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Pimples appeared on base of skull. What could it be?

Answered by
Dr. Praveen Rodrigues


Practicing since :1993

Answered : 1196 Questions

Posted on Sat, 9 Feb 2013 in Skin Hair and Nails
Question: Hi,

A few months ago, a pretty large blind pimple (tender and red) formed on the back of my neck slightly below the base of my skull. Unfortunately, I picked and squeezed at it a lot, but nothing ever came out of it. After a couple weeks, it finally subsided into a small, soft lump. Three months later it's still there. I notice that it seems to be much more soft in the morning (almost unnoticeable) but becomes a bit more stiff at night.

I'm wondering what this could be? Is it left over scar tissue under the skin from all the squeezing and picking?

Answered by Dr. Praveen Rodrigues 2 hours later
Hi there XXXXXXX
From your detailed history & cliical description, it seems to be some sort of hair follicle structure that was squeezed & ruptured & formed a 'cystic' lesion accounting for the swelling & stiffness alternating. Going by the site, a furuncle leading onto a carbuncle is also possible. A third diagnosis could be an entity called keloidalis follicularis nuchae which is again a hair follicle associated lesion that becomes as you rightly put a scar like tissue.
All three conditions are benign & are nothing to worry about but the easiest approach is to visit a dermatologist or your local surgeon & have the lesion excised in toto at this stage before contiguous hair follicles get affected. Alternatively, one may try an adapalene based cream/gel for local application on the spot evenings for a period of 2-3 weeks.
Trust this will have given you a clear idea of what it could be, prognosis & its management. Do close this query if it clears your doubt & all the best & do hope the outcome is satisfactory & you continue to enjoy a healthy skin! Cheers!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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