There is a big bump on my face, it is hard and a bit painful

Lumps on the face are very similar to acne, but the lump is usually larger. There is a type of bag that is particularly impressive, which is relatively hard and very painful. The most likely cause of a hard and painful lump on your face is a boil. This type of lump needs to be treated correctly, as severe cases may even be life-threatening. Let’s take a look at the causes and treatments of boils.

Furuncle is an acute suppurative infection caused by bacterial infection of a single hair follicle or sebaceous gland in the human skin, which forms a large red mass after infection. Multiple and recurring diseases are called furunculosis.

Causes

The main pathogen is Staphylococcus aureus, followed by Staphylococcus aureus and hemolytic Streptococcus. Skin abrasions, erosions, ulcers, etc. are conducive to the colonization, reproduction and infection of bacteria on the skin surface. Other contributing factors include low body resistance, excessive sebaceous gland secretion, malnutrition, anemia, diabetes and long-term use of hormones.

Clinical manifestations

Furuncles often occur in areas of the human body that are under pressure and in areas where oil secretion is abundant, and are prone to occur on the head, face, neck, armpits, and buttocks.

It initially appears as a follicular inflammatory papule, which gradually increases in size and becomes a red, hard nodule with pain or tenderness. After 2-3 days, the nodule becomes purulent and necrotic, forming an abscess with a necrotic pus plug in the center. After the pus plug ruptures, pus, the pus plug and necrotic tissue are discharged, the abscess subsides, and a scar is formed within 1-2 weeks, and the disease is healed. During the formation process of boils, there is often severe throbbing pain, especially if the boils grow on the forehead or jaw where the skin tissue is dense and the tension is high, it will be more painful. Some patients may also have systemic symptoms such as fever, headache and discomfort. Furuncles occurring on the face, especially the skin lesions on the nostrils and upper lip, are very dangerous if not handled properly or squeezed randomly, as the face has a rich network of lymphatic and vascular vessels, which can cause bacteria to enter the brain through the blood and lead to serious complications.

Children who are malnourished and have weak resistance will suffer from multiple episodes of illness, which may lead to the furunculosis stage, making treatment difficult.

Treatment principles

1. Systemic treatment

Systemic antimicrobial drugs may be used if the lesions are located around the nose, in the nasal cavity, or in the external auditory canal; if the lesions are large and recurrent; if there is cellulitis around the lesions; or if the lesions are refractory to local treatment. Early, adequate and sufficient course of effective antibiotic treatment, commonly used antibiotics such as β-lactams, macrolides, lincosamides/clindamycin, etc. It is best to choose antibiotics based on bacterial sensitivity tests.

2. Local treatment

For early damage, topical antibacterial drugs include 2% mupirocin ointment, 2% fusidic acid cream, compound polymyxin B ointment, etc. Assisted by warm compresses, it can promote the maturation of skin lesions, drainage and relief of symptoms; ultraviolet light, infrared light, ultrashort wave and other treatments are effective in relieving inflammation.

3. Surgical treatment

Incision should be avoided during early skin lesions and acute inflammation. When the furuncle has become localized and has a sense of fluctuation, incision and drainage of pus can be performed.

Recurrent furunculosis should be prevented by self-vaccination. Some people believe that S. aureus is carried in the nasal cavity or perianal and adjacent skin. Clean these areas frequently, apply topical antibiotic cream, and change clothes and wash hands frequently. Recurrent furunculosis can be treated with oral rifampin for 10 days combined with cloxacillin 4 times a day or low-dose clindamycin for 3 months. Azithromycin or fluoroquinolone antibiotics can also be used for recurrent cases that do not respond to treatment.