Every hard thing starts the same way. Breathe and begin, and the first small step makes the next one easier.
This photo shows a man in his forties with short dark hair and a beard, sitting on an exam table seen from behind, with a tight, dark red lump in the middle of his upper back while a nurse’s gloved hands hold gauze beside it.
A lump like this is most likely an inflamed epidermoid cyst. It starts when a blocked follicle forms a small sac under the skin that slowly fills with keratin.
The upper back is full of oil glands and is hard to see or reach, so a blocked pore there can grow for months before anyone notices it.
Once the cyst becomes inflamed it can swell to several centimetres, feel warm and shiny, and ache when leaning back against a chair or lying down.
A doctor will look at the lump closely, feel whether it moves under the skin and ask how long it has been there and how fast it grew.
If it is a cyst, the skin is numbed, a small opening is made so it can drain, and the sac is removed so the swelling does not come back.
The area is then cleaned and covered with a light dressing, and keeping it dry for a day or two helps it heal cleanly.
Washing the back daily, wearing clean breathable shirts and leaving new bumps alone all help keep new blockages from forming.
Breathe and begin, and let the professionals do the rest. The videos below show back cysts being treated by professionals.
