doctor, who can arrange for it to be drained.’

Skin tags
Painless skin-coloured flaps of skin attached by stalks to the flesh, these can crop up anywhere on the body but are most common under the arms, on the neck and in the genital area. There can be a hormonal influence and women with polycystic ovary syndrome (PCOS) are more likely to have them. Skin tags are completely harmless, but can be inconvenient if they catch on clothing or jewellery, so see your doctor if you want to have one removed.


HANDS AND FEET
Ganglion cysts
Nothing to worry about, these form when the natural lubricating fluid leaks from a joint or tendon, forming a small sac. Though they can appear at any joint, they’re most common around the wrists and feet. They can occur after a trauma or injury to the area, but in most cases the cause is unknown.

‘Ganglion cysts are harmless, but they can be drained or surgically removed if they’re troublesome,’ says Dr Christian.

Bunions
‘Common to many of us, these are bony outcrops that can cause the big toe to angle towards the second toe,’ says Dr Christian. ‘If the skin and tissue on the bump become inflamed, bunions can be very painful. See a podiatrist, who can advise on ways to make them more comfortable. Avoid shoes that aggravate the problem.’

Warts
‘These skin-coloured rough lumps are most common on the hands and feet,’ says Dr Christian. ‘They’re caused by the human papillomavirus (HPV), which causes the keratin in the skin to grow too much, producing a hard, textured wart.’ They are harmless  but unsightly and contagious. They usually clear on their own but see a pharmacist or doctor for treatment to accelerate the healing process.


GENITAL AREA
Women

Bartholin’s cysts
Appearing at the opening of the vagina, these fluid-filled sacs are usually harmless, but they do signify a problem in the Bartholin’s glands. These glands sit on either side of the vagina, releasing a mucous-like substance to keep the area moist. The fluid from each gland drains down two short ducts; if either of these becomes blocked,  it fills and expands, forming a cyst. Bartholin’s cysts don’t normally require treatment, but if they’re painful, you should see your GP, as a blocked cyst can become infected and turn into an abscess.

Vulval lumps
There are a number of reasons for the occurrence of small lumps on the vulva (the outer part of  the vagina).

‘Sebaceous cysts commonly occur here and are nothing to worry about, but  very rarely lumps can be a sign of cancer,’ says Dr Christian. ‘This is extremely unlikely if you’re under 50, but check with your GP.’

Men

Testicular lumps
The testicles are often quite lumpy, so all men should get in the habit of checking them – for example, in the shower to get used to how they feel.

‘If he notices any change, such as  a swelling or a painless small lump in one of the testes, he should see his doctor,’ advises Dr Christian. ‘Very rarely, these changes can indicate testicular cancer, which  is most common in men under 35, though still unusual. Early diagnosis means the recovery rate from this is very high, so making an appointment with the doctor is essential.’

Men and women

Genital and anal warts
Occurring anywhere around the genitals and anus, this is the most common condition seen at sexual health clinics. As with any other type of wart, they’re caused by the human papillomavirus. Also in common with other warts, they are highly contagious, spreading through any skin-to-skin contact – meaning you don’t have to have penetrative sex to be at risk, and condoms won’t offer protection. You wouldn’t necessarily know if your partner had the virus, as it
can be contagious even if the warts aren’t present.

‘Even if you do come into contact with the virus, you won’t always develop warts. And they will normally clear on their own without treatment,’ says Dr Christian.

Strains of the wart virus (though not the strains that cause visible growths) are linked to cervical cancer, and most of us will have come into contact with HPV at some point. It’s very important, therefore, to have regular smear tests to detect the cell changes that may lead to cancer.


Dr Christian says… ‘I always advise men to check their testicles and women their breasts every month. It’s also important to know your skin, particularly any moles or marks you may have. Lumps do tend to crop up from time to time and it’s important to know what has always been there and what is new, or has changed from how it used to be.’

The above feature was published in at home’s Ask the Doctor with Dr Christian Jessen in March 2011. To read more articles from the mag, just click here or visit at home‘s health section here.

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