The appearance of small grains of flesh on the neck with pain may be caused by the following reasons: first, it may be a sebaceous cyst under the skin of the neck, i.e., a powder tumor, because the inflammation of the sebaceous glands after the glands have become blocked, and over time will form a layer of envelope to wrap the powdered inflammatory material inside, thus forming a subcutaneous swelling. If there is a little inflammation or even infection and pus, there will be pain, and this pain will be accompanied by local skin flushing, increased skin temperature and other red, swollen, hot and painful manifestations. Secondly, it may be a swelling of the thyroid gland, commonly known as thyroid adenoma or even thyroid cancer. Thirdly, it may be caused by inflammation and enlargement of the lymph nodes in the neck. It is recommended to go to the hospital to check the local ultrasound for basic identification.