What causes follicular swelling with a hard lump, and what should be done about it?

Under normal circumstances, swelling and hard lumps in hair follicles may be caused by follicular blockage, friction irritation, folliculitis, infected sebaceous cysts, or furuncles (boils). Depending on the specific situation, patients can choose appropriate management methods such as general care, medication, or surgical treatment. A detailed analysis is as follows:

1. Follicular Blockage

Excessive sebum production combined with inadequate cleansing can lead to clogged follicular openings. Accumulated sebum causes swelling and forms a hard lump. Clean the affected area daily with warm water, use mild cleansing products, and avoid frequent use of irritating washes or skincare products.

2. Friction Irritation

Tight clothing or repeated rubbing against the follicle area can damage follicular tissue, leading to inflammatory swelling and hard lump formation. Switch to loose, breathable clothing to reduce friction on the affected area, and avoid squeezing or scratching the lump.

3. Folliculitis

Bacterial infection of the hair follicle triggers inflammation, causing redness, swelling, and pain around the follicle, resulting in a firm, painful nodule. Under medical guidance, topical antibiotics such as mupirocin ointment or fusidic acid cream may be applied, along with oral cephalexin capsules. Keep the affected area clean and dry.

4. Infected Sebaceous Cyst

Obstruction of the sebaceous gland duct leads to cyst formation; secondary infection causes the cyst to swell, harden, and become painful with redness. During the infection phase, take amoxicillin capsules or levofloxacin hydrochloride tablets as prescribed, and apply erythromycin ointment externally. After controlling the inflammation, surgical excision of the sebaceous cyst should be performed.

5. Furuncle (Boil)

Infection involving the hair follicle and deeper tissues results in acute suppurative inflammation, forming a large, painful hard lump. In early stages, warm compresses may help reduce inflammation. Take cefixime dispersible tablets as directed by a physician. If abscess formation occurs, incision and drainage of the boil are required.

Swollen, hardened hair follicles are often related to infection or blockage. Maintaining proper hygiene and protection in daily life is essential. If the lump continues to grow, pain worsens, or pus develops, do not attempt self-treatment. Seek timely medical attention to effectively control the infection and prevent its spread.