Hard lump on scalp under the skin

Scalp lumps can arise from a cyst connected with a hair follicle, a blocked structure, irritation, or a firm area after a knock. A boil tends to be sore, warm, red, and inflamed, sometimes with drainage. A lump with a visible crust, ulcer, or recurring bleed is a different pattern and should be checked; basal cell carcinoma is one condition a clinician may consider when a surface lesion persists.

Hair can hide colour or texture changes, so use gentle fingertip checks rather than scratching. Note whether the lump is attached to the skin, moves over deeper tissue, causes tenderness when brushing, or is accompanied by hair loss at that spot.

Avoid picking, squeezing, or puncturing the lump, and use care when combing over it. Arrange a routine examination if it remains, enlarges, repeatedly becomes sore, or catches on clothing or headwear. Photographing the surface in good light can help you describe change, but it does not replace an examination. Treatment depends on the cause and may include observation or a procedure.

Seek prompt care if the scalp becomes increasingly red, hot, swollen, or painful, if pus or fever develops, or if swelling follows a head injury with severe headache, vomiting, confusion, or unusual drowsiness. Arrange early review for rapid growth, bleeding, ulceration, marked tenderness, or a new area of hair loss over the lump.

Ask whether the lump is in the skin or deeper tissue, whether the surface needs close inspection, and whether it could be linked to a follicle or injury. Ask how to protect it while waiting and which changes should lead to urgent review.