Nodular acne forms when the skin pores are clogged with trapped dirt/impurities, sebum and bacteria. However, unlike regular pimples, nodular acne feels like a hard lump beneath the skin. You cannot pop it easily. Multiple factors can contribute to acne, and they include (2): Nodular acne is often confused with cystic acne, which also forms deep within the skin layers. However, both are different.
How Is It Different From Cystic Acne?
Unlike other acne, nodular acne may last for several weeks or months. It takes longer to heal and may cause scarring
Does Nodular Acne Cause Scarring?
Yes, nodular acne can cause scarring under two conditions:
If left untreated If you try to squeeze or pick it, causing further injury
Without appropriate management and care, this inflammation can turn into dark spots and blemishes that may not fade away easily. Therefore, it is important to get immediate treatment and never, ever try to squeeze or drain it.
Symptoms Of Nodular Acne
It appears mainly on the face, chest, and back. It looks like hard lesions and raised bumps and feels like knots under the skin. The raised bump may appear red or have the same color as your skin. It is painful to touch. The blemishes in nodular acne can be around half an inch in diameter. It may last from weeks to months.
Nodular acne is a severe form of acne and needs aggressive treatment. Oral and topical medications may not help in such cases. If you have nodular acne, consult a dermatologist immediately, who might recommend the below options.
Treatment Options For Nodular Acne
1. Oral Isotretinoin
Isotretinoin is a type of retinoid (vitamin A) and is the only medication with long-term benefits to reduce the severity of the condition. The recommended starting dose of isotretinoin is 0.5 mg/kg/day, which may gradually be increased, depending on many factors, including the dermatologist’s assessment, tolerability, and rate of improvement. Using isotretinoin may cause minor side effects like dryness, soreness of the skin, eyes, oral and nasal mucosa, pain, muscle aches, and impairment of night vision. However, these symptoms go away after treatment withdrawal or reducing the dosage (2), (7). Dermatologists prescribe the medicine, depending on the severity of the condition. It is not safe for pregnant women, and you should avoid it if you are planning to conceive.
2. Combination Therapy
This is beneficial for those who cannot take isotretinoin. Combination therapy of oral doxycycline (200 mg) and topical adapalene (0.1%), and benzoyl peroxide (2.5%) gel can also reduce the severity of nodules, papules, and pustules and total lesions in 20 weeks (8). While this treatment may not give the same results as oral isotretinoin, it can show similar benefits in reducing inflammation.
3. Laser Treatment
Using 585-nm pulse dye laser, 1320-nm Nd: YAG laser, and 1450-nm diode laser has shown clinical improvement in severe acne and scarring. They may lead to a long-term reduction in inflammatory acne and reduce acne scars (9).
4. Other Treatment Options
Depending on the severity of your condition, the doctor may also prescribe antibiotics, oral contraceptive pills (only in case of hormonal issues), and topical treatments like prescription-strength retinoids and salicylic acid. Taking care of your skin is equally important to prevent the discomfort caused by nodular acne. Although home remedies do not work on nodular acne, they can help minimize the discomfort. However, do a patch test before trying any of them, and if you experience any discomfort or irritation, discontinue using it.
Home Remedies To Soothe Nodular Acne
1. Apple Cider Vinegar
Apple cider vinegar is said to maintain the skin pH and keep it comfortable. You can use diluted ACV spray to soothe the acne lesions. Directions:
2. Tea Tree Oil
Topical 5% tea tree oil may be effective in treating mild to moderate acne (10). Directions Also, follow a good skin care regimen. Use prescribed cleansers and skin care products to care for your skin and soothe the inflammation.
Nodular Acne Prevention Tips
Wash your skin with a mild cleanser and lukewarm water twice a day. After exercising, wash your skin to get rid of excess oil or dirt buildup that may clog your pores and worsen your condition. Avoid touching your face frequently to prevent transferring dirt and bacteria from your fingers to your facial skin. Avoid using makeup products on your skin. If you can’t do without makeup, use non-comedogenic products and remove them with a makeup remover as soon as possible. Use a lightweight, good-quality moisturizer to keep your skin hydrated. Do not skip sunscreen ever. Reapply every 4-6 hours. Make sure it has at least SPF 30 to protect your skin from sun damage. Avoid using physical scrubs. You can talk to your doctor and use products with low concentrations of AHA and BHA for exfoliation. Avoid squeezing and scratching the nodules. This may cause blemishes and scarring. Follow a proper sleep schedule. The quantity and quality of sleep matter for healthy glowing skin. Keep up with your mental health. Avoid stress and practice meditation to fight anxiety and depression. Talk to a therapist if required.
Most importantly, avoid using any product or ingredient on your skin without consulting your doctor. Experimenting with random DIYs that claim to clear nodular acne and using multiple products and skin hacks can worsen your condition. Does ice help nodular acne? Yes, a cold compress may help reduce the pain and inflammation associated with nodular acne. What foods cause nodular acne? No particular foods cause nodular acne. However, refined sugars and grains, dairy products, whey protein, and processed and greasy foods may trigger or worsen symptoms of acne. Does retinol help nodular acne? Yes, retinol may help treat nodular acne. However, it is recommended to consult a dermatologist before using over-the-counter drugs for treating nodular acne as it is a severe form of acne. Will zinc help nodular acne? Dietary or oral zinc supplementation may help treat nodular acne. However, avoid taking zinc supplements without consulting a dermatologist as zinc can be toxic in the wrong doses.
