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Most swollen glands or lumps under the skin are not cause for concern. The glands (lymph nodes) on either side of the neck, under the jaw, or behind the ears commonly swell when you have a cold or sore throat.
More serious infections may cause the glands to enlarge and become very firm and tender. Glands can also swelland become tender after an injury, such as a cut or bite, or when a tumour 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 commonly develop when the body fights infections from colds, insect bites, or small cuts. More serious infections may cause the glands to enlarge and become firm, hard, or tender. Examples of such infections include:
- Bacterial infections, such as:
- Viral infections, such as:
- A viral infection of the skin (molluscum contagiosum), which causes small pearly or flesh-coloured bumps.
- Measles, rubella, chickenpox, or mumps.
- AIDS (acquired immunodeficiency syndrome), which develops in the late stage of HIV (human immunodeficiency virus) infection. This virus attacks the immune system, making it difficult 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:
Non-cancerous (benign) growths
Types of non-cancerous (benign) growths, which are usually harmless, include:
- A lipoma, a smooth, rubbery, dome-shaped lump that is easily movable under the skin.
- A cyst, 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 and do not usually cause problems unless they become infected. These cysts are most common in teenagers.
- An epidermal 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, which may also cause swelling in the neck.
- A salivary gland problem, such as inflammation, a salivary stone, an infection, or a tumour.
- An inflammation of fatty tissue under the skin (erythema nodosum) or overgrown scar tissue (keloid).
Hernias, aneurysms, or nodules
Hernias or 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 may not be visible. These types of lumps may need more medical evaluation.
- 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 pulsating lump in the abdomen, in the groin, or behind the knee. It can cause serious problems if it involves the blood vessels in the brain or the abdomen. Aneurysms may be a medical emergency and may require immediate evaluation.
- 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. Although they usually do not cause pain, some types of cancerous lumps are painful. Most lumps are not 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 to decide if and when you should see a doctor.
Check Your Symptoms
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 and natural health products 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.
The following home treatment measures may help you treat a painful lump or swollen gland.
- Avoid irritation and prevent infection.
- Do not squeeze, scratch, or pick at the lump. Do not stick a needle in it.
- Leave the lump exposed to the air whenever possible.
- Adjust your clothing to avoid rubbing the lump.
- Apply warm, wet cloths to the painful lump for 20 to 30 minutes, 3 or 4 times a day. If you prefer, you can also use a hot water bottle over a damp towel. The 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). Be careful not to burn your skin. Do not use water that is warmer than bathwater.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- A lump or swollen gland gets worse or does not go away after 2 weeks of home treatment.
- A skin infection develops.
- Symptoms become more severe or frequent.
- New symptoms develop.
Wash your hands frequently during cold and cough season. This may help prevent some upper respiratory infections that cause glands to swell.
Measures to decrease your risk of infection
- Keep your skin clean.
- Wash with lukewarm water and a mild soap or cleanser. Do not use soaps and skin cleansers that contain irritating substances.
- Rinse your skin thoroughly after you wash it, and gently pat it dry.
- Wash soon after participating in activities that cause you to sweat.
- Do not use skin care products that contain oil, because they may clog your pores. Instead, use water-based skin care products. Read the labels on products, and look for the terms oil-free or hypoallergenic.
- Do not squeeze, scratch, drain, or puncture a painful lump. Doing this can irritate or inflame the lump, push any existing infection deeper into the skin, or cause severe bleeding.
- Prevent irritation by wearing soft, cotton clothing or moleskin under sports equipment (if possible). Parts of equipment (such as chin straps) can rub your skin and irritate it. Adjust your clothing so that belts and straps or elastic from bras or underwear do not rub against your skin.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
- When did you first notice the lump or swollen gland?
- Has the lump changed? Has it gotten bigger or smaller? Has the colour of the lump changed?
- Have you had any recent illness or injury?
- Have you had a similar problem in the past in the same area or a different area?
- Were your symptoms evaluated?
- Was there a diagnosis?
- How was it treated?
- What home treatment measures have you tried? Did they help?
- What prescription and non-prescription medicines have you taken or used? Did they help?
- Do you have any health risks?
Current as ofSeptember 23, 2018
Author: Healthwise Staff
Medical Review: William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine
H. Michael O'Connor MD - Emergency Medicine