Atheroma behind the ear, on the head and face: what it is and when to see a doctor

A dense, rounded growth under the skin behind the ear, on the scalp, or on the face is a common reason for consulting a surgeon. In most cases it is a cyst: a cavity under the skin with contents, which is usually not dangerous. Below is what is known about this growth, how it is examined, and when a visit should not be postponed.

What an atheroma is and why it is called a cyst

An atheroma, or sebaceous gland cyst, is a tumor-like growth that occurs when the duct of a sebaceous gland becomes blocked. Structurally, it is a closed cavity under the skin, that is, a cyst. Wikipedia defines an atheroma as a cyst of the sebaceous gland, and MedlinePlus clarifies that epidermoid cysts are sometimes called sebaceous, although their contents are different.

An epidermoid cyst is sometimes called sebaceous, but the contents of different cysts differ: an epidermoid cyst is filled with dead skin cells, while a true sebaceous gland cyst is filled with yellowish oily material. The mechanism of the former: elements of the surface layer of the skin end up beneath its surface, and the shed material is not released outward. The cyst grows slowly, and at a certain size it usually stops enlarging.

Why an atheroma appears behind the ear

The cause has not been precisely established. Cysts are very common, occur more often in adults than in children, and are often found in blood relatives.

The appearance behind the ear is explained by anatomy: the growth forms where hair grows and sebaceous glands are active. The retroauricular fold is listed as a typical site for secondary, retention cysts of the sebaceous gland — they are more common in oily seborrhea, excessive sweating, and severe forms of acne. Such cysts are dense, painful, with a bluish tint, ranging in size from a pea to a hazelnut.

Skin cysts occur on the head, face, neck, and other areas of the body.

Atheroma on the head, face, and neck: how the sites differ

The predominant areas are the scalp, face (especially below the mouth), neck, and back. On the scalp, a pilar cyst from a hair follicle is more common: it interferes with combing the hair. If the growth is in a visible area, for example on the face, and does not bother the person, they may choose removal themselves; after healing, a small scar remains.

Secondary cysts are more often located on the cheeks, neck, in the retroauricular fold, and near the alae of the nose.

What an atheroma looks like and how to distinguish it from other growths

The typical picture: a rounded growth under the skin with clear contours, of firm-elastic consistency, mobile; the skin over it cannot be gathered into a fold. The size ranges from smaller than a pea to several centimeters. A small dark dot or pit is often visible in the center. It is usually painless and grows slowly. Sometimes an atheroma is difficult to distinguish from other benign skin neoplasms, and some malignant tumors look like a cystic nodule; therefore a new growth is examined by a doctor, and if there is doubt, a biopsy is performed.

Possible complications: inflammation and suppuration

When infected, redness, tenderness, and local elevation of temperature appear. When suppuration occurs, pain, swelling, fever, and fluctuation are added; the growth may open on its own with discharge of pus mixed with sebaceous contents. A painful abscess becomes a complication. After removal, the cyst returns if the capsule was not completely removed. In rare cases, an atheroma transforms into a malignant neoplasm. When squeezed out or ruptured, the contents may become infected, and an already inflamed cyst may spread the infection.

A growth under the skin is not in itself a reason to call an ambulance. 103 or 112 — if the condition has sharply worsened and is life-threatening.

When the growth should be shown to a surgeon

A planned visit is appropriate for any new growth whose nature you do not know. The diagnosis in most cases is made by examining the skin; if infection is suspected, a culture is taken, and if the picture is unclear, a biopsy is performed. The surgeon assesses the size, density, mobility, and condition of the skin over the growth.

• the growth has appeared for the first time, and you do not know what it is;
• the skin over it has become red, hot, or painful;
• it is rapidly enlarging or has changed appearance;
• discharge has appeared from it;
• it interferes with daily life, for example it catches when combing the hair.

This material is for reference: it does not replace consultation with a doctor, who will examine the specific growth.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer