What causes local swelling and hardening after moxibustion, and what should be done?

Generally, localized swelling and hardening after moxibustion may be caused by prolonged moxibustion duration, excessive temperature, local skin allergy, subcutaneous hematoma, or local infection. It is recommended to seek medical attention promptly, identify the underlying cause, and then improve the condition under a doctor's guidance through general management, medication, or other treatments. Specific causes are analyzed as follows:

1. Prolonged Moxibustion Duration: When a single moxibustion session exceeds 30 minutes, prolonged thermal stimulation can lead to tissue congestion, swelling, and a hardened sensation in the treated area. Immediately discontinue moxibustion and apply a cold compress with a towel for 15 minutes to relieve congestion. In future sessions, limit moxibustion to 15–20 minutes and avoid consecutive treatments on the same site for more than two days.

2. Excessive Moxibustion Temperature: Holding the moxa stick too close to the skin during treatment can result in burns due to high heat, causing localized swelling and hardness. Adjust the distance between the moxa stick and skin to 3–5 cm, ensuring the sensation is warm but not painful. If mild swelling has already occurred, apply moist burn ointment to protect the skin and promote healing.

3. Local Skin Allergy: Some individuals are allergic to moxa smoke or mugwort components, which may trigger localized swelling, hardness, itching, and rash after moxibustion. Immediately leave the moxibustion environment, clean the affected skin with water, and follow medical advice to use medications such as calamine lotion, hydrocortisone butyrate cream, or mometasone furoate gel to alleviate symptoms.

4. Subcutaneous Hematoma: Improper pressure applied during moxibustion or pre-existing poor coagulation function may cause rupture of capillaries beneath the skin, leading to hematoma formation characterized by swelling, hardness, and bruising. Follow medical advice to use Yunnan Baiyao aerosol, Huoxue Zhitong capsules, or Sanqi tablets to accelerate recovery.

5. Local Infection: If the skin is broken after moxibustion and not properly cleaned, bacterial invasion may lead to infection, presenting as swelling, hardness, pain, and pus discharge. Clean the affected area with normal saline and apply topical antibiotics such as mupirocin ointment, fusidic acid cream, or compound polymyxin B ointment as directed by a physician.

After routine moxibustion, monitor the condition of the local skin. Mild redness may resolve spontaneously without special treatment. Use high-quality moxa sticks, clean the skin before and after moxibustion, avoid moving the moxa stick carelessly during treatment, and ensure proper technique to minimize adverse reactions.