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What is Nodulocystic Acne & How is it Treated?

The mildest form of acne is the non-inflammatory type. The moderate kind is the inflammatory acne. The severe most among the common kind of acne is the cystic acne or the nodulocystic acne. Nodulocystic acne grows when the sebum is produced in large amount and instead of coming out of the pores; the sebum gets collected within the pores. The dead cells also get trap there too. The P. acne bacteria start to thrive there and lead to inflammation. The nodulocystic acne cysts are then formed by the rupture of the plug.

A very severe and rare kind of acne which grows by connecting the abscesses is known as Acne conglobata. Another rare kind of acne rising from the antibiotics killing the milder form of acne is called the gram-negative folliculitis. The third rare and severe kind of acne is the Pyoderma faciale. It mostly affects women and has a disfiguring form. Acne fulminans is the kind of acne which grows form the prior treatments taken by the patients. This kind is very severe as it grows affecting the immune system.

What is Nodulocystic Acne?

What is Nodulocystic Acne?

Nodulocystic acne is the common but severe kind of acne which usually grows on the back or on the face. The easy identification is done by noticing nodules which are not swelled up and scars on the skins. Nodulocystic acne attacks happen more on males. Nodulocystic acne which has both tough lumps otherwise known as nodules and cavities filled with fluids and lined with epithelium or cysts. Sometimes the lesions are fluctuant which also indicate pseudocysts. Such acne can not only trouble you physiologically but also it can bring down your morale. Nodulocystic acne is common among the youth since it is during this time the androgen levels increase leading to more amount of sebum production and skin cell generation. People often feel insecure and ashamed to come out in public.

The most disturbing kind of nodulocystic acne is acne conglobate. Such acne grows by interconnecting channels like sinuses and abscesses under the skin. Acne conglobata forms thin and thick scars on the skin and the acne is filled with smelly pus. If you are growing boil-like lesions in your armpits or under your breasts then it is a follicular occlusion better known as hidradenitis suppurativa. Such a symptom or condition further gives rise to acne conglobata. This kind of nodulocystic acne can also grow due the PAPA syndrome (a kind of genetic disorder.)

Signs to Identify Nodulocystic Acne

Although the signs are same like any pimple, nodulocystic acne is more easily noticeable because:

  • Deep scarring on the skin- smalls, deep pits and larger black pits. Also hypertrophic scarring (red, raised scars) and swallow depressions.
  • Cysts and nodules on the skin are symptoms of nodulocystic acne.
  • Growth or papules and pustules in the affected area.
  • Inflammation, pain and reddening.

How Can You Treat Nodulocystic Acne?

Nodulocystic acne is not the kind of acne that cannot be treated but the treatment is long and challenging. Topical treatment may not fix the nodulocystic acne and therefore several combinations of pills are required. The best medicine for treating nodulocystic acne is with Isotretinoin. The treatment continues up to five months usually. Sometimes follow up treatments to make the effect of Isotretinoin permanent since this medicine prevents scarring. The other kinds of medications that a dermatologist may prescribe include oral antibiotics, systemic steroids, hormone therapy (for women) and intralesional steroids.

If you wish to adopt home remedies along with the treatment for nodulocystic acne then you must remember:

  • Not to squeeze the pimple.
  • Wash your face only two times a day with mild medicated soap and lukewarm water.
  • Not to scrub harshly while washing your face.
  • Avoiding all kinds of make-up especially heavy make-up.
  • Reduce stress.


  1. Mayo Clinic. “Acne: Overview.” https://www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047
  2. Healthline. “Types of Acne: Causes and Treatments.” https://www.healthline.com/health/beauty-skin-care/types-of-acne
  3. Medical News Today. “What you need to know about acne.” https://www.medicalnewstoday.com/articles/107146
  4. WebMD. “Acne: Understanding and Treating Acne.” https://www.webmd.com/skin-problems-and-treatments/acne/understanding-acne-basics

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 22, 2023

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