Discovering a new lump or bump on your child can be a source of anxiety for any parent. While most pediatric skin lesions are benign (non-cancerous), some require surgical removal to prevent infection, address growth, or rule out more serious conditions. The four most common lesions I see are:
1. Pilomatrixoma
Often felt as a “stone-hard” lump under the skin, a pilomatrixoma is a benign tumor related to hair follicles. They are usually found on the face or neck. Because they can become calcified, they don’t go away on their own and can occasionally become red and inflamed. Surgery is generally recommended to remove them before they grow larger or cause skin thinning.
2. Dermoid Cysts
Dermoid cysts are present at birth and often appear near the eyebrow (lateral brow) or the midline of the neck. These cysts contain “trapped” skin structures like hair follicles and sweat glands. Unlike simple spots, they sit deep near the bone. Surgery is usually advised because they can grow, become infected, or even erode the underlying bone over time.
3. Spitz Naevi
A Spitz naevus is a type of mole that often appears suddenly as a pink or red dome-shaped bump. While benign, they can look remarkably like melanoma under a microscope. To be safe, many doctors recommend a “complete excision” (surgical removal) to ensure a definitive diagnosis and peace of mind.
4. Sebaceous and Epidermoid Cysts
These are fluid-filled sacs that can appear anywhere on a child’s body. While harmless, they can become painful if they rupture or get infected. If a cyst is recurrently inflamed or located in a spot where it’s easily irritated by clothing, surgical removal of the entire cyst wall is the only way to ensure it doesn’t return.
What to Expect
Pediatric skin surgery is typically a day-stay procedure. For younger children, this is usually done under a general anaesthetic to ensure they remain still and comfortable. I work with paediatric anaesthetists who are experts in this area.