Growing Cyst on Face: When to Seek Immediate Medical Attention?

The sebaceous cyst continues to enlarge?

About six months ago, a small, darker-colored lump appeared on my right cheek.
I didn't know what it was since it was not painful or itchy, so I completely ignored it.
However, about ten days ago, it started to become inflamed and enlarged, reaching a diameter of about 2 centimeters and feeling hard.
Pressing on it causes slight pain.
That day, I went to the surgical department at Keelung Hospital under the Ministry of Health and Welfare.
The doctor did not perform a physical examination and said it was not a lipoma, but rather a bacterial infection.
He prescribed antibiotics and anti-inflammatory medication, one of each for seven days, to be taken three times a day, and asked me to return for a follow-up after seven days.
The doctor mentioned that during this seven-day period, there would be two possible outcomes: either the lump would start to soften, indicating the beginning of pus formation, or the hard lump would gradually shrink in size.

I have been taking the medication for four days now, and while the center has indeed started to soften and form pus, the surrounding hard area has rapidly expanded.
I measured it myself, and the swollen area has now reached a diameter of 7 centimeters, almost touching my cheekbone.
I have to wait three more days for my follow-up appointment, and I am really worried.
Should I seek another doctor immediately tomorrow, or should I go to a dermatologist? Thank you for your guidance.

Ricky, 40~49 year old female. Ask Date: 2020/01/12

Dr. Wu Yuxin reply Dermatology

You should consult your attending physician about this issue, as they are the most familiar with your condition.

Reply Date: 2020/01/12

More Info

When it comes to a growing cyst or lump on the face, especially one that has recently become inflamed and enlarged, it is crucial to take the situation seriously. Based on your description, you initially noticed a small, dark-colored lump on your right cheek that was painless and ignored it. However, it has since grown to about 2 centimeters in diameter and has become painful, indicating a potential infection. After visiting a surgeon, you were prescribed antibiotics and anti-inflammatory medication, but the lump has continued to grow, now measuring approximately 7 centimeters and encroaching on your cheekbone.

Given these developments, here are some important considerations regarding when to seek immediate medical attention:
1. Rapid Growth: The significant increase in size from 2 centimeters to 7 centimeters within a short period is concerning. Rapid growth of a lump can indicate an aggressive process, such as an abscess or a more serious condition that requires prompt evaluation.

2. Pain and Discomfort: While the lump was initially painless, the emergence of pain suggests that there may be inflammation or infection. If the pain worsens or if you experience additional symptoms such as fever, chills, or increased redness around the area, these could be signs of a more serious infection that may require immediate intervention.

3. Change in Characteristics: The fact that the lump has started to soften and show signs of potential drainage (indicating possible abscess formation) is another red flag. If the lump becomes fluctuant (feels like it has fluid inside) or if you notice any discharge, it is essential to seek medical attention as this could indicate that the cyst is becoming infected and may need to be drained.

4. Consulting a Specialist: While your initial visit to a surgeon was appropriate, given the changes in your condition, it may be beneficial to seek a second opinion. A dermatologist could provide further insight, especially if the lump is related to skin conditions or if it requires a different treatment approach. They can perform a thorough examination and may recommend imaging studies (like an ultrasound) to assess the nature of the lump more accurately.

5. Follow-Up Care: If you are unable to see your original doctor before the scheduled follow-up, it is advisable to seek care sooner rather than later. You should not wait if you feel that the situation is worsening. Immediate evaluation can help prevent complications, such as the spread of infection or the development of more severe conditions.

In summary, based on the rapid growth, the onset of pain, and the changes in the lump's characteristics, it is prudent to seek medical attention as soon as possible. You may choose to visit either your original surgeon or a dermatologist for a more specialized assessment. Early intervention can be critical in managing potential complications and ensuring appropriate treatment.

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