Painful Lipoma on the Upper Back: A 44-Year-Old Male Case Study from Katy & Houston, TX
At Village Dermatology, we routinely evaluate skin growths that cause discomfort, cosmetic concern, or uncertainty. One common condition we encounter is a lipoma—a benign fatty tumor that can grow under the skin. In this case, we assessed a 44-year-old male from the Katy and Houston, Texas area with a painful skin lesion on his right upper back.
Patient Presentation
This established patient came in with a moderately painful bump that had been present for several years but had recently begun to cause discomfort. The lesion was located on the right superior upper back, measuring approximately 4 cm x 5 cm.
He was particularly concerned about how treatment might impact his ability to maintain his workout routine and was looking for the least invasive treatment option possible.
Clinical Examination
A thorough physical exam, including dermatoscopic evaluation, was performed. The patient was:
Well-developed and well-nourished
Alert and oriented
In no acute distress
Based on the findings, the lesion was consistent with a lipoma—a soft, mobile, subcutaneous mass.
What Is a Lipoma?
A lipoma is a benign (non-cancerous) fatty tumor that typically develops between the skin and the underlying muscle. Lipomas are:
Usually soft and doughy to the touch
Moveable under the skin
Slow-growing
Often painless—but may become uncomfortable or painful depending on size or location
They are most common in adults between 40 and 60 years of age.
Treatment Options Discussed
We had an in-depth conversation with the patient about multiple treatment strategies, weighing the risks, benefits, and downtime associated with each:
1. Surgical Excision
Most definitive method
Preferred by the patient if performed by Dr. Vaughn
Involves removal of the entire lipoma, usually under local anesthesia
Downtime required, but highly effective and permanent
2. Non-Surgical Options (Alternative/Experimental)
Kybella: An injectable treatment typically used for dissolving fat under the chin. May offer benefit in reducing small lipomas, though not widely studied for this use.
CoolSculpting: A non-invasive fat reduction technique using cryolipolysis. Its effectiveness for treating lipomas is not well-established.
While the patient was initially interested in options that minimize scarring and downtime, he ultimately leaned toward excision with Dr. Vaughn as his preferred path forward.
Patient Counseling
We provided detailed counseling, including:
Lipomas are benign and do not require removal unless they are painful, growing, or cosmetically concerning.
Surgical removal is curative, but carries a risk of scarring.
Non-surgical options may not offer predictable results and are not standard of care.
The patient was advised to follow up via Klara to schedule the excision if and when ready.
Why This Matters for Katy and Houston Residents
If you're noticing a painful or growing lump under your skin, it could be a lipoma. At Village Dermatology, we offer personalized treatment plans tailored to your lifestyle and cosmetic preferences. Whether you're an athlete concerned about downtime or someone looking for peace of mind, our team is here to guide you every step of the way.
Residents of Katy and Houston, TX can trust our board-certified dermatologists for both medical and cosmetic dermatologic care.
