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  5. How To Identify And Treat Nodular Acne?
The Investigator’s Static Global Assessment (ISGA) scale defines nodular acne as grade 4 or 5, which means it is one of the most severe and painful forms of acne, requiring intensive treatments. The ISGA scale is approved by the FDA for drug trials.

Nodular acne can be characterized by a hard, painful bump that appears on the surface of your skin. Unlike pimples, nodular acne bumps don’t have a head. The pus cannot be squeezed out.

In this article, we will help you understand why it occurs and the different kinds of treatments for it.

1. Where Does Nodular Acne Occur?

Nodular acne usually occurs on the face, neck, chest and back. It can last for months together.

2. What Causes Nodular Acne?

Just like a pimple, whitehead and blackhead, nodular acne occurs when a pore gets clogged by oil, dirt and P. acnes bacteria. This bacteria lives on the surface of our skin. At times, it may get trapped in between dirt and oil, resulting in acne breakouts.

One of the main characteristics of nodular acne is inflammation in the deeper layers of the skin. Squeezing or picking at the bump can worsen the symptoms of nodular acne.

3. How To Identify Nodular Acne?

  • Red, inflamed lesions on the surface of your skin.
  • No head.
  • Painful bumps on your face, chest, neck or back.
  • Usually big in size.

4. Oral Treatments For Nodular Acne

Nodular acne affects the deeper layers of your skin, making over-the-counter medication and creams almost ineffective in treating it. It requires a more intensive treatment as it does not affect the surface of your skin.

A. Isotretinoin

Isotretinoin is a Vitamin A derivative. It is usually prescribed to patients with severe cystic acne. Isotretinoin’s anti-inflammatory properties can make it effective in treating nodular acne and reducing inflammation (1).

Side-Effects Of Isotretinoin

  • Dryness (skin, lips, eyes and throat)
  • Hair loss/hair thinning
  • Headaches
  • Sun-sensitive skin
  • Body aches

B. Antibiotics

Antibiotics may prove to be effective in reducing the P. acnes bacteria, one of the main factors contributing to nodular acne (2). However, long-term use of antibiotics usually makes them ineffective. If you have very severe nodular acne, this may not be the right form of medication for you.

C. Birth Control Pills

Hormonal changes can contribute to an increase of oil production in your skin. Androgens are male hormones that are linked to sebum production. An increase in these hormones can result in clogged pores and nodular acne. Birth control pills help regulate hormone production (3).

5. Topical Medications To Treat Nodular Acne

Topical creams are directly applied onto the nodule. Unlike oral medicines, these are not to be consumed by you. Your dermatologist may prescribe:

A. Topical Antibiotics

These may help kill the bacteria residing deep inside your pores (4).

Side-Effects Of Topical Antibiotics

B. Benzoyl Peroxide

Your doctor may recommend prescription-strength benzoyl peroxide gel. These are usually more concentrated than the ones available at the drugstore.

Side Effects

  • Itchiness, tingling sensations
  • Skin dryness and peeling
  • Redness

C. Salicylic Acid

Your doctor may prescribe topical gels containing high concentrations of salicylic acid. These can be used to dry out the oil trapped under your skin.

Side Effects

  • Severe headache
  • Severe stomach pain
  • Difficulty in breathings
  • Tingling and dryness of skin

D. Topical Retinoids

These are Vitamin A derivatives. They help unclog pores and remove dirt, bacteria and oil.

Side Effects

  • Skin irritation
  • Sun-sensitivity
  • Dryness


strong If you experience any severe side effects like difficulty in breathing, headaches, stomach pains or sudden skin inflammation, discontinue the medication and visit your dermatologist.

6. Home Remedies To Treat Nodular Acne

In case you prefer giving natural reme dies a shot before you visit a dermatologist, here is a list of ingredients that may help reduce nodular acne symptoms.

A. Apple Cider Vinegar

Apple cider vinegar has antibacterial properties that can kill the P. acnes bacteria, responsible for nodular acne breakouts.

How To Use:

Dilute a few drops of apple cider vinegar in warm water and apply to the affected area of your skin.

B. Try Exercising Or Meditating

Woman doing exercise

Deep breathing, meditating and even exercising regularly can help reduce your stress levels. Studies suggest that stress can contribute to acne breakouts. Trying to divert your mind or reducing your stress levels can largely impact acne symptoms.

7. Is Nodular Acne The Same As Cystic Acne?

Nodular acne and cystic acne are severe forms of acne. They both are inflamed lesions that show up on the surface of the skin. However, nodular acne does not have a head, whereas cystic acne does.

Cystic acne is pus-filled and usually shows up as red bumps with a white head. They’re also usually softer than nodules because they are pus-filled.

Nodular acne, on the other hand, appears as bumps on the surface of your skin. These bumps are red, painful and harder as compared to cystic acne lesions.

The treatment options of nodular acne and cystic acne, however, are usually similar.

8. Does Nodular Acne Go Away Permanently?

Nodular acne can last for months. However, if treated properly, nodular acne symptoms can be reduced and treated permanently.

9. How Can You Prevent Nodular Acne?

Keeping your skin clean and maintaining a skincare regimen is vital to reduce or prevent nodular acne breakouts.

  • Wash your face two times a day with lukewarm water.
  • Wash your face post work-out, incase you exercise regularly.
  • Moisturize your face as soon as you are out of the shower and once before you sleep.
  • Take off your makeup before you go to bed.
  • Avoid touching your face constantly.
  • Wash your hands before applying makeup.
  • Apply sunscreen everyday.

Begin By Knowing Your Skin

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