Brief overview
- Treatment: Treatment is not absolutely necessary. If the lipoma causes discomfort, is very large or is aesthetically unpleasant, it can usually be removed by a doctor.
- Prognosis: The risk of a benign lipoma developing into a malignant tumor is very low. After removal, lipomas occasionally recur.
- Symptoms: Lipomas usually do not cause any symptoms. Rarely do they cause pain.
- Causes: The exact causes of lipomas have not yet been clarified.
- Diagnosis: Palpation, ultrasound (sonography), X-ray, magnetic resonance imaging (MRI) or computer tomography (CT), in some cases a tissue sample is taken
- Prevention: There is no way to prevent lipomas.
What is a lipoma?
A lipoma is a benign tumor of fatty tissue that usually causes no symptoms. It is therefore also known as a fatty tumor. The lipoma belongs to the soft tissue tumors. It consists of fatty tissue cells that are enclosed in a capsule of connective tissue. A lipoma is frequently found on the leg, often as a palpable lump under the skin on the thigh.
As a rule, a lipoma is harmless and only rarely develops into a malignant tumor. Lipomas occur more frequently from the age of 40, less frequently in children. Men get these lumps under the skin slightly more often than women.
Deep-seated lipomas, in the chest or abdomen, also exist, but are relatively rare. These lipomas include the so-called preperitoneal lipoma. It is located on the anterior abdominal wall in front of the peritoneum. The peritoneum is a thin layer that lines the abdominal cavity and surrounds the organs. It is extremely rare to find a lipoma behind the peritoneum (retroperitoneal).
If a lipoma occurs on the head, there is a possibility that it is a so-called subfascial lipoma. Subfascial means that it lies under a layer of connective tissue (fascia) that envelops a muscle. The subfascial lipoma on the head often grows at the transition from the forehead to the hair.
Other places where subfascial lipomas often occur are the neck and the shoulder area, more specifically the shoulder blade.
In general, lipomas occur frequently. The following areas of the body are most frequently affected by lipomas:
- On the legs, especially on the thigh, less so on the lower leg or shin
- On the trunk, for example on the flanks, hips, abdomen (for example at the level of the ribcage, under the right or left ribcage), in the armpit/armpit, on the neck or in the nape of the neck
- On the arm or upper arm (less frequently on the forearm and on the hand or wrist and fingers) and on the shoulder
However, there are also other possible causes of lumps under the skin. So-called boils also cause palpable lumps under the skin. In contrast to lipomas, however, these are usually painful as they are caused by inflamed hair follicles. Common areas of the body where boils develop include the face, groin or genital area, for example a lipoma on the bottom.
In many cases, small lumps or thickenings behind the ear are also not lipomas, but often so-called atheromas. These are usually caused by blocked sebaceous glands.
In rare cases, several lipomas occur at the same time. Doctors then speak of lipomatosis. Lipomas also occur more frequently as part of the hereditary disease neurofibromatosis.
A lipoma grows slowly and is usually only a few centimetres in size. In rare cases, however, a lipoma can reach a diameter of more than ten centimetres (giant lipoma). From a size of ten centimetres, it is classified by doctors as a large lipoma.
A special form is the angiolipoma. This lipoma contains blood vessels that are usually blocked (thrombosed). Angiolipomas often cause pain. It mainly affects young men. In more than half of cases, several angiolipomas occur at the same time.
How is a lipoma treated?
Although lipomas do not disappear on their own, treatment is not usually necessary. However, if the lipoma is visually disturbing, inflamed, painful or very large, it is possible for a dermatologist or surgeon to remove it.
Surgery
The lipoma and its connective tissue capsule can be completely removed by surgery. Lipomas that lie directly under the skin are particularly easy to cut out: A surgeon incises the skin over the lipoma and pushes it out. The patient is usually given a local anesthetic. In the case of very large or numerous lipomas, a general anesthetic may be necessary.
A subfascial or muscular lipoma is somewhat more complex to remove, as it must first be exposed under the connective tissue or muscle. However, local anesthesia is usually sufficient here too. The surgeon then sutures the wound and applies a pressure bandage. A scar often remains afterwards.
In the case of lipomatosis, it is often possible to have several lipomas removed without the need for a second operation.
Having a lipoma removed is usually a minor operation. It is advisable to be aware that even minor operations are associated with complications in rare cases. As with most surgical procedures, the following complications are possible:
- bleeding
- Wound infections
- Wound healing disorders
If general anesthesia is necessary, there are also risks involved. However, complications usually occur rarely.
Liposuction
An alternative treatment to surgical removal of the lipoma is liposuction. This means that the doctor does not cut out the lipoma, but sucks it out. The advantage of this procedure is that there is less scar tissue than with surgery.
However, it is not always possible to suction out the lipoma completely, including its connective tissue capsule. In this case, there is a possibility that the lipoma will continue to grow. This is why surgical removal is still usually the preferred treatment.
Discuss with your doctor which procedure is most suitable for you.
Statutory health insurance companies only cover the costs of lipoma removal in some cases. This depends on why the lipoma is being removed. It is best to discuss this with your doctor!
Are there home remedies for lipomas?
The cause of lipomas has not yet been clarified in conventional medicine. Naturopathy sees accumulated metabolic products as the cause of lipomas. For this reason, attempts are made to stimulate metabolic breakdown processes. Among other things, an alkaline diet with plenty of fruit, vegetables, wholegrain products, diluted fruit juices, still water and natural vegetable oils is recommended.
A home remedy that is shared among sufferers in Internet forums is the use of a honey and flour paste. This is thoroughly removed with warm water after a certain period of application.
However, according to many doctors, treating lipomas with an ointment is generally an unsuitable home remedy. In this context, home remedies for lipomas often include a reference to traction ointments (these are often black ointments). However, in contrast to their effective use in some inflammatory skin diseases, their use in lipomas is generally ineffective.
Some patients also report success with lipoma treatment using apple cider vinegar or coconut oil to dissolve a lipoma. There is no scientific evidence to support these assumptions. Apple cider vinegar and coconut oil against lipomas can only be used as a supplement to treatment.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not improve or even get worse, you should always consult a doctor.
Is a lipoma dangerous?
Lipomas have a good prognosis. There is only a very low risk of the benign lipoma developing into a malignant tumor. Treatment is usually not necessary.
Anyone who is bothered by the lump under the skin has the option of having it removed by a doctor. However, in some cases lipomas form again and again.
It depends on the size and location of the wound how long you will be ill after a lipoma has been removed. If it is a small lipoma and it is possible to protect the wound after removal despite working, it is usually not necessary to take sick leave.
However, if the doctor removes a larger lipoma, for example, and the wound cannot be protected at work or the patient experiences pain, the doctor will usually issue a certificate of incapacity for work.
What are the symptoms of a lipoma?
Depending on the location of the lipoma, pain may also occur when it is pressed or stretched during movement. In some cases, the angiolipoma is painful even without external influences.
What is the cause of a lipoma?
It is not known why the lumps form under the skin. It is possible that a genetic predisposition promotes the growth of a lipoma. However, this has not yet been clearly proven as the cause of lipomas that occur individually.
The causes of lipomatosis, in which many lipomas occur simultaneously, are also not yet fully understood. Lipomatosis often occurs in patients who also suffer from metabolic disorders such as diabetes mellitus or high uric acid levels (hyperuricemia). However, it is unclear whether these are actually the causes of lipoma.
It is also being discussed whether high blood lipid levels (hyperlipidemia) may lead to lipomas. Nothing is known in the current medical literature about psychological causes of lipomas.
There is a hereditary disease in which lipomas sometimes occur more frequently: neurofibromatosis. In addition to so-called neurofibromas, which give the disease its name, many lipomas sometimes also grow. Depending on the type of disease, they are mainly found on the body or on the arms and legs.
Lipoma: examination and diagnosis
This is followed by an ultrasound examination (sonography) and/or X-ray examination of the lipoma. Sometimes doctors also have a magnetic resonance imaging (MRI) or, depending on the location, a computer tomography (CT) scan carried out, for example in the case of lipomas on the abdomen or in the abdominal cavity.
These imaging procedures allow the doctor to differentiate the lipoma from cysts and other neoplasms (e.g. fibroma). It is also possible to see exactly how large the lump under the skin is. This is important as a lipoma is often larger than can be felt through the skin.
If, after these examinations, it is still not possible to determine with certainty whether the lump under the skin is actually a lipoma, a tissue sample is taken and examined under a microscope.
Occasionally, a lipoma develops in the female breast. In this case, the doctor usually removes the lump under the skin to rule out the possibility that it is a liposarcoma. This is a malignant soft tissue tumor.
Can a lipoma be prevented?
As the causes for the development of lipomas are still largely unknown, there are no specific preventative measures. It is generally advisable to maintain a balanced lifestyle.
