Inflamed infected lipoma lots of nerve pain from swollen pressure enlarged lipoma. What is next step to get relief? (photos)

Question

I've had a golf size lipoma located on my upper back just below my neck for at least 15 years. It has never given me any problems and doctors have said, there is no reason to remove it. But last week it started swelling, red & infection (I consistently run a low grade fever 99-101). I for sure want it removed now but I doubt surgery is possible without eliminating the infection & swelling. What would be my next step? Visit general MD to clear infection with referral to dermatologist for removal?

Ronald J. Edelson, MD · Answer

I don’t think it’s a lipoma.  It looks like an infected sebaceous cyst.  It needs to be drained and then packed.  It will then heal over the course of a few weeks.

Luis Villar, MD, FACS · Answer

Those photos are more suggestive of an infected sebaceous cyst.  If so, this would require incision and drainage and antibiotics.  These get painful as they progress.  In ancient times they could spontaneously rupture and heal, or remain contained and lead to septicemia and death.  Lancing was the treatment, hopefully before septicemia set in.  Lancing with antibiotics has improved outcomes since the advent of Penicillin around WWII.  After the infection resolves, the cyst wall remnants may have to be removed.Antibiotics without drainage is not prudent.

Michael I. Echavez, MD · Answer

It is unusual for a lipoma to become infected and inflamed.  It is more common for a cyst to become infected.  The mass below your neck and on your upper back may or may not be a lipoma.  I would recommend that you see a doctor and it is likely that antibiotics will be needed.  If that does not lead to improvement, it is also possible that the infection would need to be drained if there is fluid present.  The mass could be removed after the infection is cleared.

Erik Borncamp, MD · Answer

Thank you for your question.

As the other physicians have explained, it’s unusual for a “lipoma “to become infected.  This is because a lipoma consists mostly of benign, clean fatty tissue.  More likely this is an infected sebaceous cyst.  These can lie dormant for years but then bacteria gets into the white pasty junk in the cyst and it becomes infected.  They then swell, become painful and red.  Lancing may work temporarily with antibiotics to improve your symptoms.  However, if the cyst capsule is not removed there is a possibility the cyst heals, plugs again and re-accumulates.  Best to have the cyst completely excised.

There are 2 options for this:  One would be to lance the cyst and then complete a course of antibiotics followed by removal of the cyst/capsule in its entirety, later in a clean situation.  The other would be to remove the cyst/capsule entirely now with the understanding that the wound may need to be packed open to prevent an abscess.

This is most often done by General Surgeons and/or Dermatologists.  Though, I Imagine a Plastic Surgeon could do this as well.

Best of luck, 
  
Erik Borncamp, MD, FACS

Benjamin J. Cousins, MD · Answer

Thank you for your post. It is unlikely a lipoma as they usually do not get infected, It may be a cyst and removed once the infection clears. Hope this helps.Sincerely,Dr. Benjamin J. Cousins MD Board Certified Plastic Surgeon Miami/Miami Beach

Inflamed infected lipoma lots of nerve pain from swollen pressure enlarged lipoma. What is next step to get relief? (photos)

Answers (5)

Answer: Infected cyst

Answer: Infected cyst

Answer: Infection

Answer: Infection

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Everything you need to know about Lipoma Removal

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Inflamed infected lipoma lots of nerve pain from swollen pressure enlarged lipoma. What is next step to get relief? (photos)

Answers (5)

Answer: Infected cyst

Answer: Infected cyst

Answer: Infection

Answer: Infection

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Recommended reading

Everything you need to know about Lipoma Removal

Our mission is to create a world where every investment in modern beauty is Worth It.