Painful acne is due to co-infection, and the presence of a bacterial or viral infection can lead to a painful rash. In case of painful facial acne, acne and folliculitis are considered to be more likely. It is necessary to avoid picking and squeezing to avoid spreading the infection. You can apply topical fusidic acid cream or Bactrim cream topically for anti-infection treatment, or you can give povidone iodine solution and apply it topically twice a day. If it is a cluster of blister-like pimples with pain, it may be due to viral infection of herpes zoster or herpes simplex, which can be treated with topical povidone-iodine solution or penciclovir gel. The lesions should not be exposed to water to avoid infection. The lesions need to be careful not to pick and grab, squeeze, to avoid the spread of infection or aggravation.