What Are the Possible Causes of a Painful Lump on the Perineum, and How Is It Treated?

When you find a painful lump on the perineum, several things could be causing it. One common cause is a cyst, which is a small sac filled with fluid or skin cells. Sometimes, a cyst can become infected or even rupture, causing pain. For example, an epidermal cyst can become tender if it gets inflamed. Another possibility, particularly in women, is perianal endometriosis. This is rare but occurs when tissue similar to the lining of the uterus grows in the perineal area, causing discomfort and pain. Treatment depends on the exact cause. For a minor cyst that is not too painful, conservative measures like warm compresses, anti-inflammatory medications, and keeping the area clean may help. However, if the lump is very painful, shows signs of infection such as redness or pus, or if it does not resolve on its own, a doctor might decide to drain or surgically remove it. It is important to have any persistent or worsening lump examined to determine the correct treatment and to avoid complications.