Finding a lump while you’re washing your hair is a uniquely jarring experience. One second you’re thinking about your grocery list, and the next, your fingers hit a hard knot or a tender spot that wasn’t there yesterday. Your mind instantly goes to the worst-case scenario. It’s scary. You start searching for pictures of bumps on scalp to see if yours looks like the scary ones or the boring ones. Most of the time, these bumps are just annoying biological glitches, but knowing the difference between a clogged pore and something that needs a surgeon's touch is pretty vital.
Let’s be honest: the scalp is a weird piece of real estate. It’s thick, incredibly vascular, and packed with more hair follicles and oil glands than almost anywhere else on your body. This makes it a playground for cysts, infections, and weird growths. If you've been doom-scrolling through blurry medical photos, stop for a second. We’re going to walk through what these things actually look like in real life, why they happen, and when you should actually be worried.
The Most Likely Culprits Behind Those Scalp Bumps
If you see a smooth, skin-colored dome that’s been growing slowly for years, you’re probably looking at a pilar cyst. These are the "bread and butter" of scalp issues for dermatologists. Unlike the sebaceous cysts you find on your back or face, pilar cysts—also called trichilemmal cysts—specifically form from the hair follicle sheath. They feel firm, almost like a little marble under the skin.
Dr. Sandra Lee (widely known as Pimple Popper) often showcases these because they have a thick wall that makes them pop out in one piece. They aren't cancerous. However, they don't go away on their own. If you try to squeeze one, you’ll likely just cause an infection because the "gunk" inside is actually just old keratin that has been compressed into a cheesy consistency.
Folliculitis is another common visitor. This looks less like a marble and more like a crop of tiny red pimples. It’s an inflammation of the hair follicle, often caused by Staphylococcus aureus or even yeast. If you’ve been wearing a sweaty hat or haven't changed your pillowcase lately, these red, itchy bumps are a likely result. They can be tender, and sometimes they develop a little white head.
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Acne and Seborrheic Keratoses
Yes, you can get "scalp acne." It’s basically the same thing that happens on your chin. Excess oil and dead skin cells plug a pore, bacteria moves in, and suddenly you have a painful red bump. It’s common in people who use heavy hair waxes or "pomades," leading to a specific condition often called acne venenata.
Then there are Seborrheic Keratoses. These are the "barnacles of aging." They look like someone took a piece of brown or tan candle wax and stuck it onto your scalp. They have a "stuck-on" appearance and can feel warty or crusty. While they look slightly terrifying—sort of like a mole that's gone wrong—they are completely benign. You’ll often see these in pictures of bumps on scalp that look dark or scaly. They are very common as we head into our 40s and 50s.
Identifying Dangerous Growths vs. Irritations
Not everything is a harmless cyst. This is where we have to be serious. Skin cancer can and does happen on the scalp, and it’s often diagnosed later because it’s hidden under hair. Basal Cell Carcinoma (BCC) is the most frequent type. It usually looks like a pearly, translucent bump that might bleed easily and then scab over, only to bleed again a week later. It’s the "sore that won't heal."
Squamous Cell Carcinoma (SCC) is a bit different. It often looks like a scaly, red, firm bump or a flat patch with a crusty surface. These are more common in people with thinning hair or those who have spent decades working outdoors without a hat. The UV damage adds up.
And then there's melanoma. This is the one we really watch out for. It usually isn't a "bump" in the traditional sense, but it can be. Look for the ABCDEs:
- Asymmetry (one half doesn't match the other)
- Borders (irregular or notched)
- Color (multiple shades of brown, black, or blue)
- Diameter (larger than a pencil eraser)
- Evolving (the bump is changing fast)
If you find something that fits this description, skip the internet and go straight to a dermatologist.
Why Your Scalp Produces These Bumps
Basically, your scalp is an ecosystem.
Hormones play a huge role. An increase in androgens can make your sebaceous glands go into overdrive, pumping out oil that feeds bacteria. Stress can also trigger flare-ups of conditions like seborrheic dermatitis, which causes itchy, red, scaly bumps that many people mistake for a simple breakout.
Sometimes it's mechanical. If you wear tight braids, extensions, or heavy helmets, you might develop "traction folliculitis." The constant pulling on the follicle causes it to inflame and bump up. Even your hair products can be the villain. Ingredients like silicones or heavy oils can build up, creating a "cap" on the scalp that traps sweat and bacteria underneath.
How to Handle Them Without Making It Worse
The urge to pick is real. We’ve all been there. But picking a bump on your scalp is a recipe for disaster. The scalp is so vascular that it bleeds—a lot. Plus, your fingernails are surprisingly dirty. Introducing a new infection into an already inflamed cyst can turn a small marble into a painful, golf-ball-sized abscess that requires draining and antibiotics.
If the bump is a simple pimple or mild folliculitis, you can try:
- Salicylic acid shampoos: These help chemically exfoliate the scalp and clear out the follicles.
- Warm compresses: This can help bring a "head" to a simple pimple or soothe a tender cyst.
- Tea tree oil: It has natural antimicrobial properties, but be careful—it can be irritating if you use it undiluted.
For pilar cysts or seborrheic keratoses, medical intervention is the only real fix. A doctor will typically numb the area with lidocaine, make a tiny nick, and remove the growth. It’s usually a 15-minute procedure.
When Should You Book an Appointment?
Honestly, if a bump has been there for more than two or three weeks and isn't showing signs of leaving, it's time for a professional opinion.
Specific red flags include a bump that is growing rapidly, a bump that bleeds spontaneously, or a growth that has multiple colors. If the bump is accompanied by hair loss in that specific spot, it could be a sign of something like lichen planopilaris or discoid lupus, which require specific medications to prevent permanent scarring.
Don't rely solely on pictures of bumps on scalp you find online. Lighting, skin tone, and camera quality change how things look. A dermatologist has a tool called a dermatoscope—essentially a high-powered, polarized magnifying glass—that lets them see structures beneath the surface of the skin that are invisible to the naked eye.
Immediate Action Steps
If you’ve just found a bump, take these steps today.
First, take a clear photo of it. Use a hand mirror and your phone’s flash. This gives you a baseline. If you look at it again in two weeks, you’ll actually know if it’s gotten bigger or changed color, rather than just guessing.
Second, switch to a gentle, fragrance-free shampoo for a few days to rule out contact dermatitis or simple irritation from a new product.
Third, stop touching it. Seriously. Every time you poke or squeeze it, you’re increasing the inflammation.
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Finally, check the rest of your scalp. Use a comb to part your hair in sections and have a partner or friend look for any other spots you might have missed. If you find multiple similar bumps, it’s more likely a systemic issue like folliculitis. If it’s just one "lonely" bump, it’s more likely a cyst or a localized growth.
Get a professional skin check once a year. It sounds like a chore, but given how much sun our heads soak up over a lifetime, it’s the smartest way to catch the bad stuff before it becomes a real problem.