Most lumps in or under the skin are benign, and most can be removed in a single visit under local anaesthetic. This page explains what the common ones are, what makes a removal simple or complex, and what to realistically expect afterwards.
From £300
simple excision, after an £80 suitability appointment
From £550
complex excision, histology included
20 to 60 min
under local anaesthetic, awake
Norwich
in person, doctor delivered
A lesion is simply the medical word for a lump, bump or mark. These six account for most of what we remove. Each forms differently, which is why a cyst needs its sac taken out whole, a lipoma shells out of its capsule, and a mole is sometimes better shaved than cut.
Usually called a sebaceous cyst
A hair follicle or pore blocks, and the skin cells that would normally shed get trapped underneath. They keep producing keratin, which builds up inside a thin sac. The result is a slow growing dome fixed to the skin above it, often with a small dark central pore. Cysts can become inflamed or infected.
The sac must come out whole. Leave any behind and the cyst refills.
The scalp version
Arises from the hair root sheath rather than the follicle opening. Firmer and smoother than an epidermoid cyst with a tougher wall. Strongly inherited and often multiple.
The thick wall usually shells out cleanly.
Fatty lump
A benign overgrowth of fat cells inside a thin capsule, sitting between skin and muscle. Soft, rubbery, slides under the finger, with normal skin over it. Grows slowly over years. Some people inherit a tendency to many. Not caused by being overweight.
Over 5 cm, deep, fast growing or painful needs a scan first to rule out a rare fatty cancer.
Histiocytoma
A firm, button like nodule, brown or pink, commonest on the legs. Thought to be an overgrown scar reaction to an insect bite or ingrown hair. Dimples inwards when pinched from the sides. Harmless but can itch or catch on razors.
Removal leaves a scar bigger than the lesion. We often advise leaving these alone.
Melanocytic naevus
A cluster of pigment cells. Most appear in childhood and stay stable for life. Raised, fleshy moles on the face and trunk are often removed because they catch or for appearance.
We only remove moles that are clinically benign. Anything suspicious is referred urgently.
Age spot
A waxy, warty, stuck on brown patch that appears from middle age. Nothing to do with the wart virus: a build up of normal skin cells that has stopped shedding properly. Harmless but can itch, catch and multiply.
Sits on the surface, so it is shaved or frozen rather than cut out.
The lesion itself is only part of it. Where it is, what has happened to it before and what needs to happen to the tissue afterwards all change the time and skill involved.
The two prices
Full excision is the workhorse, but it is not always the right answer. Here is how we weigh each option, including the ones that only buy time.
01
Any benign lesion that is not growing, catching or bothering you
Once we have confirmed what it is, doing nothing is a perfectly good choice. Benign cysts and lipomas do not become cancerous.
Our recommendation for most dermatofibromas and for small, quiet lipomas.
02
Cysts, lipomas, moles needing histology
Under local anaesthetic, an ellipse of skin is cut around the lesion, it is removed whole with its sac or capsule, and the wound is closed with stitches.
The standard for cysts and lipomas. Most of what we do.
03
Small uninflamed cysts, small lipomas
A short cut, sometimes only a few millimetres, through which the contents are expressed and the sac or fat is teased out.
A good option on the face when the scar is the priority, with an honest conversation about recurrence.
04
Raised benign moles, seborrhoeic keratoses
The lesion is shaved flush with the surrounding skin and the base is cauterised. No stitches.
Best for raised fleshy moles on the face and trunk when we are confident they are benign.
05
A cyst that is currently infected
A small cut releases the pus and relieves the pressure and pain, sometimes with antibiotics.
A holding measure, not a treatment. We are clear about that upfront.
06
An inflamed but not infected cyst
A small dose of corticosteroid is injected into the cyst to calm the inflammation over a few days.
Useful when a cyst has flared just before an event or a holiday.
Not offered, and why
A lump we will refer rather than remove
These need the urgent NHS pathway, and we write the referral the same day.
Simple means a small, superficial lesion with clear edges, in an easy location, with no history of infection and no concern about what it is. Complex means larger, deeper, in a delicate area such as the face or over a nerve, previously inflamed, or needing wider margins and a layered closure. The distinction reflects the time, skill and follow up involved, which is why the prices differ. We tell you which applies at the suitability appointment.
In everyday use, yes. Strictly speaking most of what people call sebaceous cysts are epidermoid cysts, filled with keratin rather than oil. True sebaceous cysts are rare. The treatment is the same.
Almost never. Lipomas are benign and do not turn into cancer. A rare fatty cancer called liposarcoma can look similar, which is why we arrange an ultrasound or MRI before removing any fatty lump that is over 5 cm, deep, growing quickly or painful.
After complete excision with the sac removed whole, recurrence is around 3 in 100. If the cyst has previously burst or been infected the wall is stuck down and harder to remove completely, so the risk is somewhat higher. Drainage alone almost always leads to the cyst refilling.
All complex excisions and all pigmented lesions are sent for histology as standard. For simple, clinically obvious cysts and lipomas it is optional and we will discuss it with you. There may be a laboratory fee, which we tell you about in advance.
Simple excision is from £300 and complex excision from £550, with the exact price fixed at the £80 suitability appointment. The fee includes the local anaesthetic, the procedure, dressings and one follow up.
The NHS removes lesions that are suspected to be cancerous or that are causing significant medical problems. Removal of benign cysts, lipomas and moles for comfort or appearance is generally not funded, which is why people come to us.
Yes. Any procedure that cuts through the full thickness of skin leaves a scar. We plan the incision along the natural skin lines and close it carefully so that it matures into a fine pale line, but we will never tell you there will be no scar.
£80, in person in Norwich. A doctor confirms what the lump is, tells you whether it is simple or complex, explains the likely scar and gives you a fixed price. No obligation to go ahead.
