Causes of Nodular Acne and How to Treat It

Treating Acne Nodules Can Be a Slow Process

Table of Contents
View All
Table of Contents

An acne nodule is a severe type of inflammatory acne. Acne nodules are bigger than typical pimples and affect deeper layers of the skin. Nodular acne causes widespread, painful breakouts.

Nodular acne is also called nodulocystic acne or cystic acne. Acne nodules can appear on the face, back, and other areas of the body.

This article will cover what causes acne nodules, how this type of acne is diagnosed, and how to treat nodular acne.

Managing nodular acne

Verywell / JR Bee

What Do Acne Nodules Look and Feel Like?

Nodular acne looks and feels different from other forms of acne. You may get just a few breakouts of acne nodules, but they are often more widespread. Unlike typical small pimples, acne nodules can last for months.

Nodular acne can:

What Causes Acne Nodules?

Anyone can get nodular acne but there does seem to be a genetic component. If your parents or siblings had acne nodules, you're more likely to get them. That said, you can still get nodular acne even if no one else in your family has it.

Acne nodules are thought to be caused by several factors, including:

Nodular acne is more common in young, biologically male people. Teens and young adult males often get acne nodules on both their faces and bodies.

Adult females often get nodular acne on their jawline, chin, and neck. The acne nodules may get worse right before a person starts their menstrual period.

1:32

Click Play to Learn All About Nodule Pimples

This video has been medically reviewed by Casey Gallagher, MD.

Treating Acne Nodules

Acne nodules can be tough to treat. If you think you have nodular acne, seeing a dermatologist—a healthcare provider specially trained to treat skin, hair, and nails—can be helpful.

A dermatologist may offer you prescription acne medication for acne nodules because over-the-counter (OTC) acne treatments are not always effective at treating nodular acne.

Does Nodular Acne Scar?

Acne nodules can cause scarring. Nodular acne is so deep that you'll most likely need an oral acne medication as well as a topical acne treatment to control the breakouts. The sooner you can see a dermatologist and start treatment, the better.

If you have widespread nodular acne, your dermatologist might prescribe a synthetic type of Vitamin A called isotretinoin that you take as a pill. It is considered the best treatment for severe acne.

Your healthcare provider might want you to take oral antibiotics for a short time to help reduce the inflammation that acne nodules cause. Oral antibiotics may help your skin look and feel better while waiting for topical acne treatments to work.

If you can't take isotretinoin, your healthcare provider might want you to try a combination of topical acne treatments and antibiotics. For example, benzoyl peroxide might help acne nodules when it's used with certain oral antibiotics.

Oral contraceptives and/or a drug called spironolactone are nodular acne treatment options for people who menstruate. Both medications regulate hormones and help manage premenstrual acne nodule breakouts.

Coping With Acne Nodules

Swollen nodular acne breakouts can hurt a lot! Although the tips won't clear up your acne, they can help with your symptoms while you're waiting to be diagnosed or giving a treatment time to work.

  • Don't squeeze, pick, or try to pop acne nodulesIt's tempting, but trying to "pop" an acne nodule can damage your skin and worsen the breakouts.
  • Ease pain and inflammation. Applying ice wrapped in a soft cloth to a painful acne nodule a few times a day can help with the pain and swelling.
  • Ask about cortisone shots. Cortisone injections can be used to treat one painful acne nodule and may help it heal faster but they won't clear up nodular acne breakouts.

If having nodular acne is making you self-conscious, it's important to reach out for support. Your feelings are valid and completely normal, but tell your healthcare provider if you're having a hard time coping with the pain and stress of acne nodules.

Summary

Acne nodules are a severe kind of acne that hurts a lot and can cause scarring. Acne nodules tend to run in families, but anyone can get this kind of acne.

Several factors are thought to contribute to nodular acne, including overactive oil glands, an increase in androgen hormones, a buildup of dead skin cells, and high amounts of acne-related bacteria on the skin.

A dermatologist is the best healthcare provider to diagnose nodular acne and recommend treatment for acne nodules, including medication. While these options can be effective, they may take a few months to work.

At home, try not to pick at or pop acne nodules. Instead, use an ice pack wrapped in a cloth to help ease the pain of nodular acne while you're waiting for treatment to start helping your skin.

Frequently Asked Questions

  • Is an acne nodule a papule?

    Acne nodules and acne papules are similar, but a nodule is larger and deeper in the skin than a papule.

  • What is inside a pimple?

    A pimple has skin cells, bacteria, pus, and sebum in it. Sebum is an oily substance the sebaceous glands make to prevent the skin from getting too dry.

  • How do you shrink a cystic pimple?

    A corticosteroid injection (or a cortisone shot) is an anti-inflammatory steroid that can shrink large or painful acne lesions quickly. A healthcare provider can give it to reduce the size of a cystic pimple.

  • Can you get rid of cystic acne overnight?

    Unfortunately, cystic acne isn't likely to go away overnight. It may take at least three or four months of active treatment to see an improvement.

  • Is nodular acne the same as cystic acne?

    Acne cysts fill with pus, while acne nodules do not contain any fluid. As a result, nodules are harder and more solid than cysts.

  • Can you drain nodular acne?

    You can't really "pop" acne nodules like regular pimples because they are solid and not filled with fluid.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Newman MD, Bowe WP, Heughebaert C, Shalita AR. Therapeutic considerations for severe nodular acne. Am J Clin Dermatol. 2011;12(1):7-14. doi:10.2165/11532280-000000000-00000

  2. InformedHealth.org. Acne: overview.

  3. Kurokawa I, Nakase K. Recent advances in understanding and managing acneF1000Res. 2020;9:F1000 Faculty Rev-792. doi:10.12688/f1000research.25588.1

  4. Sutaria AH, Schlessinger J. Acne vulgaris. StatPearls Publishing.

  5. Leyden JJ, Del Rosso JQ. Oral antibiotic therapy for acne vulgaris: pharmacokinetic and pharmacodynamic perspectivesJ Clin Aesthet Dermatol. 2011;4(2):40–47.

  6. Tan J, Humphrey S, Vender R, et al. A treatment for severe nodular acne: a randomized investigator-blinded, controlled, noninferiority trial comparing fixed-dose adapalene/benzoyl peroxide plus doxycycline vs. oral isotretinoinBr J Dermatol. 2014;171(6):1508-1516. doi:10.1111/bjd.13191

  7. University of Wisconsin. Primary Lesions.

  8. Johns Hopkins Medicine. Acne.

  9. Cleveland Clinic. Cystic acne.

By Angela Palmer
Angela Palmer is a licensed esthetician specializing in acne treatment.