Nodular Acne: Causes, Treatment, Home Remedies & More

Pimples and acne are known to pop up when you definitely don't want them. Mostly, these pimples go away on their own. However, not all acne is the same. Some varieties of acne, such as nodular acne, blackheads, pustules, etc., can be a little difficult to deal with and painful. One such painful form is nodular acne.

Let us read about what it is, its causes, treatment and more.

What is Nodular Acne?

A nodule pimple or acne is a very severe form of acne. There is a development of tough nodules, which are lumps or knots that appear deep under the skin. These nodules have origins below the surface of the skin and manifest as red pimples on the surface. In most cases, there is neither a whitehead nor a blackhead at the core of these lumps.

The nodules have the potential to persist for several weeks or even months. According to studies, these nodules cause infection and inflammation. They act as a repository for a bacteria known as Cutibacterium acnes (C. acnes), which becomes trapped under your skin.

How to Identify Nodular Acne?

Acne nodules have the appearance of a tiny lump underneath the skin. It may have the colour of the skin, but it also has the potential to turn red if the area around it becomes more inflamed. People with nodular acne feel pain when it is touched. Some points of identification of nodular acne are:

Lesions on the skin’s surface are red and irritated.
There is no head.
Bumps on your face, neck, or back that are excruciatingly painful.
Generally of a large size.

Nodular Acne Causes

Anyone can be infected with nodular acne. Going by the studies, some possible nodular acne causes can be:

1. Genetics

It would appear that there is a hereditary component in developing nodular acne. If one of your parents or siblings has nodular acne, you have an increased risk of developing the condition. However, even if there is no history of acne in your family, it is still possible to get this type of acne.

2. Age and Lifestyle

Nodular acne is more prevalent in adults between 12 and 30. A nodular acne is a form of acne that affects the face and body and can also appear on the jawline, chin, and neck. In most cases, this grows significantly worse immediately before a period.

3. Some Other Causes

Clogging of sebaceous glands. The sebaceous glands secrete oils (sebum) to keep the skin moist, and when the glands get clogged, it can lead to pimples and cysts.
An overproduction of anaerobic bacterium Propionibacterium acnes. These are microorganisms that cause acne. P. acnes releases lipase that produces fatty acids by digesting sebum, causing inflammation of the skin.
Presence of excessive androgen. An increase in androgen hormones might result in a greater quantity of skin oil that is also thicker and become the cause of acne. Androgens stimulate the sebaceous glands to generate more sebum or skin oil. This extra sebum plugs pores and provides food for bacteria that cause acne. Your skin then hosts the ideal environment for acne to flourish.

Nodular Acne Treatment

Nodular acne, if left untreated, might cause irreversible scarring. Early treatment after an injury might reduce scarring. Nodular acne is difficult to treat with most over-the-counter products. Discuss therapeutic choices with your primary care doctor. They may suggest the below-mentioned nodular acne treatment methods —

1. Topical Acne Medication

Prescription topicals are preferred for treating acne nodules. These are the first measures for treating nodular acne, especially if you only have one or two nodules. More than two nodules may require different treatments. Your doctor may recommend:

Antibiotics assist in killing the germs that have become lodged in your pores.
Benzoyl peroxide comes with a doctor's prescription, as it is significantly more potent than the kinds sold in stores.
Salicylic acid of a prescription strength to remove dead skin cells and oil that have become trapped in the nodule.
Retinoids are highly effective vitamin A compounds to free hair follicles that have become blocked.

2. Oral Antibiotics

If you have broad nodular acne, you may have too many P. acne bacteria. Acne nodules may reappear after treatment or be widespread.

Your doctor may prescribe an oral antibiotic to remove excess bacteria. This prevents bacteria from getting under your pores and causing nodular acne. Antibiotics reduce the severe inflammation that commonly presents with cystic acne.

3. Different Pharmaceuticals

Oral antibiotics should only be taken for a short time, usually seven to ten days, to prevent bacterial resistance, but they can be taken for months if needed. Oral antibiotics can cause bacterial resistance.

Keeping this in mind, your doctor may consider trying different groups of continuous-use medicines. Birth control pills can help women regulate hormonal changes that cause acne.

Another option is isotretinoin (commonly known by the brand name Accutane, although that brand is no longer on the market). This vitamin A product is stronger than retinoids. It is a once-a-day therapy for all forms of acne, including nodules. The drug may not work for months.

If you are pregnant or trying to conceive, your doctor may prescribe benzoyl peroxide. Isotretinoin (Accutane) and certain antibiotics are contraindicated during pregnancy.

4. Procedures in the Office

Office therapies (improving and potentially curing acne with SmoothBeam Laser, putting the acne in remission painlessly with Isolaz treatments, and treating acne scarring with Fraxel Laser, VBeam Laser and Bellafill) may be beneficial when combined with prescription drugs.

These approaches can minimise bacteria, inflammation, and scarring. Treatment for acne involves

Drainage and extraction
Chemical peels
Laser
Blue light
Medicine administered via injection

Nodular Acne Home Remedies

1. Apple Cider Vinegar

Apple cider vinegar is an antimicrobial home treatment. Apple cider vinegar may help treat acne-prone skin. Apply diluted apple cider vinegar to the affected skin.

2. Olive Oil

Olive oil is recommended for acne-prone skin. A study discovered that olive oil on the skin had antioxidant effects. Olive oil helps lift excess oil from the skin's pores. This reduces clogging and outbreaks.

3. Stress-reduction

Stress hormones can cause acne. Meditation, yoga, and mindfulness may minimise breakouts. These practices alleviate stress and boost health.

How to Prevent Nodular Acne

You may be unable to stop nodular acne from occurring. The risk of having it might be reduced if you practice proper hygiene. It's in your best interest to:

1. Keep your Face and Body Clean

A mild cleanser is recommended in the morning, evening, and after working up a sweat.

2. Invest in High-Quality Products

Avoid products that clog your pores, such as cosmetics and lotions. Non-comedogenic skin care products should be sought out.

What are the Risk Factors for Nodular Acne?

Acne nodules can be caused by a number of different things. A breakout can be exacerbated or triggered by a variety of causes. Acne and severe acne aren't the same for everyone, even if they have risk factors. Risks and triggers include the following:

Diet: Diets rich in carbs or high glycemic index have been linked to acne outbreaks in some studies.
The Skin's Microbiome: Cleansers, cosmetics, lotions, and other skin care items that are too oily or too greasy might clog your pores. An additional risk factor is skin surface irritation due to friction or pressure from wearing too-tight clothing.

Will Scarring Develop?

First, not treating the nodule might cause more inflammation and skin cell damage. Inflamed skin can turn black after therapy. Dark spots may take months (or years) to clear, according to a study by the AAD (American Association of Dermatology). Scars may also form.

Picking nodular acne can cause scarring. You will also have a scab and an enlarged pore. You can avoid nodular acne scars by treating them quickly and avoiding popping them. Hydroquinone can reduce inflammation and lighten darkened skin from acne scars. Doctors prescribe hydroquinone.

Coping With Nodular Acne

Swollen nodules are painful. The following tips won't cure your acne, but they can help soothe your skin more while it heals:

Don't pick, squeeze, or pop pimples. It can harm the skin and worsen acne.
Ice wrapped in a soft rag can soothe a sore lesion. This reduces pain and inflammation.
Getting cortisone injections can help to an extent. They treat major lesions but not outbreaks.

Skin Care Tips

According to a study, a person should observe the following skin care practices:

Wash your face twice a day with a face wash. It helps to open the pores.
Take a shower after a workout. This helps to clean your skin and free you from sweat.
Remove your makeup before going to bed. It can cause extensive damage to your skin during the night.
Use a light moisturiser instead of a heavy one. It can worsen dry skin.
Prevent face-touching. Touching your face can also clog your pores, leading to an eruption of acne.

xmlNodular Vs Cystic Acne

Nodular and cystic acne are severe types. Both originate deep under the skin, and they are often confused.

Cystic acne appears as big, red boils. Like nodules, cysts are deep in the skin. Pus-filled cysts are softer than nodules. Cystic acne or pimples break, causing infection. Blackheads and whiteheads “spill” onto surrounding skin, causing acne cysts. In response to an attack, the body produces pus.
Acne nodules remain deep under the skin. Skin-toned nodular acne is possible. Nodules that last weeks or months might solidify into profound cysts.

Summing Up on Nodular Acne

Nodular acne or nodule pimple is one of the painful pimples you might experience on your skin. Some people also get nodular acne on buttocks, the neck, and areas other than the face. As these are painful, you will want to get rid of them.

The less severe acne goes away on its own or through the home remedies discussed above. Depending on the severity of acne, you may choose to visit a pharmacist or a dermatologist.

FAQs

Does Nodular Acne Go Away?

Yes, nodular acne does go away. You can treat it with home remedies or visit a skin care specialist if needed. No matter how severe the condition is, it does get better.

What Can I Expect if I Have Nodular Acne?

You will experience painful outbursts on the skin without any heads to pop them out. Untreated acne nodules might result in significant scarring. The skin gets inflamed and reddens.

When Should I See My Healthcare Provider About Nodular Acne?

You may visit your doctor about nodular acne when the pain is intolerable or the growth is visible and not stopping. Also, when all other OTC options and home remedies fail to heal or treat the acne, a specialist will be able to provide you with a personalised treatment plan as per your condition.

References

Acne - https://www.aad.org/public/diseases/acne/skin-care/tips

J. Tan, June 2014; A treatment for severe nodular acne: a randomized investigator-blinded, controlled, noninferiority trial comparing fixed-dose adapalene/benzoyl peroxide plus doxycycline vs. oral isotretinoin - https://onlinelibrary.wiley.com/doi/abs/10.1111/bjd.13191

Joshua A. Zeichner, January 2016; Inflammatory Acne Treatment: Review of Current and New Topical Therapeutic Options - https://jddonline.com/articles/inflammatory-acne-treatment-review-of-current-and-new-topical-therapeutic-options-S1545961616S0011X/

Emil A. Tanghetti, September 2013; The Role of Inflammation in the Pathology of Acne - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780801/

Michael H Gold, March 2009; Clinical Efficacy of Self-applied Blue Light Therapy for Mild-to-Moderate Facial Acne - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923954/