A bump on the head is a common occurrence, ranging from a minor annoyance to a sign of a serious injury. The scalp contains a dense network of blood vessels just beneath the skin, making it prone to swelling and bruising after even a slight impact. Understanding the nature of the bump is the first step toward appropriate care and determining if medical attention is necessary.
Identifying the Most Common Types of Head Bumps
Head bumps generally fall into two categories: those caused by trauma and those that develop slowly over time. Traumatic bumps, often called “goose eggs,” are a type of hematoma resulting from a direct blow. This occurs when small blood vessels rupture beneath the skin, creating a localized collection of blood and swelling on the rigid skull. These acute bumps appear rapidly after an injury and are typically tender.
Non-traumatic bumps develop slowly and are usually related to dermatological or soft tissue conditions. One frequent type is an epidermal or pilar cyst, a small, firm, slow-growing lump that forms under the skin due to a buildup of keratin or blocked hair follicles. These cysts are usually painless unless they become inflamed or infected. Another type is a lipoma, a soft, rubbery collection of fatty tissue that moves slightly when pressed. Folliculitis or abscesses, caused by an infected hair follicle, can also present as a pus-filled, painful bump.
Immediate Steps for Minor Traumatic Bumps
For a minor traumatic bump not accompanied by severe symptoms, the immediate focus is on managing swelling and pain. The rapid swelling, or hematoma, occurs because the scalp tissue has little space to absorb the fluid, pushing the swelling outward. Cold therapy is the most effective initial treatment to constrict blood vessels and limit the size of the bump.
Apply an ice pack or a bag of frozen vegetables wrapped in a thin towel directly to the injury site. The cold compress should be applied for 15 to 20 minutes every two to four hours during the first 24 to 48 hours. This intermittent application maximizes the reduction of inflammation while minimizing the risk of cold injury. Rest and observation are necessary; avoid strenuous activities and monitor the bump for any worsening symptoms.
For pain relief, acetaminophen is generally the preferred over-the-counter medication. Avoid non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin in the initial hours following a head injury. These medications can interfere with blood clotting and may increase the risk of bleeding, potentially worsening the underlying hematoma. Ensure someone stays with the injured person for at least the first 24 hours to monitor for complications.
Critical Symptoms Requiring Emergency Medical Care
While most traumatic bumps are minor, certain symptoms signal a more serious underlying injury, such as a concussion or internal bleeding, requiring immediate emergency medical attention. Any loss of consciousness, even briefly, after the impact is a serious red flag. A headache that becomes severe or progressively worsens over time is also a critical symptom.
Other neurological signs demanding urgent evaluation include repeated vomiting or nausea, which can indicate increased pressure within the skull. Confusion, slurred speech, difficulty walking or balancing, or any unusual behavior should prompt an immediate call to emergency services. Clear fluid or blood draining from the ears or nose, unequal pupil size, or the onset of seizures are signs of a potentially severe injury.
Symptoms of a serious head injury may be delayed for hours or even days. Continuous observation for at least 48 hours is necessary, particularly for children or older adults. If the bump rapidly grows larger, or if the person becomes unusually drowsy or difficult to wake up, seek professional help immediately. Prompt evaluation ensures conditions like an intracranial hematoma—a blood clot under the skull—are diagnosed and treated.
Professional Medical Treatments for Persistent Lumps
When a head lump is non-traumatic, persists long after an injury, or causes concern, a medical professional determines the appropriate treatment. Diagnosis often begins with a physical examination. Imaging tests like an X-ray, CT scan, or MRI may be ordered to assess the lump’s depth and composition, especially if a deeper mass is suspected. If the lump is a skin-related growth, a biopsy may be performed to ensure it is benign.
For non-infected cysts or lipomas, treatment is often elective and typically involves surgical excision if they are large, growing, or causing discomfort. A surgeon removes the entire sac of a cyst to prevent recurrence, while a lipoma is removed through an incision. Infected bumps or abscesses may require incision and drainage to relieve pressure and remove the pus, usually followed by antibiotics. Some inflammatory cysts can be treated with a steroid injection, which helps shrink the lesion and reduce swelling without surgery.