Nodular acne -what treatment?

[JacobReesMogadishu]

I think this is what I have.

I now have 5 hard flesh coloured lumps in a line on one cheek. First one appeared years ago. They all seem to have a thick wiry hair in the centre which struggles to get through the lump and makes the lump inflamed and sore. Then the hair gets long enough for me to tweeze, it breaks the skin as it comes out, I have a scab. It heals and then a few weeks later another hair is coming through. Continuous cycle.

Are there any acid type stuff which might break the lumps down?

Or Do I need to see a dermatologist and if so how do I find one (I’ve googled and just found one in the local private hospital which seems overkill As it’ll be £200 just for a consultation ), how many treatments would I need?

Anyone?

Although it's typically thought of as a male hormone, ladies have testosterone too, just in lower levels than men. Androgens stimulate the sebaceous glands, making them produce more skin oil or sebum. This excess sebum clogs the pores, and also makes good food for acne-causing bacteria. Androgens cause spots, you need anti androgens to get rid of them: Dianette pill or Vitex or D.I.M. plus Omega 3. My skin was clear whilst on Dianette, retinol moisturiser made me break out so trying Vitex and NIACINAMIDE moisturiser which is supposed to be anti aging and pore refining, just ordered omega 3 too.

Have you tried going to the GP? I know is not an ideal time at the moment. Acne that is that deep, is unlikely to respond satisfactorily to a topical but I’m not an expert. I saw a dermatologist for persistent acne via the NHS and had roaccutane xx

Not tried the gp as it is literally only 5 spots/lumps and I wasn’t sure if it was bad enough to warrant a GP visit. I assumed they only treated acne on the nhs if your face was covered in it?

I certainly wouldn’t go to gp in current state of the world so could try niacinimide while waiting and maybe go after. Problem is inbetween flare ups it doesn’t look to bad. So if I made an appt by the time I saw the gp it would have gone down again. Though I have got some photos.

My acne wasn’t all over my face, usually just my chin, but big, painful lumps. And much like you, in between times it was fine. Typically, when I visited the dermatologist it was pretty ok but the derm was unconcerned with that; I think they’re mire than used to descriptions of fluctuating acne. However, I also took photographs.

Boots has an online acne clinic where you can get prescription topical medications. It’s more expensive than the standard prescription cost, but I think it’s worth it as ime over the counter treatments are pretty ineffective for deep acne and I’ve spent a small fortune over the years xx

I think I probably need to see someone as I’m unsure if it’s acne, a cyst or an inflamed hair follicle. I think it’s nodular acne but not 100%.

Acneside worked for my daughter ( you can get it online via Superdrug) and she also got antibiotics from the doctor for a while too

I just looked at the boots online clinic and it’s recommended me 4 different things to choose from. But really not sure if any of them are right, they say they treat whiteheads, blackheads, pustules.....I don’t feel I have any of those.

The Epiduo is probably best for you- it’s Adapalene (retinoid- this regulates cell turn over and stops pores getting clogged) and benzoyl peroxide (this kills bacteria and thus the inflammation). I don’t think differin on its own would be enough for you- that’s mainly for milder acne xx

Thanks. I do currently use a retinol serum thing...haven’t seen a difference but guess the prescription stuff might be stronger.

Would an acid exfoliator help? I’ve not got experience with what you’re describing, but potentially building up to a strong acid to exfoliate may help.

I’ve been using retinol and glycolic acid for a while now with no result.

I’ve ordered some of the prescription Epiduo now so hopefully that’s a bit stronger.

Do go to your GP to get advice and treatment. I had terrible Roseacea in 2019. This is a type of acne. It is treated with Lymecycline (an antibiotic) and has cleared up totally. I’m so pleased, no more painful pustules. I have to stay in the antibiotics though, but this is quite usual. I’m 47 years old.

It doesn't sound like acne to me. Not if you've had them for years. It sounds more like sebaceous cysts. The only way of getting rid of those is by surgical removal.

Could be cysts. Because it is odd they’ve been in exactly the same place for years. Would a good beautician remove them or does it need to be a dermatologist?

I just googled and there’s a few dermatology clinics nearby which do it. Cheapest I can find is £395 per cyst. I’ve got 4 or 5! But they’re tiny and close together....not sure if they’d couNt them as one! 😆

I had similar with white, tough chin hairs. Delightful I know. Have you tried not plucking the hairs? I think I’d managed to get into a cycle of inflamed follicles, hard lumps on the skin, digging in to pluck the hair as soon as possible, not getting the hair out smoothly and causing more damage to the follicle and making it more inflamed. It took 2-3 months but it eventually calmed down and I read up on the most effective way to pluck hairs and started plucking less frequently and more carefully than before.

This is what I did with my chin hairs. Stop plucking. Once the hair is through the skin and gets longer, clean the skin and trim the hairs with clean nail scissors but allow them to stay long enough stick out, free of the skin. Let everything calm down. After a few weeks see how the lumps are. If it gets better, go back to basics if you want to start plucking again - clean the skin and the tweezers and check an online tutorial so you’re getting the whole hair and root out as smoothly as possible.

Yes, I’m,plucking and I do wonder if I’m making things worse. Because as soon as they’ve broken the skin I’m digging about with tweezers to get them,out. I can’t bare them being there so have no patience to wait. Sometimes because the hairs seem unable to break the tough, scarred skin I’m digging for them before they’ve broken the surface.

I could try and leave them and see how that goes. And maybe increase using my Lumea on them. I feel if I could kill the hair follicle off things would improve.

I don’t think laser works well on white hairs. There may be a way to zap the follicle and fix it for good but I decided that although I’m hyper aware of the feel of the hairs being there, the inflamed lumps were much more obvious to other people than the hairs are. Let me know if you find a permanent fix for it.

Will do. Mine are black, wiry hairs so am hoping the Lumea May zap them eventually.

@MrsChanningTatum Lymecycline is what my daughter is taking , improved her skin massively along with her confidence at 14years old , the last doctor we saw said she'd been on it long enough (6 months) and this would be her last prescription and for her to take a break .. when she's lapsed taking it before as she was convinced she was 'cured' her skin got worse again .. feel we're going to have a fight on our hands to get a repeat in a fortnight

You would prob do better to swap your glycolic to salicylic. Salicylic dissolves in oil and so is better for acne while glycolic is better for dry skin.

Paulas Choice BHA is top of the range.

When you remove the hair and it breaks the skin, does the pus drain and the bump disappear temporarily?

Definitely try a salicylic cleanser, I'm using CosRx cleanser and also the moisturiser that both have it in and my skin is miles better, my cystic lumps come through/clear much faster which is part of the problem.

Please see a GP

Some of them are doing video appointments - you may well be able to see someone. Phone your surgery and ask.

I suffered for quite a while because I thought my skin was not bad enough to "qualify" and they would think I was vain. Eventually showed up and she said "oh yes that is quite severe"

A sho