I’m Dr. Tina Jenq from Oregon Cosmetic and Reconstructive Clinic. Many patients come to me with a small bump or lump under the skin and ask, “What is this—and do I need to worry?” That’s a great question!
While most of these growths are harmless, they can look or feel similar. Understanding the differences helps you know what’s going on beneath your skin and what kind of treatment makes sense.
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Feature
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Mole
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Lipoma (Fatty Tumor)
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Sebaceous Cyst
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Feel / Texture
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Flat or raised; usually firm.
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Soft, rubbery, and moves easily under the skin.
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Firm knot; may have a visible “pore” or “dot” in the center.
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Location
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On the surface of the skin.
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Just beneath the skin in the fatty layer.
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Within the skin’s deeper layers.
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Growth Rate
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Usually slow or stays the same size.
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Very slow growth over many years.
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Can grow quickly if it becomes inflamed or infected.
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Pain Level
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Rarely painful.
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Generally painless unless pressing on a nerve.
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Can become tender, red, or painful if irritated.
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Moles: Small Clusters of Skin Cells
A mole forms when skin cells grow together instead of spreading out evenly.
They usually sit on the surface or just within the skin layers. 
Moles are:
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Round or oval in shape
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Light brown, dark brown, or pink in color
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Sometimes flat, sometimes raised
Over time, a flat mole may become more domed. Most are completely benign, but if you notice changes in color, shape, or size, it’s best to have it checked.
You can read more about skin lesion removal at our clinic if you’re curious about treatment options.
Lipomas: Soft Lumps Beneath the Skin
A lipoma is a benign growth of fat cells.
Unlike moles, lipomas grow under the skin, often in the fat layer—and sometimes even beneath the muscle.
They usually feel:
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Soft and movable when pressed
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Painless, though larger ones can cause pressure
Smaller lipomas can often be removed easily in the clinic, depending on where they are.
When a lipoma grows deeper under the muscle, removal becomes more complex. In these cases, I make a careful incision to reach the growth, remove it, and then repair the muscle layer.
Recovery is usually smooth—patients can return to most normal activities within a few days.
Sebaceous Cysts: Clogged Hair Follicles
A sebaceous cyst forms when a hair follicle that normally releases natural oil (sebum) becomes clogged.
As sebum builds up, it creates a round, smooth cyst—often with a small central punctum (a tiny opening) on the surface. 
Even though the sebum comes from the skin, the hair follicle actually sits in the fat layer. That means cyst removal involves taking out both the punctum and the entire cyst wall beneath the skin to prevent recurrence.
These minor procedures are typically done right in the clinic with local anesthesia. Patients usually feel only mild aching for a day or two afterward, easily managed with Tylenol.
By about three days, most people can resume cardio exercise without issue.
Learn more about minor in-office procedures at Oregon Cosmetic and Reconstructive Clinic.
When to See a Specialist
If you notice any lump that’s growing, changing, or uncomfortable, it’s worth getting evaluated. At Oregon Cosmetic and Reconstructive Clinic, I perform detailed assessments to determine what type of growth you have and whether removal makes sense.
Understanding what’s beneath your skin helps you make confident, informed decisions about your care.
Frequently Asked Questions
How can I tell the difference between a lipoma and a sebaceous cyst?
The main difference between a lipoma and a sebaceous cyst is how they feel and move.
A lipoma is a non-cancerous “fatty tumor” that feels soft and rubbery, and it often slips away from your finger when you press on it.
A sebaceous cyst is firmer and is actually attached to the skin. Cysts often have a small, dark opening (punctum) at the center, whereas lipomas do not.
Can a cyst develop under a mole?
Yes, it is possible to have a cyst under a mole. While the mole sits on the surface, a cyst can form in the hair follicle or skin gland directly beneath it.
This can make the mole appear raised or feel firm. If you notice a mole suddenly changing shape or feeling like there is a “lump” underneath,
it is important to have it evaluated by a board-certified surgeon to rule out more serious concerns.
Is a “fatty tumor” the same thing as a lipoma?
Yes. “Fatty tumor” is the layman’s term for a lipoma. These are very common, slow-growing lumps that are almost always harmless.
However, many patients in the Portland and Clackamas area choose to have them removed for comfort or cosmetic reasons,
especially if they are in visible areas like the arms, back, or neck.
When should I see a surgeon in Portland for a skin lump?
You should schedule a consultation if your lump is growing rapidly, becomes painful, or if you simply want a definitive diagnosis for peace of mind.
Dr. Tina Jenq specializes in the precise removal of moles, lipomas, and cysts at our Happy Valley clinic, focusing on minimal scarring and quick recovery.
In addition, many patients come in for cosmetic reasons—especially if the lesion makes them feel self-conscious or they prefer that it is no longer visible.
