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Scars From Nodular Acne

By J.M. Andrews ; Updated July 18, 2017

Approximately 40 million to 50 million teenagers and adults suffer from pimples each year, making acne the most common skin condition in the United States, according to the American Academy of Dermatology, or AAD. Most cases won't be severe, and many will respond to over-the-counter treatments. But nodular acne, one of the most severe forms of the disease, often does cause scars. Although these scars can be difficult to treat, dermatologists have an array of treatment options for scars from nodular acne.

Nodular Acne Causes

Acne results from a combination of causes, according to Fluctuating hormones, common in teenagers and in women, overstimulate the sebaceous glands located beneath the skin. The sebaceous glands then produce too much oil, known as sebum, and that oil clogs pores, providing acne-causing bacteria with the ideal breeding ground. When the skin's secretions build up deep within hair follicles, painful nodules form. These nodules, which give nodular acne its name, feel like solid, large lumps under the skin.

Scar Formation

When severe nodular acne clears, the lesions likely will leave scars, according to the AAD. Depressed scars, which can be deep, appear most commonly. Depressed scars result when the nodule drains and heals but leaves scar tissue and a depression in the skin. Large nodules or abscesses can leave long depressions in the skin. Raised acne scars are less common, but also appear after nodular acne. These scars, called keloids, result when deep ulcers form under the nodules. Keloids look like growths or irregular bumps on the skin, and can extend well beyond the border of the original nodule.

Treatment Options

Nodular acne sufferers with severe depressed scars have several treatment options, according to the AAD. Acne scar surgery removes or raises the scar tissue, potentially replacing a very large scar with one that's smaller and less obvious. Ablative laser skin resurfacing literally blasts away the top layer of skin with a laser beam, causing new skin with shallower scars to grow. Some dermatologists also use dermabrasion and strong chemical peels, both of which also remove the top layer of skin, to treat depressed nodular acne scars.

More Treatment Options

Raised acne scars from nodular acne, which might be painful or itch, can be difficult to treat, according to the AAD. A series of corticosteroid injections often can flatten raised scars and potentially can make them less uncomfortable. Your dermatologist also may recommend surgery to remove your raised acne scars, especially if they fail to respond to injections. Laser treatments also can flatten some raised scars.


Treating scars from nodular acne will take time, the AAD warns. In addition, in cases of severe scarring, it's unlikely your skin will look the same as it did before you got acne. After your first consultation, your dermatologist likely will recommend a combination of several scar treatments to achieve the best possible results.

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