Causes of hard and painful pimples include acne, folliculitis, eczema, etc. Treatment includes medication. 1. Acne: If acne is the cause of hard and painful pimples, then isotretinoin and fusidic acid can be given to treat the problem, and attention should be paid to maintaining a good daily routine and avoiding spicy and stimulating foods, etc. In severe cases, oral isotretinoin is needed. 2. Folliculitis: If it is bacterial folliculitis, then you can give clindamycin and other drugs to kill bacteria treatment, and pay attention to keep local clean. 3. Eczema: If you consider that eczema is the cause of the phenomenon of long hard and painful acne on the face, it may be the local bacterial infection, at this time you can give loratadine and other drugs antihistamine treatment at the same time, local smear fusidic acid, erythromycin and other anti-infective treatment, and oral clindamycin anti-infection if necessary. Finally, the phenomenon of long, hard and painful acne on the face, please consult a doctor in time, the above drugs must follow the doctor’s advice.