What causes a large, hard, painful, and red pimple, and what should I do about it?
Sep 29, 2024
Source: Cainiu Health
Dr. Liu Wenmin
Introduction
Its formation is associated with excessive keratinization of the pilosebaceous unit and bacterial infection. When the follicular opening becomes blocked by dead skin cells, sebum cannot be properly expelled, leading to increased pressure within the follicle, bacterial proliferation, and an inflammatory response that results in firm, cystic nodules, often accompanied by redness, swelling, and pain. Treatment of cystic acne typically requires a combination approach under medical supervision, including medications such as doxycycline tablets to reduce inflammation.
Generally, large, hard, painful, and red pimples may be caused by stress and emotional factors, improper diet, seborrheic dermatitis, rosacea, or cystic acne. If abnormalities occur, it is recommended to seek timely medical evaluation at a hospital to determine the underlying cause and receive targeted treatment. Specific analyses are as follows:
1. Stress and Emotional Factors
Stress and anxiety can promote the secretion of stress hormones such as cortisol, which may stimulate excessive activity of sebaceous glands, increasing oil production and triggering acne. It is recommended to learn stress-reduction techniques such as deep breathing, yoga, or meditation. Maintain a positive mindset and seek support from family, friends, or professional counselors.
2. Improper Diet
Excessive consumption of spicy, greasy, and high-sugar foods, along with irregular eating habits, may stimulate sebaceous glands to produce excess oil, leading to clogged pores and the development of such pimples. This may be accompanied by symptoms such as indigestion and bloating. Adjust your diet by increasing intake of fresh fruits and vegetables, reducing greasy and sugary foods, maintaining balanced nutrition, drinking adequate water, and promoting metabolic health.
3. Seborrheic Dermatitis
Seborrheic dermatitis results from excessive sebum production by sebaceous glands combined with microbial factors such as Malassezia, causing skin inflammation characterized by redness, scaling, and acne-like lesions. It may also be associated with increased dandruff and itching. Treatment under medical guidance may include topical tacrolimus ointment, pimecrolimus cream, or oral itraconazole capsules.
4. Rosacea
Rosacea may be related to abnormal blood vessel dilation, immune system dysfunction, and neurovascular regulation disorders. It typically presents with central facial redness, papules, and pustules, along with sensitive skin. Use soothing skincare products and avoid irritating cosmetics. Medications such as metronidazole tablets, tinidazole capsules, or adapalene gel may be used as directed by a physician.
5. Cystic Acne
Cystic acne develops due to abnormal keratinization within the hair follicle-sebaceous gland unit and bacterial infection. When the follicular opening is blocked by dead skin cells, sebum cannot drain properly, increasing pressure within the follicle, allowing bacteria to proliferate and trigger an inflammatory response, resulting in firm, painful cysts that are often red, swollen, and tender. Symptoms may include abscesses, scarring, persistent redness, and tenderness. Treatment usually requires a comprehensive approach under medical supervision, including oral doxycycline tablets, clindamycin hydrochloride gel, vitamin A acid soft capsules to reduce inflammation, as well as local warm compresses or surgical drainage if necessary.
In daily life, maintain a healthy lifestyle, improve dietary habits, engage in regular physical exercise, enhance overall physical health, and improve skin condition.
