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How To Treat Nodule Acne

Nodular Acne And Cystic Acne: The Bottom Line

What Are Acne Nodules?

Nodular acne and cystic acne are the two most severe forms of acne. Breakouts often cover large areas of the face, back, shoulders and arms. The acne nodules and cysts can be very painful and can leave significant scarring. Because the nodules and cysts are below the skinâs surface, topical nodular acne and cystic acne treatments are often ineffective and a doctor or dermatologist should be consulted.

What Causes Cystic Acne

Pores in the skin can clog with excess oil and dead skin cells, causing pimples. Bacteria can enter the skin pores and get trapped along with the oil and skin cells. The skin reaction causes swelling deep in the skins middle layer . This infected, red, swollen lump is an acne cyst.

Cystic acne causes include:

  • Age .
  • Family history of cystic acne.
  • Hormone changes during the teenage years and sometimes during menopause, and stress.

How To Treat Nodular Acne

This article was medically reviewed by Sarah Gehrke, RN, MS. Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.There are 15 references cited in this article, which can be found at the bottom of the page. This article has been viewed 86,552 times.

Having nodular acne can be physically painful and cause you emotional distress.XTrustworthy SourcePubMed CentralJournal archive from the U.S. National Institutes of HealthGo to source Because nodular acne is so deep in the skin, it may require treatment by a dermatologist for 15-20 weeks. Using at home and over the counter treatments together with medication may help soothe your pimples and prevent further breakouts. You can treat nodular acne by getting a medical diagnosis and treatment, and boosting prescribed medications with over-the-counter remedies.

Also Check: How To Get Rid Of Deep Acne

Reducing Your Risk Of Nodular Acne

You cant completely prevent or avoid acne, including nodular acne. However, you may be able to control your acne triggers and breakouts by:

  • Avoiding abrasive or alcohol-based cleansers and greasy or oily skin products
  • Not touching your face or squeezing pimples, which can cause more irritation and worsen the problem. Picking at acne also increases the risk of scarring.

What Is A Good Treatment For Acne Papules

Causes of Nodular Acne and How to Treat It
  • What are Papules?

Papules are a type of acne with small solid, rounded bumps rising from the skin surface. They can either be brownish, purple, pink or red in color. Papules open easily on scratching making them prone to infection. In addition to that, they have different shapes and sometimes are associated with crusts or scales.

Papules can cause some chronic conditions like Lichen Planus, which is a skin disease that forms polygonal, purple papules. Papules are unique from other types of acne in that, they contain no pus. They occur after a break of follicular wall, which allows white blood cells to rush in, causing the pores to become inflamed.

Some papules are caused by infection of an STD while others are genetic. However, papules are not caused by dirty skin pores instead they are as a result of clogged pores. When the pores become clogged, they overproduce oil, which is located in the follicle glands. This oil production causes stickiness and trapping of bacteria and dead skin cells. In turn this causes the formation of papules or other types of acne.

Papules can either be treated through medicines or natural home remedies.

There are several medical treatments for papules:

  • Medical Prescription
  • Radio Surgery
  • Carbon Dioxide Laser Treatment
    • Electrodesiccation with curettage engages scrapping the papules under local anesthesia. Although this method is effective, it can result in scarring and the skin can also lose its elasticity after healing.

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    Reduce Stress For Nodular Acne

    Stress can be bad for your health and can sometimes result in acne. It can also slow down the healing time of your current acne, therefore it is advised to keep stress at bay if you have acne. Practice yoga, meditation and exercise regularly to release happy hormones in the body. Divert your mind by taking a relaxing bath, watching a funny movie or reading a book. Spending time in nature is also known to reduce stress levels.

    What Treatment Options Are Available

    OTC acne products usually dont work for nodular acne. Widely available OTC ingredients, such as salicylic acid and benzoyl peroxide, help shed excess sebum and dead skin cells at the surface only. This can help clear up a clogged pore at the skins surface, but it will do little good for nodules, which are deep underneath the skin.

    Talk to your healthcare provider about all of your treatment options. They might recommend one or more of the following.

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    What Is Nodulocystic Acne

    Nodulocystic acne or nodular acne is characterized by the presence of large and inflamed lesions and cysts. It can manifest itself as a small bump under the skin with the same tone and eventually turn red due to tissue inflammation around the area. The breakouts can also exhibit the presence of whiteheads and blackheads, but it should be noted that these growths penetrate deep into the layers of the skin, making them painful and extremely prone to scarring. If left unchecked, the acne could spread at an alarming rate causing more damage to the affected skin.

    Due to the contamination by bacteria, when nodule acne starts to develop, the follicle structure deteriorates. This causes a chain reaction of the surrounding follicles being infected with debris. The result is a rather painful swelling due to the substructures being damaged. There is also a pus formation. However, due to the depth at which these nodules develop, whiteheads may not be visible on the surface.

    Areas that are usually affected by nodule pimple are the face, neck, back, chest, and shoulders and can vary in the number of breakouts.

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    What Is The Treatment For Nodulocystic Acne

    How to treat painful nodular acne || Steroid injection for cystic acne

    Topical treatment is usually ineffective for nodulocystic acne.

    The recommended treatment is oral isotretinoin which should be commenced early to prevent scarring. Treatment is required for at least five months, and further courses are sometimes necessary. Intralesional steroids following cyst drainage, can be used for individual persistent or large inflammatory nodules or cysts.

    Patients with acne conglobata often need additional treatments, such as:

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    Treatment Options For Acne Nodules

    You should never try to pop an acne nodule because they are fibrous lesions that do not contain pus. No matter how hard a nodule is squeezed, nothing will be expelled. Attempting to pop one will cause more harm to the skin by damaging it further, increasing the risk of infection, likely worsening the nodule, and increasing the risk of scarring.

    Instead, acne nodules should be treated with one of the following therapies:8

    Intralesional shots

    The injection of steroids directly into the acne nodule almost immediately reduces inflammation and helps to heal the lesion and prevent scarring. These shots are effective at clearing one nodule or a few nodules, but are not a feasible treatment option for people with numerous and widespread nodules.

    Benzoyl peroxide

    To prevent future nodules, treating the skin gently and applying benzoyl peroxide correctly can halt the development of any type of acne lesion, including nodules


    Isotretinoin is an oral medication that is approved only for the treatment of severe acne. It is powerful and effective, but it permanently and irreversibly changes the entire body, including the skin, and comes with many side effects, some of which can be lifelong. When nodules and/or cysts are numerous, severe, widespread, and deeply scarring, doctors sometimes advise its use.

    Caution! Isotretinoin causes dramatic birth defects or fetal death if taken by pregnant women.

    Oral antibiotics


    Hormonal treatments

    Pharmacy First Scotland: Acne Treatment From Your Pharmacy

    Acne isn’t usually serious and can be treated by a pharmacist. If your acne is severe or appears on your chest and back, it may need to be treated with antibiotics or stronger creams that are only available on prescription. Your pharmacist can advise on whether you need to see your GP for further treatment.

    If you develop nodules or cysts, they need to be treated properly through your GP to avoid scarring. Try to resist the temptation to pick or squeeze the spots, as this can lead to permanent scarring.

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    Oral Contraceptive For Nodular Acne

    Hormonal disruption in the body can cause the skin to produce excess sebum, which leads to breakouts and acne. Apart from using skincare products that will remove excess oil from the face, your dermatologist may also prescribe oral contraceptive pills to control sebum production. An increase in androgen levels are linked to nodular acne. However, do not self-medicate and pick just about any contraceptive pill because theyre not all formulated the same. Visit a gynaecologist and dermatologist who will prescribe the right one to balance the hormonal disruption in your body. Once it regulates hormonal production, your acne should subside.

    How To Treat Different Types Of Acne

    What Is an Acne Nodule?

    To see clearer skin, it helps to know what types of blemishes you’re dealing with. Each type requires different treatment.

    Whats that blemish?

    Is that a blackhead, papule, or something else? See what the different acne blemishes looks like and how to treat them.

    Blackheads and whiteheads

    These appear when pores become clogged with excess oil, bacteria, and dead skin cells. If the pore closes up, youll see a tiny bump that looks white or flesh colored. These are whiteheads.

    Blackheads and pimples

    If the pore fills with debris but stays open, youll see a blackhead. The black dots arent dirt, so resist scrubbing. It will only worsen your acne.

    Treating whiteheads and blackheads

    To unclog pores, dermatologists recommend using a retinoid. You can buy one retinoid, adapalene, without a prescription. Youll also want to use a benzoyl peroxide wash. It can help get rid of the excess P. acnes bacteria on your skin.

    Stubborn whiteheads and blackheads

    Give treatment six to eight weeks to work. If you still see blemishes, you may want to see a dermatologist. A procedure like comedo extraction may help. Prescription-strength acne treatment is another option.

    Early pimples

    When excess oil, bacteria, and dead skin cells push deeper into the skin and cause inflammation , youll see small, red bumps. The medical word for this type of acne blemish is a papule. They feel hard. If you have a lot of papules, the area may feel like sandpaper.

    Treating papules

    Pus-filled pimples

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    What Are The Other Forms Of Acne Nodules Treatment

    • Laser Therapy

    Laser treatment is another viable option for acne nodules. The laser has the potential to destroy bacteria P. Acnes that causes infection and inflammation in the skin pores. Another important benefit of laser therapy is its ability to remove acne scarring that often accompanies with acne nodules. The treatment using laser has come a long way since its first use for acne nodule treatment. The use of laser has been extended from not only fair skinned people, but also to people of different shades from light to dark.

    • Surgical Treatments for Nodular Acne

    Other methods that are available for the treatment of acne nodules includes injecting cortisone drug directly in to the affected areas. This will certainly help in reducing swelling and the pain associated with acne nodules. Another treatment possibility is surgical excision, where the solidified sebum or offending tissue is cut from under the skin. This procedure is usually done by a surgeon.

    Therapy for acne nodules may also involve a multi-pronged approach, which employs various treatment options and supplementing it with a cleansing routine. It is always essential that a patient who is undergoing treatment for acne nodules should follow doctors recommendation to attain good result.

    How Is Cystic Acne Managed Or Treated

    Acne cysts can be difficult to treat. Because they can scar, you should seek help from a dermatologist instead of trying over-the-counter acne products. A dermatologist can teach you how to treat cystic acne.

    It can take three months or more to clear up acne cysts. Treatment often involves taking oral antibiotics and applying prescription-strength topical gels or creams to the skin.

    Cystic acne treatments include:

    • Antibiotic creams, gels solutions and lotions to kill bacteria and decrease inflammation.
    • Azelaic acid or salicylic acid to kill bacteria and get rid of excess dead skin cells.
    • Benzoyl peroxide to reduce the number of bacteria on the skin.
    • Retinoids , vitamin A derivatives that help slough dead skin cells.

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    What Are The Acne Pustules Treatments

    Treatment depends upon the severity of the condition. Mild cases may require just washing the face regularly with a gentle soap and application of topical products like ointments and creams containing Benzoyl Peroxide, Retinoids and Salicylic Acids.

    In combination with topical agents, sometimes oral antibiotics may also be given. Commonly used antibiotics for this condition are Doxycycline, Minocycline, Trimethoprim, Azithromycin or Erythromycin to control the bacteria. The effects of the treatment begin to be visible only after 6 weeks or so. Hence one has to be patient and regular with the treatment.

    If there is no visible improvement after 2 months of regular usage, then some other line of treatment may have to be explored. Apart from the medical treatment, there are a number of other alternatives in the market for treating acne pustules. One of the most popular products is a formula called Exposed which helps treat pustules and prevent more breakouts.

    If acne does not respond to topical and oral treatment, the doctor can resort to minor surgical procedures to treat pustules and reduce pain. Surgical drainage may be done to drain out the pus and reduce infection. Surgical extraction of lesions can also be done, but a high level of skill is required for this procedure. Other procedures to treat pustules include Chemical peeling. Glycolic acid is used to remove the upper layer of dead skin.

    Nodular Acne Vs Cystic Acne:

    Causes of Nodular Acne and How to Treat It

    The main difference between nodular and cystic acne is based on the following grounds:

    • First of all, like mentioned above cystic acne has pus. It also has opening that flushes out water or pus. On the other hand, nodule acne is bigger and without any pus.
    • Nodular vs cystic acne also lies on the ground reality that nodular acne appears in patches and spreads in clusters. However, cystic acne doesnt come in the patches cystic acne spreads in collections.
    • More about these two kinds of acne, nodular one is harder and more painful as compared to cystic acne. We can say that because cystic acne is softer than nodular acne.

    These are the main differences between nodular and cystic acne. Other differences may include itchiness, soreness, redness, solid form in both nodular and cystic acne.

    Section 2: Treatment

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    How Acne Is Diagnosed

    A dermatologist will require information pertaining to how long the breakout has been present, the level of sensitivity of the acne , and what methods have been attempted, if any, to treat the same. Questions pertaining to change in medications and family history may also be asked to help isolate the cause.

    Are Nodular Acne And Cystic Acne The Same

    Nodular acne and cystic acne are two of the most severe forms of acne and look alike on the surface of the skin. However, one major difference between these two types of acne is that nodular acne does not have a head whereas cystic acne does.

    Cystic acne is filled with pus and looks red and inflamed with a bump, it is softer to touch as compared to nodular acne.

    Nodular acne looks like bumps on the skin and feel like hard knots under the skin. The line of treatment for both these acne types is usually the same.

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    Key Points About Acne

    • Acne is a disorder of the hair follicles and sebaceous glands that become clogged. This leads to pimples and cysts.

    • Acne is a common condition that usually begins during puberty because of hormonal changes.

    • Acne can be either superficial or deep.

    • If untreated, acne can cause scaring that can last a lifetime.

    • Avoiding substances that make acne worse, and early treatment of acne, can reduce or prevent acne scars.

    How Can I Prevent Cystic Acne

    How to Treat Nodular Acne: 13 Steps (with Pictures)

    You can lower your risk of getting acne by taking these steps:

    • Use a mild foaming facial cleanser, lukewarm water and your fingers to wash your face after you wake up, before going to bed and after exercising or sweating.
    • Apply oil-free moisturizer if you feel dry.
    • Use noncomedogenic makeup and facial products.
    • Dont sleep in makeup.
    • Keep your hands away from your face during the day.
    • Dont pick at or pop pimples or scabs.
    • Wash your hair regularly and keep hair away from your face.
    • Occasionally oily environments, such as working at a fast food restaurant, can contribute to acne flares.
    • Diets high in simple sugars and dairy, also called a high glycemic index diet, may contribute to flares as well.

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    How Is Nodular Acne Treated

    The good news is that dermatologists know that when they see nodular acne, oral medication is required. Rabach notes: It is a little more involved because it requires oral medication. Its definitely a type of acne where it’s better to see a dermatologist than take a DIY approach. I like to think of it this way: Topical medication can permeate the epidermis only so far. Nodular acne hides beneath where a cream can get. You need oral medication, and thankfully we have medication that works! If you suspect you might have nodular acne, make an appointment with a board-certified dermatologist right awaythe faster you treat the nodules, the more likely you will be able to avoid dealing with scarring afterward.

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