Painful lump on the back of the neck at the hairline

Hair follicles can become inflamed, and a blocked cyst can become tender, warm, or red. A lymph node may enlarge while your body responds to an infection affecting the scalp, ear, throat, or skin. The position, texture, movement, skin changes, and timing help a clinician narrow the cause. A lump can also require assessment for less common conditions involving the head and neck, including lymphoma or other cancers; its presence alone does not identify the cause.

Do not squeeze, pierce, or repeatedly press the lump. Keep the area clean and note when it appeared, whether it is changing, and any recent scalp irritation, insect bite, illness, or injury. A warm, clean compress may soothe surface tenderness. Arrange a routine medical visit if it remains present, returns, or is difficult to see or feel clearly. A clinician may inspect the skin and neck and decide whether imaging or sampling is appropriate.

Seek prompt medical care for rapidly increasing swelling, spreading redness, drainage, fever, severe pain, difficulty swallowing or breathing, marked weakness, or a stiff neck. Arrange an assessment soon for a firm or fixed lump, unexplained weight loss, drenching night sweats, or a lump that does not settle after an infection improves.

Ask whether the lump feels like a skin lesion or lymph node, what changes should trigger an earlier review, and whether the scalp, ears, mouth, throat, or thyroid need examination. If a thyroid cause is considered, ask what testing would come before any discussion of Thyroid Removal Surgery.