What could a lump be on the back of your neck where the hairline starts?

It could be a neck bone spur.

Look for any sores or scratches in your scalp as this could be a swollen lymph node trying to rid your scalp of infection. See a doctor if there are no other symptoms.

If the lump is in the hairline it could be an ingrown hair or a Furuncle, a Furuncle is basically a large infected hair follicle which is red, swollen, tender, and has a central core of pus like a pimple. These require incision and drainage along with antibiotic therapy, failure to keep the neck clean can contribute to these.

A Carbuncle is a collection of Furuncles and are most commonly seen in the elderly, diabetics, and debilitated persons with compromised immune systems. They commonly occur at the base of the neck.

It could also be a Wen or Sebaceous Cyst, these are slow growing benign cyst that can occur on the scalp and contain a white cheesy-like substance. They can be drained but usually will recur unless the cyst wall is removed, sometimes there is just one or their can be several. They are also seen in body builders using anabolic steroids.

There are glands in the back of the neck. These are the occipital lymph nodes, the posterior cervical lymph nodes and the jugular chain of lymph nodes. If we assume that this is a lymph node then most of the time the cause is an infection. The only clinical concern is to rule out any possibility of malignancy. I am leaning towards an infection but given the constraints of the internet I feel that I have not been able to satisfyingly rule out possible malignancy. Ofcourse it could be a myriad of other things which are less alarming. Aneurysms tend to be throbbing on touch (you can feel a very strong pulse there). Being in the back of the neck that wouldn't be a classical presentation.

I would recommend you have someone look at it. There is no substitute for clinical examination in your case.

  • A hard lump that is on the back of your neck where your hairline starts is a swollen lymph node. Lymph nodes in that area tend to swell up and become firm in the presence of an ear infection or tooth abscess/impaction - but the infection may not even be prominent. If the swelling persists for months or more, see your doctor and inquire about lymphoma, which is potentially fatal.

  • Although this lump could be a lymph node it sounds highly unlikely and it could be an in-grown hair, hard cyst (not cancerous in most cases) or a bony spur. It's best to see your doctor and have it removed if possible.
  • Everyone has that lump. It's part of neck and head, it's a joint section.