Pimple Turned into Hard Lump Under Skin: Causes, Symptoms, Diagnosis & Treatment

Acne is the most common cause of bumps on skin. Almost everyone will get these bumps at some point in life, especially during teenage years. There are many widely available products today for treating acne. In fact, a good night sleep is all it sometimes requires to get rid of these bumps.

Blocked follicles are the reason as to why acne forms. Hair follicles on your skin can get clogged with dead skin cells and sebum. Whiteheads and blackheads are the most common type of acne. If bacteria invade blocked follicles, pus formation will result in pustules and papules. A pimple turned into a hard lump under the skin is referred to as cystic acne or acne nodule. It is a more serious condition that requires medical treatment. Treatment at home will most likely result in scarring.

Difference between nodular acne and cystic acne

As earlier mentioned, a pimple turned into a hard lump under the skin is most likely a nodule acne or cystic acne. But what is the difference between the two? How can you tell which type you are dealing with?

For starters, both types cause painful bumps under skin. It is possible to have both these types at the same time. Acne nodules tend to form harder bumps compared to cystic acne. This is mainly because cystic acne bumps are filled with pus.

Skin areas surrounding an acne nodule can turn red due to inflammation. Since the nodule occurs underneath the skin, you will only feel a bump on skin, with no tip like common acne. If not treated, the nodule can remain intact for a long time.

Due to presence of pus in cystic acne bumps, surrounding skin regions will redden. A cystic acne bump can be taken for a boil.

What causes hard acne pimple under skin

Many factors can contribute to development of acne. Hormonal changes are, for example, to blame for acne outbreaks in teenager and pregnant women or during menstruation. Acne outbreaks can also occur due to stress or lack of sleep.

The chin, neck and back are common body regions on which cystic acne develops. You can for example have a painful lump under the jawbone caused by this acne type.

Cystic acne will only develop if the contents of infected acne move deep into the skin. Hormonal imbalances can sometimes trigger excess production of sebum and thus higher risk of developing cystic acne. It has also been suggested that sugary diets increase the risk of developing cystic acne.

Some lifestyle habits can be blamed for recurring nodular and cystic acne, but not always. You can try the elimination method, where you skip some habits and watch out for any improvements.

Note that cystic acne has nothing to do with poor hygiene. Excess production of sebum is mostly to blame. Unfortunately, this cannot be prevented. You can however try cleaning your face with mild soaps about twice a day. Avoid popping or picking at cystic acne. This is to avoid spreading bacteria and scar formation.

Diagnosis and treatment for cystic acne

Unlike other types of acne, cystic and nodular acne develop deep under the skin. They also linger for longer and are painful to touch. Normally, cysts are not painful. It is for example common to find a painless, cystic lump on the back of a baby’s head. It is the presence of bacteria that makes cystic acne painful.

Over the counter products that work for common acne will not succeed in removing cystic acne. A common mistake that people make is attempting to treat cystic acne at home. This will not only be fruitless but probably leave you with scars. A better approach is to visit a dermatologist for any of the following treatment options:


Since cystic acne is a form of a bacterial infection, it is often treated with oral antibiotics. The aim is to kill bacteria in the lumps. There is no guarantee that antibiotics will work. In fact, some people develop resistance to these medications after long-time use. Antibiotics work more effectively cases such as painful lump on the labia caused by a boil or an abscess.


Retinoids are powerful forms of vitamin A. They work by unclogging hair follicles. Retinoids are often used with antibiotics.

Salicylic acid

Over the counter products that contain salicylic acid do not work on nodular acne. Your doctor will prescribe stronger forms of the acid that will get rid of acne nodules.

Benzoyl peroxide

Other than salicylic acid, benzoyl peroxide is commonly used in anti-acne OTC products. Severe acne requires prescription-strength benzoyl peroxide if it is to work.

Birth control pills

Cystic acne in women is sometimes treated with birth control pills. This should be done under the directions of a doctor, especially for pregnant women.


Isotretinoin is a very powerful and effective medication for severe and mild acne. It comes in form of pills which are to be taken on daily basis for several months. Talk to your doctor before taking this medication.

Non-medication approach

Non-medication options are often used with medications to not only get rid of severe acne but also remove scars. Acne drainage is most common. It involves draining pus and most contents of cystic acne. Laser therapy is considered for stubborn severe acne. It involves use of high-energy rays. Your doctor may also prescribe chemical peels. The peels work by unclogging follicles to release trapped sebum and pus.

Is a pimple turned into hard lump under skin a sign of cancer?

A hard lump under your skin can be a sign of cancer. Squamous cell carcinoma is the most common type of skin cancer. It originates in cells of a membrane located just below the superficial skin layer. Basal cell carcinoma is a closely related type of skin cancer that also develops on skin cells. These two types rarely spread to other parts of the skin or body.

Melanoma cancer is a more deadly but rarer type of skin cancer. It develops on melanocytes, the cells that give pigment to the skin.

Signs and symptoms of cancer

If a pimple on or under your skin is to turn into a hard lump and be accompanied by the following symptoms, have it checked by your doctor immediately:

  • Gradually grows in size and mass
  • Is painless
  • Looks like a mole but keeps evolving
  • Is irregularly shaped
  • Has a rough top
  • Lymph nodes in more than one location swell
  • You have a chronic cough, lump in throat feeling or general weakness
  • You have lumps elsewhere in the body or skin such as a hard lump on the scrotum or on the breast

Lumps on body and skin are very common. You are encouraged to learn more about what a lump on different parts of your body might mean. For example, a hard lump on the roof of the mouth is most likely a benign bony growth but can as well be a sign of oral cancer. Much the same can be said about a pimple on skin that turns hard. It most likely will result from severe acne but cold as well be indicating skin cancer cells. The only way you can be certain is by analyzing the symptoms but mostly going for a medical diagnosis.