Swollen Glands, Hernias, and Other Lumps Under the Skin
Most swollen glands or lumps under the skin aren't cause for concern. The glands (lymph nodes) on either side of the neck, under the jaw, or behind the ears often swell when you have a cold or sore throat.
More serious infections may cause the glands to get bigger and become very firm and tender. Glands can also swell and become tender after an injury, such as a cut or bite, or when a tumor or infection occurs in the mouth, head, or neck.
Swollen glands and other lumps under the skin can be caused by many different things, including illness, infection, or another cause.
Swollen glands often occur when the body fights infections from colds, insect bites, or small cuts. More serious infections may cause the glands to get bigger and become firm, hard, or tender. Examples of such infections include:
Bacterial infections, such as:
- Strep throat. It's caused by streptococcus bacteria.
- A boil (abscess), similar to a large pimple. A boil may form when a hair follicle or the skin gets infected. A sweat gland abscess may form one or more lumps in the armpit that look like boils.
Viral infections, such as:
- A viral infection of the skin (molluscum contagiosum) that causes small pearly or flesh-colored bumps.
- Measles, rubella, chickenpox, or mumps.
- AIDS (acquired immunodeficiency syndrome). It develops in the late stage of HIV (human immunodeficiency virus) infection. This virus attacks the immune system. It makes it hard for the body to fight off infection and some diseases.
- Mononucleosis (Epstein-Barr virus) or cytomegalovirus (CMV). These viruses cause fever, sore throat, and fatigue.
- Other infections, such as:
Noncancerous (benign) growths
Types of noncancerous (benign) growths, which are usually harmless, include:
- A lipoma. This is a smooth, rubbery, dome-shaped lump that you can easily move under the skin.
- A cyst. It's a sac of fluid and debris that sometimes hurts.
- Cystic lesions from acne are large pimples that occur deep under the skin.
- Branchial cleft cysts are found in the neck. They don't usually cause problems unless they get infected. These cysts are most common in teens.
- A skin cyst often appears on the scalp, ears, face, or back.
- A ganglion is a soft, rubbery lump (a type of cyst) on the front or back of the wrist.
- Tonsillitis. It may also cause swelling in the neck.
- A salivary gland problem, such as inflammation, a salivary stone, an infection, or a tumor.
- An inflammation of fatty tissue under the skin (erythema nodosum) or overgrown scar tissue (keloid).
Hernias, aneurysms, or nodules
Hernias and aneurysms are bulging sections in a muscle or blood vessel. A nodule is usually a growth on a gland. A hernia, aneurysm, or nodule may be felt under the skin. But you may not be able to see it. These types of lumps may need to be checked by a doctor.
- An inguinal hernia is a soft lump in the groin or near the navel. It may be more visible when you cough. Hernias that disappear when you press on them may not need any treatment. Hernias that don't disappear when you press on them may be more serious and need medical treatment.
- A bulging section in the wall of a blood vessel (aneurysm) may feel like a throbbing lump in the belly, in the groin, or behind the knee. It can cause serious problems if it involves the blood vessels in the brain or the belly. Aneurysms may be a medical emergency and may require care right away.
- A thyroid nodule is an abnormal growth on the thyroid gland. An enlarged thyroid gland (goiter) is in the neck just below the Adam's apple.
Swelling caused by cancer
A lump caused by cancer is usually hard, irregularly shaped, and firmly fixed under the skin or deep in tissue. They usually don't cause pain. But some types of cancerous lumps are painful. Most lumps aren't caused by cancer.
Swelling may also be caused by:
- A side effect of a medicine, such as phenytoin (Dilantin).
- Other medical conditions and diseases, such as lupus, myalgic encephalomyelitis/chronic fatigue syndrome, or rheumatoid arthritis.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or nonbinary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, herbal remedies, or supplements can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Pain in adults and older children
- Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
- Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.
Symptoms of infection may include:
- Increased pain, swelling, warmth, or redness in or around the area.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
- Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
- Long-term alcohol and drug problems.
- Steroid medicines, which may be used to treat a variety of conditions.
- Chemotherapy and radiation therapy for cancer.
- Other medicines used to treat autoimmune disease.
- Medicines taken after organ transplant.
- Not having a spleen.
Hyperthyroidism occurs when your body has too much thyroid hormone.
Symptoms of hyperthyroidism may include:
- Muscle weakness.
- Weight loss.
- Sweating and not being able to tolerate hot temperatures.
- Fast heart rate.
- Feeling edgy or anxious.
- Enlarged thyroid gland (your thyroid gland is in your neck).
Hypothyroidism occurs when the thyroid gland does not make enough thyroid hormone.
Symptoms of hypothyroidism may include:
- Tiredness and weakness.
- Weight gain.
- Memory problems.
- Dry skin, brittle nails, and coarse, thinning hair.
- Not being able to tolerate cold temperatures.
A soft lump in one of these areas (belly button, groin, past surgical site) may be a hernia. A hernia can occur when there is a weakening in the muscle wall and part of an internal organ (often part of the bowel) pushes through.
With a hernia, the lump may go away when you press on it or lie down, and it may get worse when you cough. It may or may not be painful.
Symptoms of difficulty breathing can range from mild to severe. For example:
- You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. Or they might be concerned about the cost. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Try these tips to help avoid irritation and prevent infection from a painful lump or swollen gland.
- Don't squeeze, scratch, or pick at the lump.
And don't stick a needle in the lump.
- Leave the lump exposed to the air whenever you can.
- Adjust your clothing to avoid rubbing the lump.
- Apply warmth.
Heat and moisture can soothe the lump, increase blood circulation to the area, and speed healing. It can also bring a lump caused by infection to a head (but it may take 5 to 7 days).
- Apply warm, wet cloths to the painful lump for 20 to 30 minutes, 3 or 4 times a day. Or you can use a hot water bottle over a damp towel.
- Be careful not to burn your skin. Don't use water that's warmer than bathwater.
When to call for help during self-care
Call a doctor if any of the following occur during self-care at home:
- New signs of an infection, such as redness, warmth, swelling, pus, or a fever.
- A swollen gland or lump doesn't go away.
- Symptoms occur more often or are more severe.
Preparing For Your Appointment
You can help your doctor diagnose and treat your condition by being prepared for your appointment.
Current as of: May 4, 2022
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Kathleen Romito MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine