By the Harley Street Prestige Medical Editorial Team | Medically reviewed by our dermatology team | September 2026
Discovering a lump beneath your skin can be worrying. Even if it does not hurt, you may immediately wonder what it is, whether it is serious, and if it needs treatment.
A soft, painless lump may be a lipoma, but other conditions, including cysts, swollen lymph nodes, abscesses, ganglion cysts and hernias, can sometimes feel similar.
Because different lumps can share the same features, touch alone cannot confirm a diagnosis.
For patients seeking clarity, Harley Street skin care clinic provides clinical assessment and treatment options based on the type and characteristics of the lump.
Understanding the Lipoma
A lipoma is a benign, slow-growing lump made up of fatty tissue, most commonly found just beneath the skin. It typically feels soft, doughy or slightly rubbery and, unlike many firmer lumps, can often be moved slightly when gentle pressure is applied.
Lipomas commonly develop on the shoulders, upper back, arms, neck, chest and thighs. The skin covering the lump usually looks completely normal, without redness, discolouration, an opening or any obvious change in texture.
Most lipomas are painless and do not cause serious health problems. However, not every soft or moveable lump is necessarily a lipoma. Other soft-tissue conditions can feel similar, which is why a new, enlarging or unexplained lump is best assessed by a medical professional rather than diagnosed by touch alone.
Lipoma or Cyst? Knowing the Difference Matters
Lipomas and cysts are often mistaken for one another because both can appear as lumps beneath or within the skin. However, they are medically different and may require different approaches to assessment and treatment.
A lipoma is a benign lump made up of fatty tissue. An epidermoid cyst, sometimes incorrectly referred to as a sebaceous cyst, is a sac-like lesion within the skin that contains keratin, a substance naturally produced by skin cells.
Some features may help distinguish between them:
- Texture: Lipomas are usually soft, doughy or pliable, while epidermoid cysts often feel firmer and more rounded.
- Skin surface: An epidermoid cyst may have a small central opening, known as a punctum. This is not a typical feature of a lipoma.
- Inflammation: Cysts can become red, swollen, tender or infected, particularly if they rupture or become irritated. Lipomas do not usually become inflamed in the same way.
- Movement and attachment: Lipomas often move slightly beneath the skin when gently pressed. Epidermoid cysts are typically more closely attached to the overlying skin, although they may still move over deeper tissues.
These differences can offer useful clues, but they are not reliable enough to confirm a diagnosis at home. Some lumps share overlapping features, so a clinical examination is the safest way to determine whether you are dealing with a lipoma, cyst or another type of under-skin lump.
When a Lump Becomes Painful
A typical lipoma is usually painless, although some may become uncomfortable if they grow large enough to press on nearby tissues or nerves.
A cyst can behave differently. It may remain painless for a long time and then become inflamed, irritated or infected. When this happens, you may notice redness, warmth, tenderness, swelling, increasing pain or discharge from the area.
If a lump that was previously painless suddenly becomes sore, red or swollen, avoid squeezing, puncturing or attempting to drain it yourself. This can worsen inflammation and may increase the risk of infection.
Before considering lipoma removal treatment, it is important to have a painful or changing lump properly assessed to confirm the diagnosis and rule out other causes.
Other Conditions That Can Mimic a Lipoma
Several other conditions can feel similar to a lipoma:
- Swollen lymph nodes: Common in the neck, armpits or groin, often during infection.
- Skin abscesses: Usually painful, warm, red and swollen.
- Ganglion cysts: Often develop near joints or tendons, especially around the wrist or hand.
- Hernias: Usually occur in the abdomen or groin and may become more noticeable when coughing or straining.
Because these lumps have different causes and treatments, proper assessment is important before deciding on removal.
Could It Be Something More Serious?
Many under-skin lumps are benign, but appearance and texture alone cannot rule out a more serious cause.
A lump that is growing, hard, fixed, painful, unusually deep or causing skin changes should be assessed. NICE (National Institute for Health and Care Excellence) guidance also recommends considering an urgent ultrasound scan for adults with an unexplained lump that is increasing in size.
This does not mean the lump is cancerous, but it does mean further investigation may be needed.
How We Confirm a Diagnosis
Diagnosis begins with a clinical examination in which the lump’s size, location, texture, mobility and growth pattern are assessed.
If the diagnosis is unclear, an ultrasound scan may be recommended. After removal, the tissue may also be sent for histopathology to confirm exactly what the lump is.
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Do All Lipomas Need Removal?
Not necessarily. A small, stable, symptom-free lipoma that has been properly assessed does not automatically require treatment. However, many patients choose removal when a lipoma continues to grow, causes discomfort, restricts movement, catches on clothing, becomes cosmetically bothersome, or simply causes ongoing anxiety.
Where removal is appropriate, lipoma removal is typically performed through surgical excision under local anaesthetic, with the incision and closure planned to support a good cosmetic outcome.
When Should You Have a Lump Checked?
You should consider arranging an assessment if:
- You have discovered a new unexplained lump
- An existing lump is getting larger
- The lump has become painful
- It feels hard or fixed
- The overlying skin has changed
- You are unsure whether it is a lipoma, cyst or another type of lump
- It is affecting your comfort or confidence
- You are considering having it removed
Seeking an assessment does not automatically mean surgery will be recommended. The first step is understanding what the lump is and whether treatment is actually needed.
If your lump is confirmed as a lipoma and removal is appropriate, Harley Street skin care clinic offers minor surgical excision in London.
How We Remove a Lipoma
Lipoma removal treatment is usually performed using a minor surgical technique called excision.
Step 1: Local Anaesthesia
The treatment area is numbed with local anaesthetic so you remain comfortable during the procedure.
Step 2: Small Incision
A carefully positioned incision is made over the lipoma, with placement planned to support effective removal and minimise visible scarring where possible.
Step 3: Lipoma Removal
The fatty lump is carefully removed through the incision. Complete excision can help reduce the chance of recurrence.
Step 4: Wound Closure
The incision is closed with fine sutures to support proper healing and a good cosmetic outcome.
Step 5: Recovery
For suitable lipomas, removal is typically a straightforward same-day procedure, allowing you to return home shortly afterwards with appropriate aftercare advice.
Getting Clarity About Your Lump
Touch alone cannot reliably tell you whether a lump is a lipoma, cyst or something else. Because different conditions can feel similar, professional assessment is the safest way to get clarity.
At Harley Street Prestige Medical, patients considering lipoma removal treatment can receive a clinical assessment followed by an appropriate treatment plan based on the characteristics of the lump.
If you have noticed a new, growing or changing lump, arranging an assessment can help determine what it is and whether treatment is needed.
Book a consultation at Harley Street Prestige Medical for expert assessment and appropriate lipoma treatment in London.
