Skin lumps and bumps are very common in children, and the vast majority are completely benign (non-cancerous). Many are present from birth, while others develop over childhood. Plastic surgeons are often involved when a lesion is growing, causing symptoms, affecting appearance, or when removal is recommended for diagnosis. Surgical treatment usually involves simple excision under a short general anaesthetic, often as a day procedure with minimal downtime.
Paediatric Skin Conditions We Treat
Below is an overview of the most common paediatric skin lesions we treat.
Dermoid Cysts
Dermoid cysts are congenital cysts that contain skin elements such as hair follicles and sebaceous glands. They most often occur around the eyebrow, nose, or scalp. Midline dermoid cysts (especially at the nose, glabella region, or forehead midline) can sometimes have intracranial extension, meaning the cyst tracks deeper towards the skull or dura. These children require careful investigation, often with a CT and MRI, and may need a combined intra- and extra-cranial procedure with neurosurgery if extension is present. Excision is recommended to prevent enlargement or infection.
Epidermal Cysts (Epidermoid Cysts)
These are slow-growing cysts formed when skin cells become trapped under the surface. They often appear on the face, neck, or trunk. They are benign but can become inflamed or infected. Excision removes the entire cyst wall to prevent recurrence.
Pilomatrixoma
A pilomatrixoma is firm, calcified nodule arising from hair follicle cells. Commonly found on the face, neck, and upper limbs. These lesions can feel hard and irregular under the skin. They are benign but do not regress, so excision is the definitive treatment.
Sebaceous Naevi
A sebaceous naevus is congenital lesion typically appearing as a smooth, yellow-orange patch on the scalp or face. These lesions can thicken during adolescence. While benign in childhood, they have a small risk of developing secondary tumours later in life.
Epidermal Naevi
These are congenital overgrowths of the epidermis, appearing as linear or warty plaques on the skin. Most are benign and stable, though some may grow with the child. Excision may be considered for symptomatic or cosmetically significant areas.
Congenital Melanocytic Naevi
These are pigmented moles present at birth. They range in size from small spots to large or giant naevi. Small and medium melanocytic naevi are usually low-risk and may be removed for cosmetic reasons or because of changes over time. Larger melanocytic naevi may carry a small increased melanoma risk and require long-term monitoring. Surgery may be staged depending on size and location and can involve serial excision, excision and reconstruction with skin grafts or local flaps, or tissue expansion prior to definitive excision.
Acquired Melanocytic Naevi
These are common moles that develop throughout childhood and adolescence. Most are completely benign. Lesions that change in appearance, become symptomatic, or are cosmetically bothersome can be safely excised.
Spitz Naevi
These are benign, rapidly growing pink or reddish moles that typically appear in young children. Because they can resemble melanoma under the microscope, they are often excised to obtain a clear diagnosis and ensure complete removal.
Skin Tags
Soft, harmless skin projections usually found around the neck, eyelids, or underarms. They are benign and can be removed easily if catching, bleeding, or cosmetically undesirable.
Lipomas
These are soft, mobile, benign fatty lumps. Uncommon in younger children but may be excised when enlarging, symptomatic, or for cosmetic reasons.
