[41F] With itchy, draining lump on head and frequent headaches

Patient Description

A 41-year-old female presents with a lump on the top of her head that has been present for three weeks. The lump itches a lot, has some clear drainage, and is not painful. It is rounded, with the skin appearing lighter than the surrounding area. The lump feels tight at times, with some parts being stiff and hard, while other parts are movable. The patient also reports frequent headaches, occurring almost every day or every other day, located on the very top backside of the head, more on the right side. The headaches are described as aching, sometimes throbbing, with an intensity of 4 out of 10. The patient experiences weakness in her arms and constant pain in her right wrist. There are no associated symptoms of fever, neck stiffness, changes in vision, sudden changes in speech, coordination or balance issues, or seizures. The patient has no pre-existing conditions or chronic illnesses and is not taking any medications.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Sebaceous Cyst: These are non-cancerous lumps filled with a substance called sebum. They can become itchy and may drain clear fluid if they rupture. They are usually not painful unless infected.

    • Treatment: Often, no treatment is needed unless the cyst becomes infected or bothersome. In such cases, a doctor may drain it or remove it surgically.
  • Folliculitis: This is an inflammation of the hair follicles, often caused by bacterial or fungal infections. It can cause itchy, red bumps that may drain fluid.

    • Treatment: Mild cases may resolve on their own, but more severe cases might require topical or oral antibiotics.
  • Lipoma: A lipoma is a benign tumor made of fat tissue. They are usually soft and movable and generally not painful.

    • Treatment: Lipomas usually do not require treatment unless they cause discomfort or cosmetic concerns. Surgical removal is an option.
  • Tension Headaches: These are common and can cause a dull, aching pain. They can be triggered by stress, poor posture, or muscle strain.

    • Treatment: Over-the-counter pain relievers, relaxation techniques, and maintaining good posture can help manage tension headaches.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take in the meantime:

  1. Keep the Area Clean: Gently wash the lump with mild soap and water to prevent infection.
  2. Avoid Scratching: Scratching can worsen the itching and potentially introduce bacteria, leading to infection.
  3. Warm Compress: Applying a warm compress to the lump can help reduce discomfort and promote drainage if it is a cyst or folliculitis.
  4. Over-the-Counter Pain Relief: Medications like ibuprofen or acetaminophen can help manage headache pain.
  5. Hydration and Rest: Ensure you are well-hydrated and get adequate rest to help your body heal.

What you should look out for

Seek medical attention if you experience any of the following:

  • Increased Pain or Swelling: If the lump becomes more painful, swollen, or red, it could indicate an infection.
  • Fever: A fever could be a sign of an infection that needs medical treatment.
  • Changes in the Lump: If the lump grows rapidly, changes in color, or becomes hard and immovable, it should be evaluated by a healthcare professional.
  • Severe Headaches: If your headaches become severe, persistent, or are accompanied by other symptoms like vision changes or weakness, seek medical attention.

Remember, while this information can be helpful, it is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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People Also Ask


What could cause a lump on the head that itches and drains clear fluid?

A lump on the head that itches and drains clear fluid could be a sebaceous cyst, folliculitis, or another benign condition. Sebaceous cysts are non-cancerous and filled with sebum, while folliculitis is an inflammation of hair follicles often due to infection.


How can tension headaches be managed at home?

Tension headaches can be managed at home by using over-the-counter pain relievers like ibuprofen or acetaminophen, practicing relaxation techniques, maintaining good posture, and ensuring adequate hydration and rest.


What are the signs that a lump might be infected?

Signs that a lump might be infected include increased pain, swelling, redness, warmth around the area, and possibly fever. If these symptoms occur, it is important to seek medical attention.


When should I seek medical attention for a persistent headache?

You should seek medical attention for a persistent headache if it becomes severe, is accompanied by other symptoms such as vision changes, weakness, or if it does not improve with over-the-counter medications and rest.


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