Nodular Acne: What It Is, What Causes It + The Do's & Don'ts Of Care

No pimples are welcome. But when they're large, painful, and red, they're really annoying. Nodular acne is unique and isn't treated like your typical white- or blackhead. And if we're being honest, nodular acne can become a monster to deal with if you don't act quickly. That's why detecting nodular acne in its early stages can help keep unwanted breakouts at bay. We tapped dermatologists to get the scoop on nodular acne, what it is, what causes it, and how to treat it so you can get your breakouts under control, stat. Keep reading to learn more.  

Cosmetic and general dermatologist at Marmur Medical Rachel Maiman, M.D., says nodular acne affects deeper layers of the skin than the average breakout and has a higher risk of scarring coupled with a tendency to persist for weeks to months. Maiman says this type of acne, "often feels like firm knots under the skin and can be found on the face and body." 

Engelman adds that nodular acne is firmer than cystic acne and is also more widespread than typical pimples. But if you're experiencing a breakout that seems to be under the skin, red, inflamed, and/or painful, you'll want to book an appointment with your local dermatologist for treatment. 

But when it comes to discerning why some people are more likely to develop nodular acne over others, Maiman says it's still a mystery. "There does appear to be a genetic component, meaning that, if your parents or sibling had nodular acne, you're more likely to get it, too." 

Before we dive into the do's of treating nodular acne, let's start with the don'ts. 

This rule is pretty universal for all forms of acne, but it's especially true for the nodular kind. "There is no pimple head to pop," warns Engelman. "So, trying to squeeze the bump will only cause pain and may even exacerbate the acne."

Maiman says over-the-counter acne treatments simply aren't effective against nodular acne, no matter how consistently you apply it. So, save that spot treatment for your next whitehead instead.

Engelman says steer clear of skin care products that add excess oils to your skin. "Look for products that are labeled noncomedogenic, which means it won't clog your pores." Now is not the time to use that handy-dandy coconut you used to lather from head to toe.

"If nodular acne is in consideration, you should see a dermatologist as soon as possible in order to reduce the chance of scarring," Maiman suggests. "Your dermatologist will know which medications to prescribe or recommend to treat and prevent any additional lesions from forming. This is usually prescription topicals."

Engelman says in-office peels can help to remove excessive dead skin cells and trigger cell turnover, which makes you less prone to nodular acne. If you're prone to acne or have a family history of nodular acne, consider scheduling a regular peel with your dermatologist or esthetician to help keep breakouts at bay. 

Nodular acne can leave unwanted scars. "If you have acne scarring, start incorporating hydroxyl acids and brightening ingredients like vitamin C, hydroquinone, and hydroquinone's plant-based alternative, alpha arbutin, into your routine." Hydroxy acids help remove dead skin cells and promote cell turnover, while brightening ingredients like vitamin C help to fade dark spots over time. 

If you've got under-the-skin acne forming that is firm, red, and painful to the touch, you may be dealing with nodular acne. And while it can be quite inconvenient, visiting your local dermatologist as soon as possible is the best way to get this type of acne under control.