Last updated: Aug 14, 2025
What Is Nodular Acne?
Nodular acne is a severe form of inflammatory acne characterised by large, deep, and painful
lesions that form under the skin and may persist for weeks or months. Unlike typical
pimples, nodules do not develop a visible whitehead and often feel firm to the touch.
Nodular acne can be physically painful and emotionally distressing. The deep, inflamed lumps often
last for weeks and may leave behind scars. When they appear on visible areas like the face, they can
affect your confidence and how you feel about your appearance, especially when
breakouts are frequent or hard to manage.
Prompt and appropriate treatment is essential to minimise inflammation, reduce the risk of scarring,
and protect your skin’s long-term condition. At Medical Aesthetics, we offer treatments for nodular
acne and post-acne scarring to support clearer, healthier skin.
What Causes Nodular Acne?
Nodular acne typically develops when hair follicles become clogged with excess oil
and dead skin cells, creating an environment where Cutibacterium
acnes (a common skin bacterium) can multiply.
This bacterial activity triggers a strong inflammatory response deep within the skin,
leading to painful nodules that may persist for weeks.
Common underlying causes within the body include:
- Hormonal changes – Increased androgen levels can overstimulate oil glands, leading to more severe breakouts.
- Excess oil production – Overactive sebaceous glands can clog pores and contribute to deeper inflammation.
- Bacterial overgrowth – When C. acnes bacteria thrive in blocked follicles, they can trigger the body’s inflammatory response.
- Genetic predisposition – A family history of severe acne may raise your likelihood of developing nodular acne.
External factors that can worsen or trigger nodular acne include:
- Use of comedogenic products, including certain makeup or skincare items that clog pores.
- High humidity, which increases skin oiliness.
- Prolonged friction or pressure on the skin can irritate acne-prone areas and contribute to inflammation.
These factors often overlap, contributing to the severity and persistence of nodular acne.
What Are the Symptoms of Nodular Acne?
Nodular acne is characterised by deep, inflamed lumps beneath the skin that are typically
skin-coloured or red, painful to the touch, and do not form a whitehead. These nodules
most commonly develop on the face, chest, back, and shoulders.
They often persist for several weeks or longer. In some cases, multiple nodules can develop in close
proximity, leading to more widespread inflammation, increased tenderness, and a greater risk of
permanent skin damage.
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Nodular vs Cystic Acne
Nodular and cystic acne are both severe forms of inflammatory acne that develop deep beneath the skin, but they differ in texture, content, and how they present.
| Nodular Acne | Cystic Acne |
|---|---|
| Forms as firm, painful lumps under the skin. | Appears as soft, swollen lumps filled with pus. |
| Lesions feel solid and may persist for weeks or longer. | Cysts may rupture, worsening inflammation and increasing the risk of scarring. |
| Does not contain pus. | Contains pus and is more tender than nodules. |
| Often leads to scarring if untreated. | Also has a high risk of scarring, especially if lesions rupture. |
In some cases, both types occur together in nodulocystic acne, which is considered one of the most severe and persistent acne forms. Because of their depth and severity, both nodules and cysts are more likely to result in permanent skin damage without appropriate medical care.
Nodular Acne Treatment Options
Treatment for nodular acne often involves prescription medications and professional dermatological procedures. Over-the-counter treatments generally offer limited improvement for deep, inflamed lesions.
| Treatment | Description | Commonly Used For |
|---|---|---|
| Oral Antibiotics | Prescription medications that help control C. acnes bacterial overgrowth and reduce inflammation in the skin. | Initial treatment for moderate to severe inflammatory or nodular acne. |
| Topical Retinoids | Vitamin A–derived creams or gels that help prevent clogged pores and promote skin turnover. They also reduce inflammation over time. | Often prescribed with oral antibiotics for moderate nodular acne or as maintenance therapy. |
| Hormonal Therapy | Medications such as oral contraceptives and anti-androgens like spironolactone, which reduce androgen activity to help lower sebum production and minimise breakouts. | Women with hormonally influenced or cyclical nodular acne. |
| Intralesional Corticosteroid Injections | Involves injecting corticosteroids directly into nodules to quickly reduce inflammation, swelling, and pain. | Individual, painful or persistent nodules. Helps prevent scarring if treated early. |
| Oral Isotretinoin | A systemic retinoid that reduces oil production, normalises skin cell shedding, and lowers inflammation and bacterial levels. Requires regular monitoring. | Severe, treatment-resistant, or scarring nodular and nodulocystic acne. |
Each treatment is recommended based on the individual’s acne severity, skin type, medical history, and response to past therapies. Long-term management often requires a combination approach under medical supervision.
Are There Any Procedures That Can Support Treatment?
Professional skin procedures can complement medical therapy for nodular acne by helping reduce
active inflammation, prevent scarring, and support long-term skin recovery. These are typically used
alongside prescription treatments and should be performed by qualified professionals.
Common options include:
- Chemical peels – Use exfoliating solutions, such as salicylic or glycolic acid, to help unclog pores, reduce post-acne pigmentation, and improve skin texture over time.
- Laser therapy – Medical-grade laser treatments can help target inflammation, reduce oil production, and minimise acne-related scarring.
Can Nodular Acne Cause Scarring?
Nodular acne can result in permanent scarring, particularly when left untreated or if lesions are picked, squeezed, or otherwise disturbed. Types of acne scars include:
- Atrophic scars – Indented marks caused by loss of collagen during healing. These may appear as ice-pick, boxcar, or rolling scars.
- Hypertrophic or keloid scars – Raised, firm scars that can form when excess collagen is produced in response to prolonged inflammation.
In addition to scarring, nodular acne may also lead to post-inflammatory hyperpigmentation (PIH), especially in individuals with darker skin tones.
For those with existing scars, procedures such as laser resurfacing, or subcision may be recommended, depending on the type and severity of the scarring.
Nodular Acne Treatment: Before and After Photos
Owing to the regulations of The Ministry of Health (MOH), we are unable to publish before and after photos on our website. However, you may view these photos during your consultation with our doctor to understand more about the treatment you seek.
Why Choose Dr Robert Ong's Nodular Acne Treatment in Singapore?
The Medical Aesthetics Track Record
Patients Consulted Since 2002
Years of Experience
Google Reviews
Experienced & Friendly Doctor
Dr Robert Ong listens attentively to your concerns and patiently discusses with you the appropriate treatment options, based on over 20 years of medical and aesthetics experience.
Affordable Treatments
We are priced competitively and affordably. We also have a variety of treatment options depending on your budget and requirements.
Safe & Effective Results
Our treatment options are safe, effective and promotes natural healing for your skin. We strive to keep your experience a comfortable one and will minimize any pain or discomfort, if any.
Nodular Acne Treatment Cost
At Medical Aesthetics, we offer treatment for nodular acne, other acne types, and acne scars. Pricing varies based on the treatment provided.
| Treatment | Price* |
|---|---|
| Consultation | From $38.15 to $70.85 |
| Oral Antibiotics | From $2.40 / tablet |
| Retinoid | From $21.80 |
| Antibiotic Gel | From $38.15 |
| Cortisone Acne Injection | From $109 |
| Chemical Peel | From $114.45 |
| Fractional CO₂ Laser | From $436 |
| Laser Soft Peel | From $436 |
*Prices are NETT and inclusive of GST.
All patients are required to undergo a consultation with our doctor to assess his or her
suitability for the relevant treatment(s).
How to Prevent Nodular Acne?
While not all cases of nodular acne can be prevented, adopting a consistent skincare routine and addressing known triggers may help reduce the frequency and severity of breakouts. Prevention tips include:
- Use non-comedogenic skincare and cosmetic products.
- Keep your skin clean, particularly after sweating.
- Avoid touching or picking at acne lesions.
- Avoid excessive scrubbing or harsh cleansers that may irritate the skin.
- Manage stress, which may influence hormone levels.
Where Can I Find Nodular Acne Treatment in Singapore?
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