"I Have a Soft Lump on My Temple That's Been There for Years—Do I Need to Have It Removed?"
Finding a lump beneath your skin can be unsettling, especially when it's on your face. Even if it isn't painful, many people worry that it could be something serious or wonder whether it will continue to grow over time.
Recently, a 19-year-old man visited our dermatology clinic in Houston with a soft bump on his left temple that had been present for several years. Although the lesion wasn't causing pain or other symptoms, he wanted to know exactly what it was and whether it should be removed.
After a careful examination, our board-certified dermatologist determined that the mass was most consistent with either an epidermal inclusion cyst (EIC) or a lipoma, while also considering the possibility of a dermoid cyst. Because the lesion measured approximately 1.7 × 1.2 cm and was located on the face, surgical excision was recommended both to establish a definitive diagnosis and remove the growth.
If you've discovered a painless lump on your face or scalp, here's what you should know.
What Is an Epidermal Inclusion Cyst?
An epidermal inclusion cyst (EIC) is one of the most common benign skin growths seen by dermatologists.
These cysts develop when skin cells become trapped beneath the surface instead of shedding normally. The trapped cells continue producing keratin, a natural skin protein, causing the cyst to slowly enlarge over time.
Most epidermal inclusion cysts are:
Soft or slightly firm
Round or oval
Mobile beneath the skin
Slow growing
Usually painless
Although harmless, they can become inflamed or infected if they rupture.
Could It Be a Lipoma?
Another possibility discussed during this patient's visit was a lipoma.
Lipomas are benign tumors made up of normal fat cells.
Compared with cysts, lipomas are often:
Very soft
Easily movable
Located deeper beneath the skin
Slow growing
Usually painless
Because both cysts and lipomas can feel similar during an examination, distinguishing between them sometimes requires surgical removal and laboratory analysis.
What Is a Dermoid Cyst?
Because the lesion was located near the temple, a dermoid cyst was also included in the differential diagnosis.
Dermoid cysts are congenital growths that develop before birth and may contain skin structures such as:
Hair follicles
Oil glands
Keratin
Although many dermoid cysts remain stable for years, they are often removed to confirm the diagnosis and prevent gradual enlargement.
How Dermatologists Evaluate Facial Lumps
During this patient's examination, the dermatologist carefully assessed several characteristics of the lesion.
The bump was:
Soft
Freely mobile beneath the skin
Well-defined
Approximately 1.7 × 1.2 centimeters
Located on the left temple
Not inflamed or tender
A dermatoscope was also used to closely evaluate the overlying skin and help rule out other skin lesions.
These findings favored a benign diagnosis rather than skin cancer.
Do All Cysts Need to Be Removed?
Not necessarily.
Many epidermal inclusion cysts can simply be observed if they are:
Small
Not painful
Not infected
Not rapidly enlarging
Not cosmetically bothersome
However, removal is often recommended when a cyst:
Continues growing
Frequently becomes inflamed
Ruptures repeatedly
Causes discomfort
Is located in a cosmetically sensitive area such as the face
For this patient, elective surgical excision was recommended because of the lesion's size and facial location.
What Does Surgical Excision Involve?
Complete surgical excision is considered the most effective treatment for epidermal inclusion cysts and many lipomas.
During the procedure:
Local anesthetic is used to numb the area.
A small incision is made over the lesion.
The entire cyst or fatty tumor is carefully removed.
The incision is closed with sutures to promote optimal healing.
Completely removing the cyst wall significantly reduces the chance of recurrence.
Will There Be a Scar?
One of the most important parts of the discussion involved balancing the benefits of removing the lesion with the possibility of a scar.
Our dermatologist explained that while surgical excision removes the bump, it replaces it with a carefully planned surgical scar.
Fortunately, facial skin generally heals very well, and dermatologic surgeons use meticulous techniques to minimize visible scarring whenever possible.
For many patients, replacing a noticeable lump with a thin, well-healed scar provides a significant cosmetic improvement.
When Should You Seek Medical Attention?
Although most cysts are harmless, patients should schedule an evaluation if a lump:
Grows rapidly
Becomes painful
Turns red or warm
Begins draining material
Repeatedly becomes inflamed
Changes in appearance
Early evaluation allows dermatologists to determine whether observation or removal is the best option.
Expert Cyst Evaluation and Removal in Katy & Houston, Texas
If you've noticed a lump beneath your skin, don't ignore it or try to squeeze it at home.
At Village Dermatology, our board-certified dermatologists diagnose and treat epidermal inclusion cysts, lipomas, dermoid cysts, and other benign skin growths using advanced diagnostic techniques and precise surgical procedures designed to achieve excellent cosmetic outcomes.
Whether your concern is located on the face, scalp, neck, or body, our experienced team proudly serves patients throughout Houston, Katy, and surrounding Texas communities.
Schedule your consultation today to learn whether your skin growth can simply be monitored or whether removal is the best option for your long-term health and peace of mind.
