What is nodular acne?

Nodular acne is a severe form of acne typically found on the face, chest, and back. It is characterized by deep under-the-skin inflammatory nodules and cysts that are red and painful to touch, and do not typically respond well to standard acne medication.
Though anyone can get nodular acne, and it can occur at any age, it is most common during puberty. Leaving nodular acne untreated can result in pain, severe scarring, and even psychological symptoms such as depression, anxiety, and poor self-esteem.
When a pimple occurs under the skin, it is referred to as cystic acne or nodular acne. Though you may be wondering how to get rid of pimples under the skin by yourself, it is important to treat severe acne under the guidance of a dermatologist, and in a way that will minimize the risk of infection and damage to your skin.
Popping a pimple at home can backfire by worsening the condition and appearance of your skin rather than improving it. Some of the contents from the pimple can be inadvertently pushed deeper inside the skin and lead to increased inflammation, acne that is more noticeable, and possible infection.
Diagnosis for nodular acne
Doctors look at the type of lesions present on the skin to determine how to classify acne. Acne lesions fall on a spectrum from noninflammatory lesions, such as blackheads and whiteheads, to inflammatory lesions such as cysts and nodules. When acne is severe, and consists of mostly inflammatory lesions, a diagnosis of nodular or cystic acne might be given.
Treatments for nodular acne
Nodular acne is one of the most difficult forms of acne to treat, but there are a few common courses that will likely be recommended by a dermatologist. Nodular acne is incredibly persistent and when left untreated, can result in significant scarring, so it is important to seek treatment.
Medications
The first treatment plan that most doctors will try is a combination of antibiotics and topical medication. The antibiotic may help lessen redness and inflammation of the skin while the topical medication can soothe and rid the skin of harmful bacteria.
If this treatment plan does not work, as is often the case with severe nodular acne, oral isotretinoin may be prescribed.
Oral isotretinoin is typically prescribed short term, with directions to take it if acne flares up again. Isotretinoin is a potent retinoid medication with severe side effects and should only be taken under the care of a physician.
About 40% of patients achieve remission while on isotretinoin, and others do well when isotretinoin is combined in their treatment plan with oral antibiotics or topical steroids.
Procedures and surgery
To help get rid of acne under the skin, dermatologists often inject a corticosteroid. This method improves the healing time and has a reduced risk of scarring. This procedure is best used when treating one acne nodule or cyst and is not recommended for the treatment of multiple acne blemishes, as corticosteroid injections should be used sparingly.
A procedure called incision and drainage may be used to remove cysts or nodules. During this procedure, a sterile needle or blade will be used to drain the cyst or nodule.
Home care
Your dermatologist may recommend comfort measures that you can perform at home to reduce the pain and discomfort of nodular acne. They may also encourage basic skincare hygiene measures to keep your skin clean and healthy between flare-ups. Below are a few ways that you can care for your skin at home:
- Apply cold compresses to the skin to reduce inflammation and soothe painful areas
- Use your fingertips to clean your face with a gentle, non-abrasive, alcohol-free cleanser twice a day
- Rinse your face with warm water
- Limit time in the sun and avoid tanning beds
- If you have oily hair, wash it daily
- Avoid popping acne, and let your skin heal naturally

QUESTION
Acne is the result of an allergy. See AnswerPossible complications and side effects
When left untreated, nodular acne can result in severe scarring. Because nodular acne does not respond well to standard topical or oral acne medications, the medications that it does respond to come with a higher risk of side effects. If you are experiencing nodular acne that does not resolve itself on its own, contact a physician to figure out a treatment plan that works for you.
Health News
- Chinese Company May Help Ease U.S. Shortage of Cancer Drug
- Opdivo Could Boost Outcomes for People Battling Hodgkin Lymphoma
- More U.S. Kids, Teens Are Getting Weight-Loss Surgeries
- Could a Nitroglycerin Patch Ease Hot Flashes?
- One Form of Menopause Hormone Therapy Might Raise Blood Pressure
More Health News »
Health Solutions From Our Sponsors
American Academy of Dermatology Association: "How to Treat Different Types of Acne."
American Academy of Dermatology Association: "Pimple Popping: Why Only a Dermatologist Should Do It."
American Academy of Dermatology Association: "What Can Clear Severe Acne?"
American Family Physician Journal: "Diagnosis and Treatment of Acne."
Top How Do You Get Rid of a Pimple Under the Skin? Related Articles
How to Get Clear Skin: 15 Proven Tips for Fighting Acne
Acne is the most common skin problem that affects more than 80% of people at some point in their life. If not treated properly, it can lead to scars and dark marks on the skin which might take longer to go away.Acne
Acne is a localized skin inflammation as a result of the overactivity of oil glands at the base of hair follicles. This inflammation, depending on its location, can take the form of a superficial pustule (contains pus), a pimple, a deeper cyst, congested pores, whiteheads, or blackheads. Treatments vary depending on the severity of the acne.Acne Quiz
Acne is the most common skin disorder in the world. If you suffer from acne, you are not alone and many treatment options are available. Learn more about pimples, blackheads, and comedones with the Acne Quiz.Dealing with Adult Acne
Adult acne causes include hormones, medications, makeup, and other things. Adult acne is treated with medications, products, face washes, and home remedies. Use a skin care regimen provided by your dermatologist to treat adult acne.azelaic acid
Azelaic acid is commercially produced to treat skin conditions such as acne vulgaris, which causes pimples, bumps, pustules, cysts, and whiteheads or blackheads (comedones), and rosacea, a disorder that causes flushing and red bumps on the skin. Common side effects of azelaic acid include burning, tingling, stinging, pain, itching (pruritus), dryness, redness, tightness, scaling, peeling, irritation, skin rash, contact dermatitis, and acne vulgaris. Consult your doctor if pregnant or breastfeeding.How Do I Get Rid of Deep Pimples on My Back?
Learn what medical treatments can help ease your back acne symptoms and speed up your recovery.resorcinol/sulfur
Resorcinol/sulfur is a combination topical lotion used to treat acne vulgaris, a skin condition that causes pimples, bumps, pustules, cysts, and comedones (whiteheads and blackheads), usually in adolescents and young adults. Common side effects of resorcinol/sulfur include excessive skin peeling, skin irritation, skin inflammation, and skin redness (erythema). Excessive or prolonged topical use of the drug can cause blue-black discoloration of the skin. Consult your doctor if pregnant or breastfeeding.silver nitrate
Silver nitrate solution is used topically as an anti-infective agent to cauterize infected wound tissue, and remove warts and excess granulation tissue. Common side effects of silver nitrate include discoloration of skin, local irritation and burning on the application site, and methemoglobinemia. There are no well-controlled studies on silver nitrate use in pregnant women. Use if potential benefits to the mother outweigh possible risks to the fetus. There are no studies on use of silver nitrate in nursing mothers; avoid use.Acne and Food
How can you get rid of acne breakouts with nutrition? Does this food cause acne? Milk, chocolate, and seaweed are all considered by some to promote acne. Find healthy foods that promote acne treatment. What can diet changes do to improve acne care?Skin Problems: Rosacea, Acne, Shingles, Covid-19 Rashes
Learn to spot and treat skin conditions commonly found in adults such as acne, Covid-19 rashes, eczema, shingles, psoriasis, rosacea, hives, cold sores, razor bumps, athlete's foot, and more dermatology details.Skin Quiz
What's that all over you? Skin, of course! Test your knowledge of your most amazing organ with the Skin Quiz!Skin Health: How to Get Clear Skin
Acne, pimples, zits and blemishes often appear on the face, back, chest, neck, and shoulders where skin has the most amount of oil glands. Few of us are immune to breakouts, but treatments can minimize outbreaks. Follow these 15 tips for a clear complexion and skin.tretinoin (Retin-A, Retin-A Micro, Atralin, Avita)
Tretinoin (Retin-A, Retin-A Micro, Atralin, Avita) is a topical medication prescribed for the treatment of acne, wrinkles, and skin that has been damaged by excessive exposure to the sun. Side effects, drug interactions, warnings and precautions, and pregnancy efficacy should be reviewed prior to taking any medication.and precautions, and pregnancy efficacy should be reviewed prior to taking any medication.vitamin A
Vitamin A is a micronutrient used as a dietary supplement to compensate for natural deficiency and to treat dry eyes (xerophthalmia). When used topically as a retinoid (Retinol), it is used to treat acne. Side effects of vitamin A may include dry mucus, opacity of the cornea, inflammation of the membrane in the eye whites and inner surface of eyelids (conjunctivitis), facial dermatitis, lip inflammation (cheilitis), inflammatory lesions (granulomas) in acne, and others. Acute overdose of vitamin A can cause nausea, dizziness, fatigue, headaches, skin peeling, liver failure and coma that can lead to death. Never exceed the daily recommended dose of vitamin A, especially if pregnant.What Actually Gets Rid of Acne?
We all love surprises, but not all surprises are pleasant. One such surprise being acne or pimple that may appear like an uninvited guest on our face. Often, this may happen right before an important event, such as a function or a presentation. Acne is one of the commonest skin conditions affecting almost everyone at some point in their life.Why Am I Getting Pimples on My Scalp?
Getting pimples on the scalp is a common but irritating problem. Learn the reasons for pimples on the scalp, how to treat pimples on the scalp, and how to keep pimples on the scalp from coming back.Why Do I Get Pimples on My Butt?
Everyone can get pimples on their posterior. Learn what they are, what causes pimples on the butt, how doctors diagnose them, and how you can treat pimples on the butt. Learn how your lifestyle changes can make acne worse, including diet, exercise, and cosmetics.Why Do We Get Forehead Pimples?
Why do we get forehead pimples? Learn the signs of acne on the forehead, how to treat it, and how to prevent future breakouts. You can make pimples go away fast by using medications and home care. Medications for pimples include antibiotics, birth control pills, and topical products containing benzoyl peroxide, retinoids, or salicylic acid. Home care for pimples includes cleaning your skin, avoiding oil-based cosmetics, avoiding rubbing alcohol and toners, and shampooing oily hair. Learn what medical treatments can help ease your pimples symptoms and speed up your pimple recovery.Zilxi (minocycline)
Zilxi (minocycline) is a topical prescription medicine used on the skin to treat adults with pimples and bumps caused by a condition called rosacea. Serious side effects of Zilxi include harm to an unborn baby, permanent tooth discoloration, slow bone growth, diarrhea, liver problems, central nervous system effects, sensitivity to sunlight (photosensitivity), and others.