A close-up image of the area behind the ear can reveal something that most people would never notice in everyday life: large, swollen bumps with visible openings in the center.

In the image, the skin around the ear appears raised and irritated, while one of the bumps has a prominent dark central opening. A medical professional is carefully examining the area with gloved hands.

Although images like this can look shocking, the appearance alone cannot confirm exactly what is inside the bumps or what caused them. Several different skin conditions can produce lumps, swelling, and a visible pore-like opening.

What Could Cause a Bump With a Central Opening?

One possibility is an epidermoid cyst, a common type of skin cyst that can develop when skin cells become trapped beneath the surface.

These cysts can remain small for a long time and sometimes gradually become larger. Some have a noticeable central opening, called a punctum, which may appear as a tiny dark spot.

When a cyst becomes inflamed, the surrounding skin may become:

• Red
• Swollen
• Tender
• Warm
• Sensitive to pressure

In some cases, cyst contents can also drain through the opening.

However, not every bump with a dark center is an epidermoid cyst. Other lesions can look similar, which is why an examination by a healthcare professional is important.