Vaishnavi, from your description, you’re dealing with recurrent deep nodular acne (a form of inflammatory acne)
Causes Hormonal fluctuations (androgen excess, PCOS, menstrual irregularities) increase oil production.
Excess sebum & clogged pores bacteria thrive deep inside skin.
Increase diary or sugar intake
Internal Treatment Since this is long-standing (2–3 years), you should get:
Hormonal profile: Testosterone, LH, FSH, Prolactin, DHEAS.
PCOS check: Pelvic ultrasound if periods are irregular.
Vitamin & mineral tests: Vitamin D, B12, Ferritin
Daily Skin Routine (Acne-Safe) Morning:
Salicylic acid face wash (2%).
Niacinamide serum (5%) — oil control + healing.
Oil-free moisturiser.
Sunscreen SPF 50.
Night: Gentle cleanser.
Adapalene gel (0.1%) or Retinoid — thin layer on acne-prone areas (start alternate nights).
Oil-free moisturiser.
Weekly: Once a week — clay mask (oil absorption).
Twice a month — chemical peel at dermatologist (salicylic/glycolic) for faster healing.
Diet Adjustments Avoid: Sugary drinks, milk & milk-based sweets, fried foods.
Eat more:
Protein paneer, tofu, dals, chickpeas. Omega-3 flaxseeds, chia, walnuts. Antioxidants amla, berries, carrots, spinach. Drink 2–2.5 L water/day.
Lifestyle Keep pillowcases & phone screen clean.
Don’t press or pop deep pimples — it causes scars & pigmentation.
Manage stress — meditation, yoga.
Medicine Tab Azithromycin 500 mg in afternoon 1 hour after lunch for 5 days Consult endocrinologist in case your hormone are imbalanced
Your recurring deep-seated acne nodules with pus and discoloration suggest nodulocystic acne, which can cause long-term skin damage if untreated. This type often needs prescription oral and topical medicines rather than just over-the-counter care. Please consult a dermatologist for a thorough evaluation and treatment plan, which may include oral antibiotics, retinoids, or hormonal therapy.
Internal acne, such as nodules and cysts, typically arise from deeper within the skin layer and can be particularly stubborn to treat. The fact that this has been a persistent issue for 2-3 years suggests it could be more than just usual acne and might require a more targeted approach. Given your skin type as normal to oily, hormone fluctuations could be a contributing factor, especially around your age. First, consider over-the-counter topical treatments containing benzoyl peroxide or salicylic acid; they can help reduce inflammation and prevent new breakouts. However, since these nodules are recurring and may lead to scarring, a prescription treatment might be more appropriate. A visit to a dermatologist would allow for a tailored treatment plan, which might include topical retinoids or even oral medications like antibiotics or isotretinoin if deemed necessary by a specialist. Avoid picking or squeezing the nodules to minimize risk of infection or scarring. Implementing a consistent skincare regimen including a gentle cleanser and oil-free moisturizer, could help manage oil production and keep the skin’s barrier intact. Make sure to also focus on lifestyle factors; a balanced diet, regular hydration, and stress management can play a significant role in overall skin health. Be mindful of red-flag symptoms like excessive pain, rapid swelling or any signs of a broader infection (increased redness or heat), where immediate medical attention would be warranted. A consistent follow-up with a healthcare provider reflects best practice, as they can frequently adjust your treatment based on your skin’s response over time. This multifaceted approach will likely be the most effective avenue for long-term resolution of your acne concerns.
