Nodular acne is a severe type of inflammatory acne that causes large, painful pimples called nodular acne.1 Acne nodules are larger than regular pimples, and affect the deeper layers of the skin. This type of acne is also known as nodulocystic acne or cystic acne. Nodular pimples can appear on the face, back, and other areas of the body.
Nodular acne is a severe, deep form of acne where clogged pores develop into bumps that are completely under the skin. That is, the bumps are not in contact with the surface of the skin — so it is impossible to extract this type of pimple just like that. Usually a lump that the patient can feel, deep into the dermis and often painful (because that’s where nerves gather).
Nodular pimples can appear the same color as the skin, but are more often red and inflamed — as a result, your immune system tries to break down and absorb the dead skin, sebum, and other inflammatory cell debris that collects under the skin.
Nodular acne is a serious form of acne and can progress to a chronic condition. Unlike other forms of acne, the lesions are painful and affect deeper layers of skin. Therefore, nodular acne requires aggressive treatment and medication.
Over-the-counter acne medications do not usually work for nodular or cystic acne. Common acne spot treatments such as benzoyl peroxide and salicylic acid help wash away dead cells on the surface of the skin, but nodular acne occurs deep beneath the skin.
Below are some of the best dermatologist-recommended treatments for nodular acne:
Topical Medications
Although over-the-counter acne creams usually don’t work for nodular acne, prescription topical medications can. Topical retinoids like tretinoin are among the most common treatments for severe acne.
Available in several concentrations, the tretinoin cream and gel can be applied directly to the affected area. This medication helps increase the rate of skin cell turnover which helps your body shed dead cells and produce new skin faster.
In a 2015 study, people with facial acne who were prescribed tretinoin 0.025% and clindamycin 1% gel achieved a statistically significant reduction in the number of inflammatory acne lesions over a 12-week treatment period.
The thing to watch out for with this medication is that your acne may get worse before it gets better. It may take a few weeks to see the full benefit of this treatment. However, in general, tretinoin is considered safe and has been approved by the FDA for decades.
