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Topical Treatment for Acne Nodules

By Kristin Leigh ; Updated July 18, 2017

The severity of acne varies from person to person. Most cases of acne consist of non-inflammatory blackheads and whiteheads as well as smaller inflammatory pimples. But some people suffer from more severe blemishes, called nodules. While these blemishes may not be as serious as acne cysts, having multiple acne nodules can become painful. If you suffer from acne nodules, various topical treatments may lessen pain and inflammation.


Acne nodules differ from smaller pimples in both depth and size. Acne nodules occur when the wall of a clogged follicle bursts deep in the skin. The bacteria and debris from inside the pore then spills out into the dermis, or the middle layer of skin. The infection then invades surrounding follicles. This process results in a large, red bump that may be tender to the touch. Unlike cysts, nodules are firm and can be felt deep in the skin.

Benzoyl Peroxide

Benzoyl peroxide is an ingredient in many over-the-counter acne treatments. Products containing benzoyl peroxide may come in the form of cleansers, gels or lotions. Benzoyl peroxide helps reduce inflammatory breakouts by fighting bacteria as well as reducing excess oil production. According to the American Academy of Dermatology’s AcneNet, the most common side effect of benzoyl peroxide treatment is excessive drying of the skin. Benzoyl peroxide is primarily indicated for mild acne, but may be effective at treating or preventing an occasional acne nodule.

Topical Antimicrobials

For chronic acne nodules or multiple nodules, prescription treatment may be warranted. Topical antimicrobials focus primarily on fighting the Propionibacterium acnes bacteria. These bacteria live on the skin and contribute to inflammatory acne breakouts. Topical antimicrobials may be prescribed along with treatments that focus on factors other than bacteria. Clindamycin, erythromycin and azelaic acid are examples of antimicrobials prescribed for acne. Possible side effects include skin dryness and irritation.

Topical Retinoids

For moderately severe cases of acne nodules, topical retinoids may be prescribed. According to, tretinoin, a topical retinoid, effectively treats acne partly by keeping the pores clear. Topical retinoids also lighten the skin, which may reduce discoloration or red spots caused by acne breakouts. They also replace old skin with new skin and slow down the sloughing of dead skin cells, which prevents a buildup of dead skin cells from clogging pores. Possible side effects include increased sun sensitivity and severe dryness, redness, stinging or peeling of the skin.


Acne nodules are a severe form of pimples and should be evaluated by a dermatologist. People who suffer from mild acne may get the occasional acne nodule that can be treated with over-the-counter products. However, chronic breakouts of multiple acne nodules and cysts warrant dermatological care. Scarring can result from delaying treatment. Sufferers should never attempt to squeeze or pop acne nodules because they occur deep in the skin. Topical treatments may not be sufficient to treat more severe forms of acne, which may require oral medications for successful treatment.

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