Hard Lumps on the Buttocks: Symptoms and Treatment - Surgery

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There is a hard lump in the buttock?


Hello, doctor.
Two weeks ago, I suddenly developed a hard lump on my buttock, which is noticeably red and swollen, about 5 centimeters in diameter, and it was painful.
Out of fear of seeing a doctor, I went to the pharmacy for medication.
The pharmacist looked at it and said it might be cellulitis.
After squeezing out a lot of blood, I took home some medicated dressings to apply.
As of now, it no longer hurts, but there is still redness and swelling, and it is no longer hard.
I would like to ask: 1.
Is cellulitis usually caused by an infection from a wound? 2.
Is this symptom really cellulitis? 3.
If it is necessary to see a doctor, which specialty should I consult? Thank you for your clarification.

A-Ming, 20~29 year old female. Ask Date: 2001/10/17

Dr. Li Junde reply Surgery


Hello Mr.
A-Ming: The hard lump on your buttock shows signs of inflammation, which, based on your description, resembles an abscess rather than cellulitis.
Abscess formation is typically caused by local trauma, folliculitis, or infection of sebaceous cysts, usually due to Staphylococcus infection.
In contrast, cellulitis presents with ill-defined erythema and symptoms of redness, swelling, heat, and pain, and rarely leads to purulence.
Conditions like erysipelas are caused by Streptococcus infection and can occur without an obvious wound.
You may consult a general surgeon for further management.

Reply Date: 2001/10/17

More Info


Understanding hard lumps on the buttocks can be concerning, especially when accompanied by symptoms like redness, swelling, and pain. Based on your description, it seems you may be dealing with a condition known as cellulitis, which is indeed often caused by a bacterial infection that can occur when bacteria enter through a break in the skin. Let’s address your questions one by one.

1. Is cellulitis caused by an infected wound?
Yes, cellulitis is typically caused by bacteria, most commonly Streptococcus and Staphylococcus species, entering the skin through a cut, scrape, or other breaches in the skin barrier. This can lead to inflammation and infection of the deeper layers of the skin and subcutaneous tissues. The redness, swelling, and pain you experienced are classic signs of this condition. If the infection is severe, it can lead to the formation of abscesses or hard lumps, which may require drainage.

2. Is this symptom truly cellulitis?
While your symptoms align with cellulitis, it is essential to consider other possibilities as well. Conditions such as abscesses, lipomas (benign fatty tumors), or even cysts can present similarly. The fact that the lump was painful and red initially, but has since become less painful and still remains red and swollen, suggests that while the acute phase may have resolved, there could still be residual inflammation or another underlying issue. If the lump persists or if you notice any new symptoms, it would be prudent to seek medical attention.

3. Which specialist should I see if necessary?
If you decide to see a doctor, a good starting point would be a primary care physician or a dermatologist. A primary care doctor can evaluate your symptoms and determine if you need further treatment or referral to a specialist. A dermatologist specializes in skin conditions and would be well-equipped to diagnose and treat skin infections, including cellulitis. If an abscess is suspected, they may also perform a drainage procedure if necessary.

In terms of treatment, if cellulitis is confirmed, it typically requires antibiotics to clear the infection. Over-the-counter pain relievers can help manage discomfort, and keeping the area clean and dry is crucial. If you notice any worsening of symptoms, such as increased redness, swelling, or fever, it is essential to seek medical attention promptly, as these could indicate a spreading infection.

In summary, while your symptoms suggest cellulitis, it is vital to have a healthcare professional evaluate the lump to rule out other conditions and to determine the appropriate treatment. Early intervention can prevent complications and promote faster healing. If you have any lingering concerns or if the lump does not resolve, please do not hesitate to consult a healthcare provider for a thorough examination.

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