Have you developed a deep and hard pimple on your face that refuses to disappear? It can be nodular acne that usually forms under your skin, unlike other types of acne.
In this article, let’s understand what causes nodular acne and how you can get rid of it naturally. Let’s begin!
What Is Nodular Acne?
A nodular acne is a deep form of acne that starts developing under the dermis and appears as a hard and painful bump on the skin surface.
“A nodular acne  can be large as it involves infection and inflammation of more than one hair follicle on your skin,” says Dr. Zeel Gandhi, Chief Ayurvedic Doctor at Vedix.
What Does Nodular Acne Look Like?
An acne nodule appears as a small bump under your skin. It's usually larger compared to other forms of acne, painful to touch and becomes red if inflamed. It develops on the face, back, and chest.
How Is Nodular Acne Formed?
Like in any other acne type, nodular acne is formed in a skin pore that has overly active sebaceous glands. The sebum produced in excessive levels fills in the hair follicle and traps the dead skin cells and other debris, which forms a solid plug that is deep under the skin and clogs your skin pore. When acne-causing bacteria, Cutibacterium acnes , colonizes in such a deeply clogged skin pore, your body triggers an immune response that results in pain and inflammation. Thus, nodular acne is formed.
What Causes Nodular Acne?
According to Ayurveda, every skin problem has an underlying root cause of imbalanced dosha levels in the body. And, nodular acne is linked to highly aggravated Kapha and Vata doshas along with the slightly increased Pitta dosha in your body.
“While imbalanced Kapha and Pitta are responsible for excessive sebum production and inflammation, aggravated Vata is responsible for the overproduction of dead skin cells which combine with sebum and clog the skin pores. Also, the acne gets hardened due to excessive Vata dosha (increased dryness) in the body,” says Dr. Zeel.
Below are some of the triggering factors for dosha imbalances in your body, that may result in nodular acne:
- Fluctuations in the production of androgen hormones
- Imbalanced or wrongful diets
- Certain medications containing steroids, phenytoin, lithium, etc.
- Stressful lifestyle
- Improper sleep cycle
- Smoking and alcohol consumption
Studies have found that there is a significant association between stress and severe acne flares .
How To Identify Nodular Acne?
Signs and symptoms of nodular acne are:
- No formation of black or whitehead
- No formation of pus
- Typically, larger compared to other forms of acne
- A painful lesion with heaviness
“Face, neck, chest and back are the most common regions for the appearance of nodular acne,” adds Dr. Zeel.
Does Nodular Acne Go Away?
Yes. Nodular acne lesions can be controlled permanently with regular treatments. However, it may take a few months to get rid of it completely.
How To Get Rid Of Nodular Acne?
1. Ayurvedic Ways
A. Topical Herbal Treatments
Below are some of the powerful Ayurvedic herbal remedies that help in controlling nodular acne by bringing balance to all the three aggravated doshas, especially Vata and Kapha:
- Jatiphala: Mix 1 spoon of jatiphala or nutmeg powder, 1 spoon of raw honey, and 2 spoons of rosewater and prepare a smooth paste. Apply it on your nodular acne and wash it off after half an hour. Do it twice a week.
- Kushta: Prepare a thick paste by adding adequate water to a spoon of kusta powder. Apply it on your face and wash it off after half an hour. Do it once a week.
- Guduchi: Extract juice by crushing 5-8 fresh giloy leaves. Apply the juice on the affected area and rinse it off after half an hour. Do it once a week.
- Triphala: Use triphala powder as a face cleanser. However, ensure that the powder is blended smoothly to avoid any skin damage.
- Amalaki: Dab freshly made amla juice on your nodular acne using a cotton ball and wash it off after half an hour. Do it once a day.
- Haridra: Apply turmeric or haridra paste on the affected area and rinse it off after an hour. Do it twice a day.
B. Ayurveda Panchakarma
Panchakarma therapy in Ayurveda is known to be one of the most effective ways to correct the deep-rooted dosha imbalances in your body, which in turn helps in controlling nodular acne. An ayurvedic therapist will perform the panchakarma which involves the following 5 procedures using the most suitable Ayurvedic medications by evaluating your dosha imbalances:
- Vamana (Emesis)
- Virechana (Purgation)
- Basti (enema)
- Nasya (nasal drop administration)
- Rakta moksha (blood detoxification)
C. Diet & Lifestyle
- Ensure you eat a healthy and balanced diet that includes a lot of raw vegetables and fresh fruits, whole grain cereals, sprouted seeds, etc. that are rich in omega-3 fatty acids, antioxidants, and dietary fibers.
- Pastured eggs, flax seeds, mustard seeds, navy beans, spinach, soybeans, fish, and nuts are some of the best foods you can have when you have nodular acne.
- Avoid harmful food combinations such as milk with citrus fruits, cold drinks with cheese, etc.
- Stay away from foods that have a high glycemic index (GI) such as excessive sweets, bread, processed foods, artificial sweeteners, fried and junk foods, etc. 
- Perform regular exercises to keep yourself stress-free. Practicing meditation and yoga have many benefits in controlling stress levels, in turn, reducing acne
- Devote a fixed time for eating and sleeping. You must get a sound sleep of at least 6 hours.
- Limit your exposure to mobile screens and other electronic gadgets. Instead, you can prefer spending more time with your family and loved ones or indulge in activities like gardening or playing.
2. Essential Oils
Add a few drops of any of the following essential oils in your face cleanser or moisturizer to control nodular acne:
- Lemon oil
- Tea-tree oil
- Oregano oil
- Frankincense oil
- Rosemary oil
“You can dilute it by adding 5-10 drops of any of these essential oils to a cup of any carrier oil such as jojoba or argan oil and use it to massage your face on alternate days. However, always do a patch test before using any essential oil for your skin,” says Dr. Zeel.
3. Home Remedies
- Add a spoon of raw honey to a spoon of yogurt and apply the mixture on your nodular acne. Leave it for half an hour and then wash it off.
- Combine each spoon of raw honey, lemon juice, and egg white. Mix the ingredients well and apply on your nodular acne. Rinse it off after half an hour.
- Apply green tea added with honey on your nodular acne and wash it off after 15-20 minutes.
- Wash your face with baking soda and water solution. After 15 minutes, give your face a final rinse with normal water. Do it every day.
- Apply diluted apple cider vinegar on the nodular acne using a cotton ball. Rinse it off after half an hour.
- Massage the skin above the nodular acne with olive oil regularly.
Vedix Tip: Avoid scrubbing or over-exfoliating your skin when you already have developed nodular acne. It may cause abrasion and scarring on your skin.
4. Other Medical Treatments
A. Oral Medications
- Birth control pills for women
- Spironolactone (anti-androgen) 
- Benzoyl peroxide
- Salicylic acid
C. Surgical Treatments
- Chemical peels
- Injecting steroids to control inflammation
- Laser therapy
How To Prevent Nodular Acne?
Below are some of the common ways to prevent the formation of nodular acne on your face:
1. Keep your face clean by washing it at least twice a day with lukewarm water and a gentle herbal cleanser.
2. Stick to a dosha-balancing skincare regimen that is best for your skin type. Avoid using oily or greasy products for your skin.
3. Always clean your face as well as body after any type of physical exertion that causes sweat.
4. Do not sleep with makeup on your face. Always remove it before you hit the bed.
5. Maintain personal hygiene by keeping your mobile screens, makeup accessories or anything that comes in contact with your skin always clean.
6. Restrain yourself from touching your face constantly.
7. Always clean your hands before applying makeup.
8. Apply sunscreen religiously every day while you are stepping out in the sun.
9. Never use acne concealers and avoid picking your pimples.
10. Quit smoking and alcohol consumption.
Is Nodular Acne The Same As Cystic Acne?
No. Though both are severe forms of acne, nodular and cystic acne are different. While nodular acne forms as an inflamed lesion that appears as a closed bump (without head) on the surface of your skin, cystic acne forms as a pus-filled red bump which usually develops a white head. Also, nodular acne is much harder and painful than cystic acne.
“As per Ayurveda, the high rise in Kapha dosha accompanied by a moderate increase in Pitta dosha may result in cystic acne. On the other hand, nodular acne is caused when there is a high elevation of Vata and Kapha doshas along with moderately imbalanced Pitta dosha,” says Dr. Zeel.
Please seek your doctor’s advice before following any of the treatments mentioned in the article to cure nodular acne.
The Last Word
As nodular acne is deeply rooted in the skin, it is tough to treat it when compared to other acne types. But, treating it with Ayurvedic solutions can do wonders. These treatments involve use of natural ingredients and do not have any unwanted side effects. However, if the acne does not subside even after 2-3 months of herbal treatments, then it's recommended to visit your doctor immediately for further evaluation of your condition.
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