Heberden s Nodes: Symptoms, Causes, and Treatments

They can appear on any part of your body, but they most often appear on your shoulders, neck, torso, or in your armpits.

What’s Causing This Hard Lump Under My Skin?

Cancer lumps under the skin can occur, but it’s common to have one or more lumps throughout your life from other causes. However, it’s always good to have them checked out by a doctor.

Lumps, bumps, or growths under your skin aren’t uncommon. A lump can form under your skin for many reasons.

Often, lumps are benign (harmless). Specific traits of the lump can sometimes tell you more about possible causes and whether you should have the lump checked out by your healthcare professional.

Read on to learn more about common causes of hard lumps under your skin and when it’s a good idea to have it checked out.

An epidermoid cysts are small, round lumps under your skin. They usually develop when shed skin cells move into your skin instead of falling off. Epidermoid cysts can also form when hair follicles become irritated or damaged, due to a buildup of keratin.

• grow slowly
• may not go away for years
• may have a small blackhead in the center of the bump
• can leak yellow, foul-smelling discharge (keratin)
• are usually painless but can become red and tender if infected

They’re also twice as common in men and usually don’t develop before puberty.

You can find these cysts anywhere on your body, but you’ll most often see them on your face, neck, or torso.

treatment

Epidermoid cysts generally don’t require any treatment. But there’s a small chance they could become cancerous. Keep an eye on it and let your doctor know if you see any changes in its size or appearance.

If the appearance bothers you or the cyst becomes painful, make an appointment with your healthcare provider. They can usually drain the cyst with a quick, in-office procedure. If that doesn’t work, or the cyst returns, they can surgically remove the entire cyst.

Lipomas develop when fatty tissue grows under your skin, forming a bulge. They’re common and usually harmless. No one’s sure about the exact cause of lipomas, but they might be a result of trauma to a certain area.

In addition, multiple lipomas can sometimes be a symptom of an underlying genetic condition, such as Gardner’s syndrome. Still, it’s not uncommon to have more than one lipoma without any underlying condition.

• are typically no more than about 5 centimeters (cm) across
• often form in adults between the ages of 40 and 60 but can develop in people of all ages, including infants
• are rarely painful
• grow slowly
• feel rubbery
• may seem to move when you touch them

They can appear on any part of your body, but they most often appear on your shoulders, neck, torso, or in your armpits.

treatment

Lipomas generally don’t require any medical treatment. But if you don’t like the way it looks, or it becomes painful or very large, make an appointment with your healthcare provider. They can surgically remove the lipoma.

A dermatofibroma is a small, hard bump that grows under your skin. This skin lump is harmless, but it might itch or hurt at times.

Though it’s not clear what causes them, some people report having had splinters, insect bites, or other minor trauma at the spot where they develop.

• range from dark pink to brown in color, though their color may change over time
• have a firm, rubbery feeling
• are more common in women
• tend to be no bigger than 1 cm across
• grow slowly

You can develop dermatofibromas anywhere, but they appear most often on the lower legs and upper arms.

treatment

Dermatofibromas are harmless and don’t require treatment. Still, if their appearance bothers your or you start noticing pain or itching, your healthcare provider can surgically remove it.

Just keep in mind that full removal might leave some scarring. If you opt to only remove the top part, there’s a good chance the lump will return over time.

A Keratoacanthoma (KA) is a small skin tumor that grows out of your skin cells. This type of lump is fairly common. Experts aren’t certain what causes it, but sun exposure may play a part because KA is more common in high-exposure areas, like your hands or face.

KA may look like a pimple at first but will grow larger over a period of several weeks. The center of the lump can burst, leaving a crater.

• may itch or feel painful
• can grow up to 3 cm in just a few weeks
• have a core of keratin that may look like a horn or scale in the center of the bump
• are more common in light-skinned people and older adults
• are usually round, firm, and pink or flesh-colored

They tend often grow on skin that’s been exposed to sun, such as your face, hands, and arms.

treatment

While KA is harmless, it’s very similar in appearance to squamous cell carcinoma, so it’s best to have it looked at by a healthcare provider.

The lump usually heals on its own over time without any treatment, but medication and surgery can both help to remove KA.

A skin abscess is a round, pus-filled lump that develops when bacteria gets underneath your skin’s surface. This can happen in hair follicles or open cuts and wounds.

Your body reacts to the bacteria by sending white blood cells to the infection site. As tissue around the area dies, a hole forms. Pus, made up of white blood cells, bacteria, and dead skin and tissue, fill the hole, causing an abscess.

• have a firm membrane surrounding them
• feel squishy due to pus
• are painful
• may be surrounded by red or inflamed skin
• may feel warm to the touch
• may leak pus from a central pinprick opening

Skin abscesses can develop anywhere on your body.

treatment

Small, minor abscesses usually go away on their own within a few weeks. But if you have a fever or if your abscess gets larger, feels very painful, or is surrounded by skin that’s warm or red, see your healthcare provider right away.

Never attempt to pick at or drain a skin abscess. This can deepen the infection and allow it to spread.

Lymph nodes or lymph glands are small groups of cells located in various parts of the body. Part of their job is to trap bacteria and viruses and break them down.

Your lymph nodes are usually pea-sized, but exposure to bacteria or a virus can make them swell.

Some common reasons lymph nodes may swell include:

• bacterial infections, such as mono, strep throat
• viral infections, including the common cold
• tooth abscesses
• cellulitis or other skin infections
• immune system disorders

You might notice swelling at one or more sites, including:

• under your chin
• in your groin
• on either side of your neck
• in your armpits

treatment

Lymph nodes should return to their usual size once the underlying cause is addressed. Sometimes, this just means waiting out an illness. But if you’re not sure what’s causing your swollen lymph nodes, make an appointment with your healthcare provider.

Seek immediate medical care if you have swollen lymph nodes that interfere with swallowing and breathing or are accompanied by a fever of 104°F (40°C).

A hernia is a lump that develops when part of your body, such as one of your organs, pushes through surrounding tissue. They’re generally caused by strain to the abdomen and groin. They may also result from muscle weakness associated with aging.

There are several types of hernias. They typically appear in the abdominal area, below your chest and above your hips.

Signs of a hernia include:

• a bulge you can push in
• pain when you strain the area by coughing, laughing, or lifting something heavy
• a burning sensation
• a dull ache
• sensation of fullness or heaviness at the hernia site

• constipation
• fever
• nausea
• intense pain

A ganglion cyst is a small, round, fluid-filled lump that grows under the surface of the skin, usually on your hands. The cyst sits on a small stalk that may seem movable.

It’s not clear what causes ganglion cysts. Irritation to your joints and tendons may play a part.

• are often painless but can cause tingling, numbness, or pain if they press on a nerve
• can grow slowly or quickly
• appear most often in people between the ages of 20 and 40 and women
• are usually smaller than 2.5 cm across

These cysts most often develop on wrist joints and tendons, but they can also develop on your palm or fingers

Treatment

Ganglion cysts often disappear without treatment and are unlikely to cause any issues. But if it starts to hurt or makes certain activities difficult, you may want to have the cyst drained.

Heberden’s Nodes: Symptoms, Causes, and Treatments

Heberden’s nodes are hard bony lumps in the joints of your fingers. They are typically a symptom of osteoarthritis.

The lumps grow on the joint closest to the tip of your finger, called the distal interphalangeal, or DIP joint.

Causes

The main cause of Heberden’s nodes is osteoarthritis. That’s a form of arthritis that happens when the tissue that covers the ends of your bones — called cartilage — wears away.

Your cartilage can break down because of slow wear and tear over time or if you have an injury to the joint. The result is that the smooth cushioning of your joints gets rough and causes pain, stiffness, and inflammation.

This friction often causes bony growths called bone spurs to form around the joints. If you have these bone spurs in your fingers, they can lead to Heberden’s nodes.

If these bumps show up on the middle joint of your fingers, doctors call them Bouchard’s nodes.

Symptoms

Besides the visible bumps, you may have some pain from Heberden’s nodes when they first develop. The pain usually goes away over time. You might still hurt from your osteoarthritis, though.

Once you get Heberden’s nodes, they typically stick around for good.

The nodes might also lead to joints and fingers that are misshapen, along with other symptoms of osteoarthritis like loss of cartilage, loose ligaments, and swelling,

Other symptoms of osteoarthritis in your hand might include:

Stiffness. As the disease moves further along, it may get harder to use your hands. You might have trouble opening and closing your fingers all the way.

Pain. It comes and goes at first, but it can sometimes get worse over time. It might hurt more when you first wake up.

Swelling. The irritation and damage from bone-on-bone friction can lead nearby tissues to get swollen and tender to the touch.

Weakness. Pain, swelling, misshapen joints, and loss of motion can make your hands weak over time. It might get harder to do things like turn a key or open a jar.

Crepitus. This is grinding, cracking, or clicking that happens when you move your hands.

Diagnosis

The appearance of Heberden’s nodes at your DIP joints is a common first sign of osteoarthritis.

Your doctor will ask about your symptoms and your family history and might take some X-rays of your joints to look for bone spurs and cartilage that’s worn away.

Treatment

You can treat pain and swelling with rest, splints, ice, physical therapy, and pain medicines like nonsteroidal anti-inflammatory drugs (NSAIDs).

In rare cases, your doctor might suggest surgery to remove the nodes, or replace or fuse one of the joints in your fingers.

Other than that, they will likely treat the osteoarthritis that is the root cause of your Heberden’s nodes.

Show Sources

American Academy of Family Physicians: “Painless Nodules in the Fingers.”

American Society for Surgery of the Hand: “Osteoarthritis.”

Annals of the Rheumatic Diseases: “Heberden’s and Bouchard’s nodes.”

Arthritis Foundation: “Osteoarthritis of the Hands.”

Cleveland Clinic: “Is There Any Help for Hard, Painful Bumps on Your Fingers From Osteoarthritis?”

Encyclopedia of Molecular Mechanisms of Disease: “Heberden’s Nodes.”

Vermont Orthopaedic Clinic: “Osteoarthritis of the Hand.”