During acne flare-ups, you may sometimes notice that you develop large, painful bumps under the skin on your face. These bumps are called nodules and are a particularly severe form of acne. According to the American Academy of Dermatology, nodular acne, like regular acne, is likely due to the overproduction of oil that becomes trapped in the facial pores, stimulating bacterial growth that causes inflammation. In nodular acne, the blockage of the pore occurs very deeply within the skin, causing a particularly strong inflammatory reaction. Nodules can be extremely difficult to get rid of without professional help.
Speak to a dermatologist. Aggressive, expert treatment is needed to get rid of nodular acne. A dermatologist can prescribe oral antibiotics to kill acne-causing bacteria and reduce inflammation. If after a period of time this treatment is not effective, the doctor may prescribe isotretinoin, more commonly known by the brand name Accutane. MayoClinic.com notes that isotretinoin is highly effective but is only used in the most severe cases of acne, as it can produce serious side effects.
Take your medicine regularly. For best and fastest results, follow your dermatologist’s instructions carefully. Never miss a treatment and wait 4 to 8 weeks to see results. If you are taking isotretinoin you must also see your dermatologist regularly as you will need to be closely monitored for physical and psychological effects.
Handle your skin gently. The American Academy of Dermatology recommends washing your face with a mild cleanser once or twice a day to get rid of excess oil. Avoid the temptation to wash your face more often or to scrub away the acne, as this may exacerbate the problem. It is essential that you never squeeze or pick at the nodule, as it greatly heightens the risk of permanent scarring.
Pregnant women or women trying to conceive must not take isotretinoin as it is highly likely to cause severe birth defects.
Other side effects of isotretinoin include dry eyes, lips, nose and mouth, sun sensitivity, poor night vision and increased levels of triglycerides and cholesterol in the blood. It has also been linked to depression and suicide, though an actual causal relationship has not been proven.