Hard, Non-Moving Lump in Pubic Area for 6 Months – Not Painful, Reddish Color. Dermatofibroma, angioma, or deep cyst? (Photos)

Thank you for your question and for providing a detailed description.

Based on what you’ve shared — a firm, painless, reddish-pink lump in the pubic area that hasn’t changed in size over six months — this does sound like a benign lesion. Possibilities include:

Dermatofibroma – a harmless, firm growth under the skin that often feels fixed and may have a pink to purplish tone.

Angioma or Angiokeratoma – benign vascular lesions that are usually red or purple and may bleed if irritated.

Deep epidermoid or pilar cyst – typically firm and can feel embedded, though they usually grow over time or become inflamed.

To answer your questions:
Does this look like something benign I can leave alone?
Yes, it appears benign based on your description. The fact that it’s painless, non-growing, and not changing is reassuring.

Will it go away on its own or should I get it removed?
Lesions like this typically do not go away on their own. If it’s not bothering you, it’s reasonable to leave it alone. However, removal is an option for cosmetic reasons or peace of mind.

Would an ultrasound help?
Yes, an ultrasound can be helpful, especially if the lesion feels deep or fixed. It can help distinguish between a solid mass, cyst, or vascular lesion.

If the lesion begins to change — becomes painful, grows, bleeds, or ulcerates — I recommend having it evaluated in person by a board-certified dermatologist. Otherwise, if it’s stable and not bothersome, monitoring is a safe option.

Hope this helps! Feel free to follow up with photos for a more specific opinion.

I would not wait on this. Get an MRI with and without contrast. This is the gold standard for diagnosis in this situataton. It does not look like a regular subcutaneous lipoma, which do not, in my experience, have overlying skin color changes. I have had a patient who had similar skin color changes, turned out to be a liposarcoma. Lipomas are rubbery and mobile under the skin. This one isn't you say.
The MRI should be done first. You do not want any cutting into this lesion without a screening MRI, and then proceed as indicate by the findings. Sometimes that would involve a fine needle aspirate by an appropriate specialist. Surgical removal could follow depending on the pathology finding.

Our office has many different treatments for scars depending on the depth of atrophy or hypertrophy. Scars require a combination approach using our HI DEF protocol which uses a combination of lasers, topical scar modulation, and RF treatments to pixelate scars, improve contour, reduce hyperpigmentation, and improve the visibility of the scars so that they are no longer visible in ambient light. Everyone has a unique pattern of scarring and we employ our HIDEF technique to improve texture, color, contour, and topography. We often use a combination of treatments that begin with a careful examination to examine the micro texturing of the acne scars. Atrophic scars and indented scars can benefit from injectable fillers such as Radiesse, Sculptra, and Restylane with or without subcision to remove tethered scars and atrophic depression. Hyper-redness in scars can be improved with V beam laser, Excel V, BBL, IPL, and Venus RF to improve the redness and reduce the visibility of deep scars. Fractional Thulium laser and clear & brilliant can also reduce the inflammation and redness of the scar when combined with topical therapy. Fractional lasers such as Fraxel, erbium, and CO2 laser can be combined with radio frequency and also fractional RF to improve textual issues and microtopography. Subcision and TCA cross are also used for deep ice pick scars and narrow valley scars in order to improve the micro texture. Above all, our combination approach with our clinical nurses and board-certified plastic surgeons can improve the quality of your skin by using at home Melarase creams combined with PRP treatments in our office to improve your skin quality and tone. I recommend getting a formal evaluation with an experienced team of experts in order to reduce your scarring.


Finally, hyperpigmentation of scars can be improved with at-home Melarase AM, Melarase PM, and Melapads to help reduce active PIH and melanin deposition.

Best,
Dr. Karamanoukian
Realself100 Surgeon