A bump inside the nose often causes immediate concern, but these lumps are common and have a wide range of causes. The nasal cavity is lined with delicate skin, hair follicles, and mucous membranes, all susceptible to irritation, infection, and chronic inflammation. Determining the exact nature of the bump depends heavily on its characteristics, such as whether it is painful, soft, acute, or chronic. While many bumps are benign and resolve on their own, others signal a more complex issue requiring professional medical evaluation.
Acute Infections: Folliculitis and Nasal Boils
One of the most frequent causes of a painful lump is an acute bacterial infection of the hair follicles located just inside the nostril. This area, known as the nasal vestibule, contains small hairs (vibrissae) that can become infected, usually by Staphylococcus aureus bacteria. When the infection is superficial and localized to the hair follicle opening, it is termed folliculitis, often presenting as a small, tender pimple with a red base.
A more severe, deeper infection of the entire hair follicle and surrounding tissue leads to a nasal boil, also known as a furuncle. These boils are larger, much more painful, and represent a localized abscess containing pus. They typically appear suddenly with noticeable swelling, intense tenderness, and may eventually come to a visible white or yellow head. The acute onset and pronounced pain of these infections distinguish them from other, slower-growing nasal lumps.
Avoid squeezing or popping any boil or pimple inside the nose. The veins in this region of the face drain toward the brain, specifically to the cavernous sinus. Manipulating an infected bump can push bacteria into this venous system, potentially leading to a rare but life-threatening complication called cavernous sinus thrombosis. Infections in this location require serious caution.
Chronic Inflammatory Growths: Nasal Polyps
Nasal polyps are a distinctly different type of bump, arising from long-standing irritation and inflammation of the nasal lining rather than acute infection. These growths are soft, non-cancerous, and painless to the touch, contrasting sharply with the acute pain of a boil. Polyps form when the mucous membrane becomes severely swollen and fluid-filled, eventually resembling a peeled grape.
They commonly develop in individuals with chronic rhinosinusitis, asthma, or severe allergies, suggesting a link to an overactive inflammatory response. Unlike a boil, which is highly localized, polyps often occur in clusters and may block the nasal passages or the openings of the sinuses. The symptoms they cause are related to obstruction and inflammation, including persistent nasal congestion, a reduced or complete loss of the sense of smell, and post-nasal drip.
Because they are soft and pale, polyps are often unnoticed until they grow large enough to interfere with breathing or drainage. Their development is a slow, chronic process, usually taking months or years, and they can affect both sides of the nose. The absence of acute pain, along with the presence of chronic respiratory symptoms, helps differentiate a polyp from an infectious cause.
Trauma, Irritation, and Cysts
Bumps can result from mechanical injury, such as chronic nose picking (digital trauma), which causes direct injury to the delicate nasal lining. This trauma can lead to localized swelling, scabs, or small, firm areas of scar tissue. Persistent physical irritation can also cause nasal vestibulitis, a low-grade inflammation and infection at the nostril entrance characterized by persistent crusting, redness, and mild swelling.
Sometimes the bump is a cyst, which is a closed sac under the skin containing fluid or semi-solid material. A common example is an epidermoid or sebaceous cyst, which forms when surface skin cells or debris, such as keratin, get trapped beneath the skin. These cysts are usually firm, slow-growing, and often harmless, but they can become tender if they rupture or become infected.
A localized reaction to a foreign object is another potential cause, especially common in children. The immune response to an object lodged inside the nasal cavity triggers inflammation and swelling, creating a bump often accompanied by foul-smelling discharge. These structural causes are typically neither as acutely painful as a boil nor as diffuse as a polyp.
When to Seek Medical Attention
While many nasal bumps are temporary and benign, certain signs necessitate a consultation with a healthcare professional, such as a primary care physician or an otolaryngologist (ENT). Any bump that causes severe, rapidly worsening pain, or is accompanied by a high fever or chills, requires immediate attention, as these symptoms can indicate a spreading infection.
A bump that does not resolve or begin to shrink within seven to ten days should also be evaluated. Other red flags include lumps that cause recurrent or excessive bleeding, vision changes, swelling around the eyes, or a severe, persistent headache. These symptoms suggest the issue may be serious or potentially spreading beyond the nasal cavity. Any persistent or recurring bump warrants investigation to ensure an accurate diagnosis and timely treatment.