Painful Armpit Lumps: When to Seek Surgical Help

There is a lump in the armpit?

I actually felt a small lump under my armpit before, but about a week ago, a red swollen lump appeared and it has been getting bigger (about the size of my thumb) and is very painful.
I wasn't sure which department to visit, so I went to the endocrinology department.
The doctor prescribed antibiotics for me, but after taking them for three days, there has been no improvement, and small pus-filled blisters have appeared on the swollen lump.
Did I go to the wrong department? What could be my issue? Please let me know, thank you!

Niming, 10~19 year old female. Ask Date: 2012/09/14

Dr. Niu Zhenyuan reply Surgery

Based on the description, it may be a sebaceous gland tumor (sebaceous cyst) complicated by infection.
Antibiotics may temporarily suppress the symptoms, but the definitive treatment should involve excision of the tumor.
A referral to a surgical specialist is recommended for evaluation and management.

Reply Date: 2012/09/14

More Info

When it comes to painful lumps in the armpit, it is essential to understand the potential causes and when surgical intervention may be necessary. Based on your description, it seems you have developed a painful, red lump in your armpit that has increased in size and has not improved with antibiotic treatment. This situation warrants a closer examination.

The lump you are experiencing could be due to several conditions, including but not limited to:
1. Infection: The presence of a painful, red lump that has developed into a pus-filled abscess suggests that there may be an infection. Common causes of such infections include bacterial infections of the skin (like folliculitis or abscesses) or lymphadenitis, where lymph nodes become inflamed due to infection.

2. Lymphadenopathy: Swollen lymph nodes in the armpit can occur due to infections, inflammatory conditions, or malignancies. If the lymph nodes are reactive due to an infection, they may become painful and swollen.

3. Cysts: Sebaceous cysts or other types of cysts can form in the armpit area. These are usually benign but can become infected, leading to pain and swelling.

4. Tumors: While less common, lumps in the armpit can also be due to benign or malignant tumors. If the lump persists or continues to grow, further evaluation is necessary.

Given that you have already been prescribed antibiotics without improvement, it may be time to seek further medical evaluation. Here are some steps you should consider:
1. Consult a Specialist: Since the initial consultation was with a metabolic disease specialist, it may be more appropriate to see a dermatologist or a general surgeon. They can provide a more focused evaluation of skin and soft tissue issues.

2. Imaging Studies: Depending on the physical examination, your doctor may recommend imaging studies such as an ultrasound or CT scan to assess the lump's characteristics and determine if it is an abscess, cyst, or something else.

3. Surgical Intervention: If the lump is determined to be an abscess, surgical drainage may be necessary. This procedure involves making an incision to allow the pus to escape, which can relieve pain and promote healing. If a cyst or tumor is present, surgical removal may be indicated, especially if there is concern about malignancy.

4. Follow-Up Care: After any surgical intervention, follow-up care is crucial to monitor for signs of infection or recurrence of the lump.

In summary, your situation requires further evaluation, especially since the lump has not improved with antibiotics and has developed into a painful abscess. Seeking a consultation with a dermatologist or general surgeon would be a prudent next step. They can provide a thorough examination, appropriate imaging, and determine if surgical intervention is necessary. Early intervention can help prevent complications and ensure a better outcome.

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