Hard lumps on the forehead are most often attributed to osteomas, or hard, bony growths in the skull, according to plastic surgeon Dr. Amil Shah. Osteomas are not very common, but are usually benign, slow-growing and asymptomatic. Osteomas may be hereditary or formed at birth, according to the National Library of Medicine. While only symptomatic osteomas require treatment, many people who do not have symptoms still choose treatment due to their unsightly nature.
To diagnose an osteoma, a doctor typically performs a general physical exam, according to the University of Pittsburgh Medical Center. A CT scan or bone scan may also be used to confirm the diagnosis and make sure the osteoma does not extend deeper into the skull. The doctor then asks the patient about any symptoms he may be experiencing. Although symptoms are rare, they do occur in some cases depending on the location of the osteoma. Symptoms include vision or hearing problems or pain in the area of the osteoma due to nerve compression.
Treatment usually involves surgical removal of the osteoma through a tiny incision in the forehead. The doctor uses special instruments to remove the bony growth and trim or grind the area smooth. It can be performed using local or general anesthesia and is typically completed within about an hour. Recovery time is minimal and the patient is released the same day. Another technique, according to the University of Pittsburth Medical Center, is the Endoscopic Endonasal Approach, or EEA, a less invasive technique in which the doctor uses the nose and nasal cavity to reach the osteoma without needing to cut into the patient's skin.