A blemish forming just under or inside the nose often causes a sharp, throbbing pain far exceeding a typical facial pimple. This small area, including the philtrum groove and the nasal vestibule, combines sensitive anatomy with constant physical movement. The intensity of the pain is a direct consequence of the body’s highly specialized sensory mapping in this central facial region. When inflammation occurs here, the pain receptors react with a heightened distress signal.
Why the Area Under the Nose is So Sensitive
The sensitivity of this facial region is rooted in its dense concentration of sensory nerves. The face receives sensation primarily from the trigeminal nerve, with the area around the nose and upper lip served by branches of its maxillary division. This nerve network is packed with receptors designed to detect even the slightest touch or pressure, necessary for functions like breathing and complex facial expression.
Inflammation from a pimple causes localized swelling. Because the skin around the nose is relatively thin and tethered to underlying structures, there is little room for this pressure to dissipate. The resulting expansion pushes directly against the high density of sensory nerve endings, which translates into a disproportionately intense throbbing sensation. Furthermore, the skin here is in perpetual motion from talking, eating, and the simple act of breathing. Every subtle movement tugs at the inflamed tissue, continuously irritating the compressed nerve endings and exacerbating the feeling of pain.
Specific Causes of Painful Blemishes
The most common and painful blemishes in this area are deep-seated infections that create significant internal pressure, rather than typical acne. One frequent cause is nasal vestibulitis, a bacterial infection of the hair follicles located in the nasal vestibule. This infection is often caused by Staphylococcus aureus bacteria, which enters through small breaks in the skin from activities like nose picking, excessive nose blowing, or plucking nasal hairs.
Nasal vestibulitis often presents as a painful boil or furuncle, which is a deep, pus-filled lump that rapidly inflames. The intense swelling pushes forcefully on the surrounding tissue and nerves, causing severe pain. Similarly, a deep, cystic acne lesion can form near the philtrum. These cysts are large, fluid-filled pockets of sebum, dead skin cells, and bacteria that develop far beneath the skin’s surface. The depth and size of these lesions create a significant mass effect, and the inflammatory swelling increases pressure against the sensitive facial structures.
Safe Treatment and When to See a Doctor
The most important rule for a painful blemish in this location is to avoid picking at or squeezing it. Squeezing can push the infection deeper into the tissue, worsening inflammation and increasing the risk of complications.
Focus on reducing the swelling and encouraging the natural healing process. Applying a clean, warm compress for 10 to 15 minutes, three to four times a day, can help soothe the pain and encourage safe drainage. Over-the-counter anti-inflammatory pain relievers, such as ibuprofen, can also reduce the internal swelling irritating the nerve endings. Keep the area gently clean, but avoid applying harsh topical acne treatments, like benzoyl peroxide or salicylic acid, inside the nasal opening, as this can cause severe irritation.
This central facial area is part of what is medically known as the “Danger Triangle of the Face,” spanning from the corners of the mouth to the bridge of the nose. This area has venous connections that drain toward the cavernous sinus at the base of the brain. While rare, an infection that is squeezed or severely irritated can potentially spread backward through these veins, leading to a life-threatening complication called Cavernous Sinus Thrombosis. Seek immediate medical attention if the pain rapidly worsens, or if you develop symptoms such as a fever, spreading redness and swelling around the eyes, confusion, or changes in vision.