A raised hard bag with a black spot in the center on the back is usually caused by sebaceous cysts, acne, etc., and needs to be treated with medication, surgery, and physical therapy. 1. Sebaceous cysts: Patients with sebaceous cysts on the back will have a medium hard cyst with a black pinpoint-sized depression in the middle of the cyst. For patients with sebaceous cysts combined with infection, antibiotics such as cefixime, cefuroxime or topical erythromycin can be used as prescribed by the doctor. If the sebaceous cyst inflammation is eliminated, the cyst can be surgically removed according to the situation. 2. Acne: Acne on the back will appear as conical elevated pimples with dotted black tips. Patients with acne can apply retinoic acid ointment, such as tazarotene gel, adapalene gel, etc. under the guidance of a doctor. If the acne becomes locally infected, antibiotic ointments such as erythromycin ointment and fusidic acid ointment will need to be applied as directed by the doctor. Needle clearing treatment can be carried out if necessary. It is recommended that patients with the symptoms of a raised hard bag with a black spot in the center of the back need to consult a doctor in a timely manner, and the doctor will choose the appropriate measures according to the cause of the treatment.