Most things get easier when we stop overthinking them. Keep it simple: notice the problem, get it checked, follow the advice.
This photo shows a man with short brown hair seen from behind with his head tilted down, with a tight, red swelling on top of his shoulder near the neck and a doctor’s gloved hands holding gauze beside it.
A lump in this spot is most likely an inflamed epidermoid cyst. It forms when a pore or follicle becomes blocked and a sac under the skin slowly fills with keratin.
The top of the shoulder is rubbed all day by collars, bag straps and seat belts, which keeps irritating the follicles and makes blockages more likely.
Once inflamed, the cyst can grow to a few centimetres in days, feel hot and tender, and make it painful to carry a bag or turn the head.
A doctor will examine the lump, feel whether it moves under the skin and check that the swelling is not coming from anything deeper.
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 lump does not come back.
The area is then cleaned and covered with a light dressing, and keeping straps off the spot for a few days helps it heal without irritation.
Washing the shoulders and neck daily, padding bag straps and not picking at bumps all help prevent new cysts from forming.
Keep it simple and let it be treated the right way. The videos below show shoulder and upper back cysts being treated by professionals.
