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Q. What is the treatment for the fistulous tract in my face that gets reactivated now and then?

Answered by
Dr. Shyam Kalyan. N
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 25, 2021

Hi doctor,

I am a 31-year-old male. I have facial swelling caused by an allergic reaction to Propranolol. One side of my face has been swollen for many months now, and it seems permanent. I have an abscess that used to drain at the start but not anymore. Occasionally it will be mildly inflamed, and will temporarily heal again with no clear sign of reduced swelling. In ultrasound, it was found that there was cystic fluid build-up at the site. Is this curable? Kindly help.

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Hi,

Welcome to icliniq.com.

Thanks for writing in, and I understand your concern.

For a better assessment of the condition, kindly send a picture of the affected area of the face. Do you have any pain in that area?

Hi doctor,

The lower left side of the mandible is the swollen portion. There is no pain, but the swelling will itch when inflamed.

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Hi,

Welcome back to icliniq.com.

I had gone through the photographs attached (attachments removed to protect the patient's identity). The left side of your face, most likely the area over the angle of the left mandible, does appear slightly swollen compared to the right. I hope the appearance of inflammation is intermittent. Kindly confirm. When it gets inflamed, do you have any altered taste sensation? Is there any collection of pus or liquid in it? Does it turn red? Do you suffer from acne? Kindly reply.

Hi doctor,

The appearance of abscess is intermittent, but the general swollen appearance does not change. The area of the former abscess turns to an itchy bump at times; otherwise, it will subside. There is no altered taste sensation. The occasional bump may have a collection of pus. Earlier it used to leak, but not anymore. It has never appeared red. I suffer from ingrown hairs that regularly cause acne. I have attached the picture of acne.

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Hi,

Welcome back to icliniq.com.

I had gone through the photographs attached (attachments removed to protect the patient's identity). You seem to have two problems—first, the acne and ingrown hairs. I suggest getting a complete shave. Razor to be used in the proper direction and not the other way round. I also recommend applying Clindamycin skin cream and Niacinamide cream once daily at night for a couple of weeks. Clean shave every three or four days.

The second is the abscess issue. It appears that there is a fistulous tract that is getting reactivated now and then. After you do a clean shave, take a clear picture of the area and send it again. If such a tract is there, it might have to be surgically excised. Sometimes there might be an incompletely healed acne inside, which is periodically getting activated and discharges and then goes back to its dormant state. In such a case, when it is discharging, we will have to do hot fomentation and try to break it out and release all of its contents.


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