Clear or Pearly Bump on Skin: Could It Be Cancer?

Pearly describes a particular sheen: translucent and slightly waxy, a bit like a small bead of glass, so that you seem to see a little way into the bump. It catches the light differently from the skin around it, and differently from a pimple.

The look comes from a tight cluster of cells that make no pigment, with light passing partly into it before reflecting back. Once you've seen one, you tend to recognize the next.

BCC tends to grow slowly and rarely spreads to other parts of the body ^[1], but if it's left for years it can grow deep into the surrounding skin ^[1]. The nodular type, the most common on the face ^[2], typically has some of these features:

A shiny or pearly bump with a smooth surface ^[2].

Fine blood vessels running across it, which under a dermatoscope branch like a tree ^[2].

A rolled edge around a central dip or sore ^[2].

A center that bleeds or crusts, seems to heal, then breaks down again ^[1].

Most BCCs are on the head and neck ^[1]. Because it grows slowly, people often live with one for months or years before getting it checked.

For a clear or pearly bump you're unsure about, our skin cancer checker describes what is visible in a photo and suggests a next step. It is paid and does not diagnose.

Sebaceous hyperplasia. Small yellow bumps up to about 3 mm on the forehead or cheeks of middle-aged and older people, caused by enlarged oil glands ^[3]. They are sometimes confused with BCC ^[3].

Milia. Tiny white cysts, often in clusters around the eyes.

Dermal nevus. A soft, skin-colored or pale mole that has been the same for years.

Molluscum contagiosum. Small pearly bumps with a dimple in the middle, caused by a virus, mostly in children. They clear up by themselves.

Fibrous papule. A small, firm, skin-colored bump, usually on the nose.

Syringoma. Small skin-colored bumps under the eyes, from sweat glands.

Several of these can look very like a small BCC to the naked eye, and a dermatoscope is often needed to tell them apart. That's one of the most common reasons for a dermatology referral.

1. Fine red blood vessels on the surface. UK guidelines list prominent fine blood vessels around a lesion as a typical feature of BCC ^[4].

2. A raised, rolled edge around a central dip or sore ^[4].

3. A center that bleeds, scabs and won't heal ^[1].

4. Slow, steady growth over months. Sebaceous hyperplasia stays the same size.

5. Sun-exposed skin in an adult: the face, ears, scalp, neck or upper back.

6. One new bump on its own. Sebaceous hyperplasia usually comes as several bumps that have been there for years.

Amelanotic melanoma. Can look like a pink or pearly bump. It usually grows faster than BCC, feels firm, and sometimes has a fleck of pigment. It is rarer than BCC and more dangerous if missed; our amelanotic melanoma guide covers it.

Merkel cell carcinoma. Rare. A firm, painless pink, red or violet lump that grows over weeks, usually on sun-exposed skin of older adults.

Sebaceous carcinoma. Rare. A yellowish-pink lump, often on the eyelid, that can be mistaken for a stye. An eyelid lump that doesn't settle the way a stye does should be checked.

Book within 2 weeks: a pearly bump that bleeds without an injury, or has a sore or crust that hasn't healed in four weeks ^[5]; one that is growing over weeks rather than months; a firm, fast-growing pink or red lump; or any new bump if you've had skin cancer before or your immune system is suppressed.

Book in the next few weeks: a pearly bump that is new in the past year, growing slowly, not bleeding, on sun-exposed skin. UK guidelines refer suspected BCC non-urgently because it grows slowly, unless its size or position makes a delay a real problem ^[4].

Mention it at your next check-up: small yellowish bumps you've had for years, several of them alike.

BCC is usually treated with a small operation under local anesthetic. On the face, doctors may use Mohs surgery, which removes the tumor layer by layer to spare healthy skin. Treating it while it's small keeps the scar small.