Acne Nodules

All acne begins with a trapped pore. Oil (sebum) mixes with dead skin cells, clogging your pores. This combination often causes blackheads and whiteheads to form.

Although it’s normal to have this type of bacteria on your skin, it can turn into an infection when it gets trapped in your pores alongside sebum and dead skin cells. The resulting infection can go deep underneath your skin, causing the affected pores to become red and swollen.

Because it causes issues deep within the skin, nodular acne is considered a more severe form of acne. Unlike other types of acne, such as blackheads, acne nodules can’t be cleared up with over-the-counter (OTC) products alone.

Severe Nodular Acne

An acne nodule looks like a small bump under your skin. It may be skin toned, but it can also turn red as the surrounding area gets more inflamed. It doesn’t have a “head” like a less severe pimple might. Nodular acne is also painful to the touch.

Nodular acne and cystic acne are two of the most severe forms of acne. They’re sometimes confused with one another because they both form deep underneath the surface of the skin:

OTC acne products usually don’t 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 skin’s surface, but it will do little good for nodules, which are deep underneath the skin.

Cystic Acne On The Body

Prescription, rather than OTC, topicals are applied directly to the acne nodule. These are the preferred first steps for nodular acne, especially if you’re trying to treat more-isolated cases where you only have one or two nodules at a time.

Bacteria on your skin. You might notice that acne nodules keep coming back after treatment, or the nodules might be widespread all over your body.

In such cases, your healthcare provider may recommend an oral antibiotic to help clear up excess bacteria. This is done so that the bacteria doesn’t get trapped under your pores and lead to nodular acne. Antibiotics can also reduce the painful inflammation associated with this type of acne.

Acne] What To Do About These Huge Under The Skin Bumps (cyst? Nodule?) How Can I Bring Them To A Head? I Have Some Tretinoin Cream, Would Using Them Help? I Also

The problem with oral antibiotics is that you should only take them for a short period of time — usually 7 to 10 days at a time so that your body doesn’t become resistant to bacteria — but can be continued for several months if necessary.

With this in mind, your healthcare provider may recommend other types of medications that may be taken on a long-term basis. For women, birth control pills can help control the hormonal fluctuations that sometimes cause acne.

Another option is isotretinoin (commonly known by the brand name, Accutane, although that brand is no longer on the market). This is also made from vitamin A, but it’s much more powerful than retinoids. This is a daily medication that can be used to treat all types of acne—including nodules. However, it can take months for the medication to take full effect.

Types Of Acne You Should Know About

If you’re pregnant or plan to become pregnant, your healthcare provider may recommend prescription-strength benzoyl peroxide — isotretinoin (Accutane) and some types of antibiotics cannot be taken during this time.

Nodular acne can scar for two reasons. First, a failure to treat the nodule can lead to further inflammation, which can damage surrounding skin cells. Once you do finally seek treatment, the inflamed skin can turn into a dark spot.

According to the American Academy of Dermatology, dark spots may take several months (even years) to clear up. They may even turn into permanent scars.

Nodular Acne: Causes, Treatment, Home Remedies And Prevention

More significant scarring can develop if you pick or try to pop nodular acne. You’ll also likely be left with a scab and an enlarged pore.

The best way to prevent scars from nodular acne is to treat it promptly while also resisting the urge to pop it. If you end up with acne scars post-treatment, consider getting a prescription with hydroquinone to reduce inflammation and darkened skin. Hydroquinone is only available as a prescription through your doctor. Previously it had been available OTC, but the status was changed in 2021 following a ruling by the FDA

Nodular acne can be difficult to get rid of, but it’s certainly not impossible. Good skin care habits coupled with resisting the urge to pop acne nodules is a start. Your dermatologist can offer further advice for acne nodules and their treatment.

Closeup Skin Problems, Nodular Cystic Acne Skin Stock Photo

As a bonus, your dermatologist is also a great resource for addressing acne scars. If OTC products don’t do the trick, they might recommend in-house procedures, such as professional dermabrasion treatments or laser therapy.

It’s especially important to see your dermatologist if you have recurring cases of nodular acne. You might need more preventive treatment measures to help keep the nodules from coming back.

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How To Identify And Treat Nodular Acne?

Most everyone has experienced an acne breakout from time to time. After all, pimples of all kinds are a very common skin condition. But some types of acne are more stubborn and painful than your typical blackhead, like nodular acne. We’re here to tell you everything you need to know about nodules and how to identify them, treat them, and help prevent them from occurring.

You might already know about the several types of acne (like whiteheads, blackheads, papules, and pustules), but what about nodules? Nodular acne causes large, hard blemishes to form deep below the skin’s surface. Unlike cystic acne, nodules don't contain pus, but they're often also painful to the touch.¹

Nodular acne can be painful and frustrating, so preventing it from happening in the first place can save you the headache of treating it. One of the best ways to prevent nodular acne is to dedicate yourself to a good skincare routine. Here are some tips to help you get started:

Nodular Acne: Causes, Symptoms, Treatment And More

Of all the different types of acne, nodules often prove to be one of the most stubborn. But fear not—science is on your side. Here are some ingredients found in many skincare products that can help reduce it:

And speaking of prescriptions, if over-the-counter topical treatments don’t seem to be effective in reducing acne lesions and helping you say goodbye to nodules, several prescription-only alternatives may help: 

A common concern with nodular acne is that it can cause scarring. Once acne scars appear, eliminating them altogether can be difficult, so it’s best to prevent them as best as possible. You can also help prevent scarring by:

Nodular Acne: Treatment And Home Remedies

Nodular acne is considered severe, so if you’re experiencing nodules, again, seeing a medical provider is probably the best course of action, especially if you’re experiencing symptoms such as these:

If you’re struggling with nodular acne, can help! ’s dermatologist-designed Custom Formula is made to match your skin’s unique needs—and your personalized formula can evolve as those needs change. You get a personal dermatology provider to check-in and help you along your skincare journey, plus delivery straight to your door. Sign up for a 30-day free trial for just $4.95 + tax* (to cover shipping and handling).

Nodular acne causes large, hard blemishes to form deep below the skin’s surface. Unlike cystic acne, nodules don't contain pus, but they're often also painful to the touch.

The Ultimate Guide To Adult Acne

4. Tanghetti, Emil A. The role of inflammation in the pathology of acne. The Journal of clinical and aesthetic dermatology. (September 2013).

7. Diane Thiboutot, et al. New insights into the management of acne: An update from the Global Alliance to Improve Outcomes in Acne Group. (2009, May 1).

11. Kawashima, M., et al. Clinical efficacy and safety of benzoyl peroxide for acne vulgaris: Comparison between Japanese and Western patients. The Journal of dermatology.(November 2017).

Acne Nodules And Cysts. Courtesy Of Bethanee Schlosser, Md, Phd.

We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.

Our medical review process: We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.

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How To Treat Painful Nodular Acne

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