Nodular Acne: Causes and Remedy

What Is Nodular Acne Feature Image

Nodular Acne: Causes and Remedy

What Is Nodular Acne Feature Image

Nodular acne is a severe form of pimple breakout that is often large, painful, and inflamed. The nodules are larger than the typical pimple and often affect the deeper layers of then skin. asas 

Unlike the common zits, nodular acne can last for weeks or months before clearing. Understand that it can lead to severe scarring, and should therefore be treated by a dermatologist. Here, find out the causes and the forms of treatment available.

What is Nodular Acne?

Like all other pimples, nodular acne occurs when the pores are blocked by dead skin cells and sebum. Most people experience a severe outbreak and blackheads. When the Propionibacterium Acne (P. acne) bacterium living on the skin gets trapped in the pores, an outbreak occurs. An infection that affects the deeper layers of the skin may develop. 

This infection is to blame for inflammation in the deep skin layers which then creates a hard pimple (nodule) underneath the skin. These nodules can occur individually or form a cluster. When squeezed, these hard pimples do not release any pus. Instead, they become more inflamed because of the introduction of bacteria from your hands.

The Symptoms

The appearance of hard lesion in and underneath the skin is the first sign of an existing nodule. Although they can affect any other part of the body, they are common on the face, the back, and the chest. They are described as hard painful knots beneath the skin. If not treated, nodular acne may lead to scarring.

Man troubled by acne on his face

The Causes of Nodular Acne

This form of breakout is mostly caused by an abnormal buildup of dead cells in the pores, an overgrowth of bacteria, resulting in acne, and overactive sebaceous glands. Androgen hormones [1] are the other notorious triggers. 

When the levels of androgen rise, oil production increases. It also tends to change the makeup of the skin’s sebum causing it to be thicker. This then creates the perfect environment for acne-causing bacteria to grow.

Although this is a common form of acne among people of all ages, it is mostly experienced by teenage boys and young adult men, often occurring around the face and the body. Adult women in the productive age also experience these breakpoints a week or two before their period. They are normally concentrated around the chin, the jawline, and the neck.

Nodular Acne Vs Cystic Acne

Nodules appear as small bumps under the skin. The nodule may have a similar color to your skin tone but then turn red as it gets more inflamed. Both cystic and nodular acne are severe and painful. Sometimes, it is hard to tell them apart because they form deeper under the layers of the skin.

Cystic acne appears as large boils on the surface of the skin. Like nodules, they also reside deep in the skin. However, since they contain pus, they are softer. Once the cystic acne bursts, an infection occurs. 

Cysts develop when blackhead or whitehead contents spill to the surrounding area of the skin. The body’s immune system on perceiving an attack tries to protect the skin by producing pus. Nodules remain intact and tend to harden into stubborn cysts.

What is the Best Form of Remedy?

Nodular and cystic acne are both very tough to treat. Over the counter treatments may not be effective in these types because they mostly target the production of excess sebum and dead skin cells on the surface of the skin. 

Nodular and cystic acne form in the deep layers of the skin, meaning a more intensive form of treatment will be required. In this case, you need prescription medication. For severe pimple outbreak, the following may be recommended:


Nodular acne is mostly caused by the overgrowth of P. Acne bacteria. Oral antibiotics may therefore be prescribed to prevent the bacteria from being trapped in the pores leading to a breakout. Antibiotics are also perfect for reducing pain and inflammation. Note; antibiotics can only be consumed for not more than 10 days; otherwise they would lead to more complications and ineffectiveness in acne.


Hormones can also be nodular acne culprits. Androgen is known to promote the production of oil on the skin leading to a higher risk of acne outbreak. If the breakout might have been triggered by hormonal changes, your doctor may recommend contraceptives


Isotretinoin is considered to be highly effective. It is likely that your doctor will recommend this treatment. Although it can be used to cure all other types of pimple breakouts, dermatologists only prescribe it for the more severe recalcitrant nodular and cystic acne because it has adverse effects. Upon using it, some of the side-effects you are likely to experience include:

  • Dryness in the lips, nose, skin, eyes, and throat
  • Sun sensitive skin
  • Nose bleeding
  • Pains
  • Headaches

If you are pregnant, let your dermatologist know or check out other milder and safer treatments that you can do. This is because this medication can harm a growing fetus and must not be consumed by pregnant women. 

Women Applying Cream On Face


Certain procedures may be carried out to get rid of the nodular acne. The procedures can help in the prevention of P. Acne growth and scars. They include:

  • Chemical peels
  • Blue light therapy
  • Injections
  • Removal through extraction
  • Laser therapy

Trying to pick or pop the pimples can lead to severe scarring, and an enlarged pore would be left behind. When not treated, the nodule may form a dark spot which could then develop into a permanent scar. You can prevent the formation of scars from nodules by seeking prompt treatment, such as microdermabrasion acne scars treatment.

Home Remedies

After a prescription from your doctor, you could include the following home remedies as a daily regimen for faster results.

Olive Oil: Olive oil can be used to cleanse the skin. It is believed to remove excess oils from the skin, a process that reduces breakouts. It prevents clogging due to its antioxidant properties.

Apple Cider Vinegar: This contains antibacterial properties known to target the acne-causing bacteria. Dilute this vinegar with warm water and apply it directly to the affected area.

Reduce Stress: Stress is a contributing factor to nodular acne. While it doesn’t directly result in acne, researchers say it triggers the production of the hormones cortisol and androgen, both of which can worsen an outbreak in people prone to pimples.

A lot of people suffering from inflammatory breakouts have papules which then become pustules when they are filled with pus [2]. The two are the common types of inflammatory acne. The other two types of severe breakouts include cysts and nodules, 2 conditions that create cystic and nodular acne.

Both acnes are severe and can cause permanent scarring. Because they form underneath the skin, topical treatments may be infective. It is crucial that you seek the intervention of a dermatologist before administering any medication. This is to prevent any possible scarring should you take the wrong medication.